Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study

Introduction: Prostate cancer is a common malignancy affecting men beyond middle age. In developed countries, the life time risk of developing microscopic prostate cancer in men is 30%. Prostate cancer is a slow-growing tumor and the risk of developing clinical disease is 16% with 3% lifetime risk of dying from the disease. Prostate biopsy serves as a means for obtaining specimen for cancer diagnosis. The procedure though relatively simple and safe may result in complications hence the need to take some precautions during patient preparation. There is wide variability in the workup protocol amongst urologist with no consensus. The aim of this study was to compare bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infectious complications following transrectal prostate biopsy. Methodology: Patients who met the inclusion criteria were randomized into two groups. Group I had bowel preparation and antibiotic prophylaxis while group II received antibiotic prophylaxis only. Both groups were followed up and assessed for complications. Data were collected and analyzed using SPSS Version 20. Data were presented using tables and figures and p-value of < 0.05 was considered statistically significant. Results: A total of 106 men were recruited for the study. Subjects were randomized into two groups. Group I had 54 subjects while group II had 52 subjects. Age range was 48-96 years with a mean age of 65.4±10.4 years. Both groups had comparable socio-demographic and clinical characteristics. Overall Infective complication in this study was seen in 72 (67.9%). Incidence of significant complication requiring hospitalization was seen in 5 (4.7%). For group I infective complication was seen in 28 (51.8%) while for group II 47 (90.2%) patients had infective complications (p = 0.009). The incidence of significant complications requiring hospitalization was 2 (3.7%) for group I and 3 (5.8%) for group II (p = 0.675). Conclusion: Overall there is statistically significant difference between the use of bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infective complication following transrectal prostate biopsy.