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Post TRUS – prostate biopsy patient’s instruction

TRUS Topic
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

In 1989, the first ever (TRUS) or Transrectal Ultrasound-Guided prostate biopsy was introduced to the world. Since then and now, the TRUS biopsy still the only way for the confirmation diagnosis of the prostate cancer while more than 4 million procedures are being performed worldwide through the years. In this content we’re going to discuss about the complications that possibly happen after TRUS prostate biopsy.

Prepare procedure
Transrectal ultrasound-guided biopsy is a day-care procedure.
  1. Bleeding complications ***that would recover within 10 days post-operation
    • Blood in urine – 66%
    • Blood in your ejaculation – 38%
    • Blood in stool – 28%
  2. Inflammation complications
    • Urinary tract infection – 6%
    • Fever – 4%
    • Persistent painful urination – 3%
    • Pain or burning sensation while urinating – 1%
    • Serious blood stream infection – 0.5%
    • Serious perineal skin infection – 0.05%
  3. Miscellaneous complications
    • Sweating, nausea, dizziness, fainting – 7%
    • Acute urinary retention – 0.3%
    • Myocardial infarction – 0.3%
Ultrasound guidedance
Urologist will target the prostate tissue by ultrasound machine.

You can notice that even we have use proper prophylaxis antibiotic in every case before doing the biopsy; the infection relatively-complications still possibly to be encountered. It described by the method of procedure which needs to insert the ultrasound probe into rectal canal, and absolutely it is contaminated with feces. Lots of literature confirmed that the rate of postoperative infection cannot be reduced by any preoperative rectal preparation.

Prophylaxis ATB
Preoperative antibiotic must always be given for Post-TRUS blood stream infection prevention.

In conclusion, even some complicated were reported but the pros of the TRUS biopsy still stands out the cons. Under a professional Urologist care, the first step prior doing the biopsy and recommended is a well-patient selection then follow by a well patient preparation before the procedure. Also tell them about the possibility of the TRUS-relatively-complications that would dramatically decrease level of anxiety. See you in next article.

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