Transrektal Ultrasonografi Eşliğinde Prostat Biyopsisi Öncesinde Povidon Iodin ile Perineal Bölge Temizliğinin İşleme Bağlı İnfektif Komplikasyonlara Etkisi

Abstract

Purpose: To analyze the effect of perineal region cleansing with povidone iodine (PI) before transrectal needle biopsy of the prostate on infectious complications. Material and Methods: From 01/07/2013 to 05/01/2014, 120 consecutive patients with a PSA > 2.5 ng/ml or abnormal digital rectal examination were prospectively randomized to perineal cleansing (60) with PI or no cleansing (60) before their first transrectal needle biopsy of the prostate. Patients in both groups received 3 gr fosfomycin po the day before and after the procedure and 1 gr amikacin iv infusion 30 minutes before the procedure. The patients characteristics, comorbidities, PSA, fPSA, f/t PSA ratio, total prostate and transitional zone volume and thus PSA dansity (PSAD) and transitional zone PSA dansity (TZPSAD), previous history of antibiotic usage in the last three months, previous history of transrectal needle biopsy of the prostate, hematuria, hematospermia, rectal bleeding, the pathological results and the primary end point which was infectious compilications were evaluated in both groups. Results: There was no difference in baseline evaluation between groups, except mean volume of the prostate was larger in PI group (63.9 vs 52.8 cc, p=0.016). Infectious complications were observed in 4 patients (3,3%); 1 (1.7%) in PI group and 3 (5%) in control group (p=0.309). Regarding the other parameters and pathological results, there was no significant difference between two groups. Conclusions: Although there was a trend for reducing infectious complications in patients with perineal cleansing with PI before ultrasound guided transrectal needle biopsy; this difference has not reached significant level in this study. Further studies with larger number of patients are needed to clarify the effect of perineal cleansing with PI.