Trucut biopsy of the prostate: an unusual complication

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Minor hematochezia after transrectal ultrasound and prostate needle biopsy is well reported. We present a case report of a 64-yr-old man on aspirin and with poorly controlled hypertension who developed severe hematochezia requiring blood transfusion. The bleeding was stopped with digital compression. The literature on hemorrhagic complications after prostate needle biopsy is reviewed.

Seminoma metastatic to the prostate resulting in a rectovesical fistula

We report an unusual presentation of metastatic seminoma within the prostate gland. Histological diagnosis was obtained using trans-rectal ultrasound guided prostatic biopsy. The patient developed a rectovesical fistula after ten weeks of chemotherapy, which healed following a complete radiological response to treatment

Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program

OBJECTIVES

Screening for prostate cancer to reduce the mortality and morbidity from this disease has become an important issue in recent years. Of all procedures used to diagnose prostate cancer, biopsy of the prostate is the cause of most complications. To evaluate the safety of the screening procedure, we have studied the complications and risk factors for complications within the screened population of the European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam section.

METHODS

Between June 1994 and July 1996, 1687 transrectal ultrasound-guided systematic sextant biopsies were performed after screening 6198 men through prostate-specific antigen level, digital rectal examination, and transrectal ultrasonography.

RESULTS

From these 1687 biopsies, 302 cases of prostate cancer were diagnosed. Mild complications such as hematuria and hematospermia were reported frequently with rates of 23.6% and 45.3%, respectively. More severe complications were far less frequently seen. Fever, usually of low grade, was seen after 4.2% of biopsies. Seven men (0.4%) were admitted to a hospital after biopsy. Risk factors for complications could not be identified.

CONCLUSIONS

Review of the literature concerning transrectal biopsies of the prostate shows that the complication rates within this screened population are comparable to those reported within referred patients. The admittance rate is slightly lower. Transrectal ultrasound-guided systematic sextant biopsy of the prostate is a safe procedure for the diagnosis of prostate cancer within the general population; however, identification of risk factors for complications might further improve the safety of the screening procedure.