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Risk factors for infection and acute urinary retention following transperineal prostate biopsy

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Abstract

Purpose

To calculate the frequency of infection and acute urinary retention (AUR) following transperineal (TP) prostate biopsy at a single high-volume academic institution and determine risk factors for developing these post-biopsy conditions.

Methods

Men undergoing TP prostate biopsy from 2012 to 2022 at our institution were retrospectively identified and chart reviewed. TP biopsies were performed with TR ultrasound (TRUS) guidance with anesthesia using a brachytherapy grid template. TRUS volumes were recorded during the procedure, and magnetic resonance imaging (MRI) volumes were calculated using the ellipsoid formula. When available, MRI volume was used for all analysis, and when absent, TRUS volume was used. AUR was defined as requiring urinary catheter placement within 72 h post-biopsy for inability to urinate. Univariable analysis was performed and variables with p < 0.1 and/or established clinical relevance were included in a backward binary logistic regression to produce an optimized model that fit the data without collinearity between variables.

Results

A total of 767 TP biopsies were completed in the study window. The frequency of infection was 1.83% (N = 14/767). The total frequency of AUR was 5.48% (N = 42/767). On multivariable regression, patients who went into AUR were five times as likely to develop infection (p = 0.020). Patients with infection post-TP biopsy were four times as likely to develop AUR (p = 0.047) and with prostates > 61.21 cc were three times as likely (p = 0.019).

Conclusion

According to our model, AUR is the greatest risk factor for infection post-TP biopsy. With regard to AUR risks, infection post-biopsy and prostate size > 61.21 cc are the greatest risk factors.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA

    Maxwell Sandberg, Wyatt Whitman, Janmejay Hingu, Parth Thakker, Ronald Davis III, Ashok Hemal, Matvey Tsivian & Alejandro R. Rodriguez

  2. Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA

    Jacob Greenberg

  3. Wake Forest University School of Medicine, Winston Salem, NC, 27101, USA

    Anita Rong, Caleb Bercu & Hannah Dabagian

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  1. Maxwell Sandberg
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Contributions

Maxwell Sandberg headed the project and delegated tasks and assisted in writing the first draft of the manuscript. Wyatt Whitman, Maxwell Sandberg, Jacob Greenberg, and Matvey Tsivian ran statistical analysis for the project. Janmejay Hingu, Parth Thakker, Anita Rong, Caleb Bercu, and Hannah Dabagian did a literature review for the manuscript and outlined the manuscript. All authors did chart review for data analysis on this project. Ronald Davis III, Ashok Hemal, Matvey Tsivian, and Alejandro Rodriguez provided expertise in oncology for writing the background of the paper. All authors reviewed the first draft of the manuscript and provided edits. All authors approved the final draft of the manuscript.

Corresponding author

Correspondence to Maxwell Sandberg.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethics approval and consent to participate

This retrospective chart review involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Atrium Health Wake Forest Baptist approved this study under IRB00087534. The need for written informed consent to participate was waived by the Wake Forest Baptist IRB ethics committee due to retrospective nature of the study.

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Sandberg, M., Whitman, W., Greenberg, J. et al. Risk factors for infection and acute urinary retention following transperineal prostate biopsy. Int Urol Nephrol 56, 819–826 (2024). https://doi.org/10.1007/s11255-023-03854-0

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