Is there any effect of long term alpha-adrenergic blocker and a single dose antibiotic usage in reducing febrile urinary tract infections after prostate biopsy?

Abstract

Aim: To investigate whether the using long term alpha-adrenergic blockers before biopsy has an effect on preventing febrile urinary tract infections (FUI) secondary to biopsy in patients undergoing prostate biopsy due to elevated prostate specific antigen (PSA) .
Material and Method: The data of 2558 patients who underwent transrectal ultrasonography-guided prostate biopsy (TRUS+BX) due to elevated PSA in our clinic between January 2008 and July 2021 were analyzed retrospectively. The patients were divided into two groups as those who used alpha-blockers for a minimum of three months or longer before biopsy (Group 1) and those who did not use alpha-blockers before applying to the outpatient clinic (Group 2) . Demographic data of the groups and post-biopsy FUI development rates were compared.
Results: It was observed that 1340 (52.4%) of the patients were using alpha-blockers (Group 1) and 1218 (47.6%) did not (Group 2) . The median age of the patients in the pre-biopsy groups was similar [Group 1=68 (IQR=9) years and Group 2=68 (IQR=9) years, p=0.887]. There was no significant difference between the groups in terms of median prostate volume [Group1=57 (31) ml and Group 2=58 (34) ml, p=0.199]. The median PSA value was found to be significantly higher in Group 1 than in Group 2 [10.50 (5.40) ng/dl vs 10.35 (6.80) ng/dl, p=0.026]. Postvoid residual urine volume (PVR) was found to be significantly higher in Group 2 [Group 1=40 (30) ml and Group2=60 (90) ml, p<0.001]. Similarly, the frequency of FUI development after biopsy was found to be significantly higher in Group 2 [Group 1=17 (1.3%) and Group 2=65 (5.3%) , p<0.001].
Conclusion: The use of alpha-adrenergic blockers for a minimum of three months or longer before prostate biopsy significantly reduces the incidence of FUI that may develop secondary to biopsy.

Keywords

• Urinary tract infection
• prostate
• core needle biopsy

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