In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?

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• 作者：Michael Meier-Schroers ; MD^a ; ^{michael.meier@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Rami Homsi ; MD^a ; ^{rami.homsi@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Guido Kukuk ; MD^a ; ^{guido.kukuk@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Karsten Wolter ; MD^a ; ^{karsten.wolter@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Georges Decker ; MD^a ; ^{georges.decker@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Stefan Fischer ; MD^a ; ^{stefan.fischer@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Christian Marx ; MD^a ; ^{christian.marx@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Frederic Carsten Schmeel ; MD^a ; ^{carsten.schmeel@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Wolfgang Block^a ; ^{wolfgang.block@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Alois Martin Sprinkart ; MSc^a ; ^{sprinkart@uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Frank Traeber ; PhD^a ; ^{frank.traeber@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Hans Heinz Schild ; MD^a ; ^{hans.schild@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Winfried Willinek ; MD^b ; ^{w.willinek@bk-trier.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：MRI ; Prostate ; Biopsy ; Complications ; Risk factors
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：85
• 期：12
• 页码：2169-2173
• 全文大小：744 K

文摘

To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB).

Materials and methods

90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification.

Results

We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications.

Conclusion

In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.