Authors (including presenting author) :
Leung CH(1), Yu KN(1), Yau KL(1), Kwok SC(1), Liu PL(1)
Affiliation :
(1)Department of Surgery, Caritas Medical Centre, Hong Kong
Introduction :
Transrectal ultrasound guided prostate biopsy (TRUS-Bx) is the gold standard for diagnosing and staging of prostate cancer. It is however associated with infection risk and can lead to life-threatening sepsis in rare occasions.
Objectives :
(1) To demonstrate reduction of infectious complications after TRUS-Bx with povidone iodine rectal preparation (PIRP)
(2)To demonstrate the cost-effectiveness of the PIRP
Methodology :
A quasi-experimental study with historical control group was adopted. From April of 2018 to July of 2019, all patients (n=277) received PIRP before TRUS biopsy. Patients (n=297) undergone TRUS biopsy from January of 2017 to March of 2018 were included in the control group retrospectively. All electronic patient records and logbooks were reviewed in data collection. Demographic data and post TRUS biopsy complications included infectious complications, sepsis and other complications were recorded. Infectious complications were defined as the presence of at least one of the following: 1) fever greater than 38°C 2) symptomatic UTI with positive urine culture and 3) clinical sepsis.
Result & Outcome :
3 patients in intervention group and 5 patients in the control group suffered from sepsis. (p= .762, Fisher exact test) . It is noted that there was a shorter length of stay (4 to 6 vs 5 to 8 days) and fewer ICU admissions (0 vs 40%) in the intervention group although the sepsis rate between groups did not demonstrate a statistical significance. The cost in reducing one case of sepsis with the PIRP was estimated to be HKD$ 217.1, while an estimated cost of treatment to a single case of septicemia is as high as USD$4090 (approximately HKD$ 31,493).Povidone iodine rectal preparation is a cost effective intervention in reducing post TRUS biopsy sepsis.
