Transrectal Needle Biopsy of the Prostate: The Efficacy of a Pre-biopsy Enema

Purpose: There are numerous biopsy protocols that have been described in the clinical literature. We especially assess the role of the use of an enema before a transrectal prostate biopsy by comparing the post biopsyinfectious complications rate. Materials and Methods: From January 2007 to August 2007 we retrospectively evaluated 302 men who underwent transrectal needle biopsy of the prostate according to the inclusion criteria. Patients in group 1 (121 patients) did not receive an enema and were given oral ciprofloxacin (500 mg) for 3 days. Those in group 2 (181 patients) received an enema before the biopsy and were also administered intravenous ciprofloxacin (400mg) and an additional oral form (500mg) for five days. Only complications related to infection were evaluated, that is, fever and chills with systemic inflammatory symptoms, within two weeks after the biopsy. Results: Patients demographics, such as age and prostate size did not differ between the two groups (p>0.05), but the level of prostate-specific antigen (PSA) in group 2 was significantly higher than in group 1 (12.70ng/ml versus 28.88ng/ml, p 0.05). The infectious complications rate was 2.6% (8/302) overall and did not differ significantly between the two groups (2.5% versus 2.8%, p>0.05). Especially for group 2 patients, there were two cases of bacteremia and Escherichia coli was reported as the pathogen. Conclusions: Our findings suggest that the use of a pre-biopsy enema shows no significant benefit given the considerations of infectious complications rate, and the patient quality of life. (Korean J Urol 2008;49:248-251) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏