Mp74-04 Rectal Povidone-Iodine Gel Reduces Infectious Complications Following Transrectal Prostate Needle Biopsy

You have accessJournal of UrologyProstate Cancer: Detection & Screening VI (MP74), Moderated Poster 741 May 2024MP74-04 RECTAL POVIDONE-IODINE GEL REDUCES INFECTIOUS COMPLICATIONS FOLLOWING TRANSRECTAL PROSTATE NEEDLE BIOPSY Gary S. Fialk, T. Hunt Batter, and Daniel Nemirovsky Gary S. FialkGary S. Fialk , T. Hunt BatterT. Hunt Batter , and Daniel NemirovskyDaniel Nemirovsky View All Author Informationhttps://doi.org/10.1097/01.JU.0001008632.59099.b9.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous studies have strongly supported the use of an intra-rectal bowel prep of povidone-iodine (topical, enema or suppository) to reduce post transrectal prostate needle biopsy (TRPNB) infections. This prospective study incorporates a 10‰ povidone-iodine (PI) gel at the time of transrectal prostate biopsy as a lubricant and topical antiseptic. The study assessed the incidence of post procedural infections requiring hospitalization for treatment of febrile UTI/sepsis, or treatment of outpatient urinary tract infection. METHODS: An 8-year, 8-month review of consecutive TRPNB procedures performed by 2 urologists, prospectively, in both a community office and facility (Ambulatory Surgery Center and Hospital) setting. A total of 884 procedures were performed. Office patients all had a standard periprostatic nerve block (PPNB). All patients received similar oral fluoroquinolone antibiotic prophylaxis. Patients in the facility had total intravenous anesthesia (TIVA) and no PPNB. In the left lateral decubitus position, patients had a digital rectal exam prostate using the 10‰ povidone- iodine gel to reassess the prostate for abnormalities and to "paint" the anterior rectal wall. This was followed by a generous application of the 10‰ PI gel to the ultrasound transducer tip prior to rectal insertion. A standard TRPNB was performed in the usual fashion securing 12-14 cores (or additional cores if MRI-fusion biopsy performed) as appropriate. RESULTS: A total of 884 consecutive TRPNB procedures were reviewed, 604 performed in the office and 280 performed in the facility. Of the facility procedures, 49 were MRI Fusion TRPNB. Overall, one patient required hospital admission for treatment of a febrile UTI for an incidence of 0.113‰. Five other patients were treated for suspected/documented urinary tract infections (UTI) with antibiotics as outpatients for an incidence of 0.57‰ post-procedural infection rate. Overall infection rate was 0.68‰ (6/884). CONCLUSIONS: By implementing an inexpensive 10% PI gel at the time of TRPNB, we had one patient with a febrile UTI requiring hospitalization out of 884 procedures for an incidence of 0.113‰. Five other patients had outpatient antibiotic treatment for UTI with an incidence of 0.57‰. Total infection incidence is 0.68‰. Routine use of 10‰ PI gel should be adopted to minimize infectious complications following TRPNB. Particularly, in light of the 2023 AUA Guidelines supporting either TR or TP prostate biopsy, the incorporation of intrarectal PI during the TR approach transforms the procedure into one with acceptable risk. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1194 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gary S. Fialk More articles by this author T. Hunt Batter More articles by this author Daniel Nemirovsky More articles by this author Expand All Advertisement PDF downloadLoading ...