Güncel Profilaksi ve Antisepsi Uygulamaları Altında Transrektal Prostat Biyopsisi Öncesi Rutin İdrar Kültürüne Gerek Var Mı? Retrospektif Kohort Çalışma

Abstract

Amaç: Sefalosporin temelli profilaksi ve modern antisepsi protokolleri altında gerçekleştirilen transrektal prostat biyopsisi (TRUS-PB) yapılan hastalarda, işlem öncesi rutin olarak idrar kültürü taramasının işlem sonrası dönemde enfeksiyon komplikasyonlarına etkisini değerlendirmektir.

Gereç ve Yöntemler: Ocak 2024- Haziran 2025 tarihleri arasında kliniğimizde TRUS-PB yapılan 295 ardışık hasta retrospektif olarak incelendi. Hastalar iki gruba ayrıldı; son 1 ay içinde idrar kültürüne bakılmayan hastalar Grup 1 (n=130) ve son 1 ay içinde idrar kültürüne bakılan hastalar Grup 2 (n=165). Tüm hastalara sefalosporin profilaksisi, işlem sırasında rektal povidon-iyot temizliği ve iğne ucunun her kor sonrası formalin dezenfeksiyonu uygulandı. Çalışmaya dahil edilen tüm hastaların verileri hastane bilgi yönetim sistemi ve hasta dosyalarından retrospektif olarak taranarak kaydedilmiştir. Biyopsi sonrası gelişen enfeksiyon komplikasyonları kaydedildi.

Bulgular: Gruplar arasında serum PSA düzeyleri (p=0,251), alınan toplam kor sayıları (p=0,200) ve Diabetes Mellitus varlığı (p=0,345) açısından anlamlı fark saptanmadı. Toplam enfeksiyon oranı %2,03 (n=6) olup; bu oran Grup 1’de %2,31 (n=3), Grup 2’de %1,82 (n=3) olarak saptandı (p>0,999). Biyopsi sonrası idrar kültürü pozitifliği toplam 3 hastada (%1,02) saptandı; bu oran Grup 1’de %0,77 (n=1) iken, Grup 2’de %1,21 (n=2) olarak bulundu (p>0,999). Enfeksiyon nedeniyle hastaneye yatış oranları (Grup 1: %1,54 vs. Grup 2: %1,21) açısından da gruplar arasında istatistiksel bir fark bulunmadı (p=1,000). Her iki grupta da çalışma süresince sepsis gelişimi izlenmedi.

Sonuç: Bulgularımız, güncel profilaksi ve antisepsi kurallarına uyularak yapılan biyopsi öncesinde, asemptomatik hastalarda rutin idrar kültürü taraması ve sterilizasyon takibinin gerekli olmayabileceğini düşündürmektedir. Ancak bu sonuçların daha geniş serili, prospektif ve randomize çalışmalarla desteklenmesi gerekmektedir.

Keywords

• Prostat biyopsisi
• idrar kültürü
• profilaksi
• enfeksiyon

Ethical Statement

Bu çalışma, Düzce Üniversitesi Klinik Araştırma Etik Kurulu tarafından onaylanmış (Karar No: 2025/176; Karar tarihi: 28.07.2025) ve Helsinki Bildirgesi’nin etik standartlarına uygun olarak yürütülmüştür.

Is Routine Urine Culture Necessary Before Transrectal Prostate Biopsy Under Current Prophylaxis and Antisepsis Practices? A Retrospective Cohort Study

Abstract

Aim: To evaluate the effect of routine urine culture screening before prostate biopsy on post-procedural infectious complications in patients undergoing transrectal prostate biopsy (TRUS-PB) performed under cephalosporin-based prophylaxis and modern antisepsis protocols.

Material and Methods: 295 consecutive patients who underwent TRUS-PB in our clinic between January 2024 and June 2025 were retrospectively reviewed. Patients were divided into two groups: Group 1 (n=130), patients who did not have a urine culture in the last month, and Group 2 (n=165), patients who did. All patients received cephalosporin prophylaxis, rectal povidone-iodine cleaning during the procedure, and formalin disinfection of the needle tip after each core. Data were recorded retrospectively from the hospital information management system and patient files. Post-biopsy infectious complications were recorded.

Results: No significant differences were observed between the groups regarding serum PSA levels (p=0.251), total number of cores (p=0.200), and diabetes mellitus rates (p=0.345). The total infection rate was 2.03% (n=6); it was 2.31% (n=3) in Group 1 and 1.82% (n=3) in Group 2 (p=1.000). Post-biopsy urine culture positivity was detected in a total of 3 patients (1.02%); it was 0.77% (n=1) in Group 1 and 1.21% (n=2) in Group 2 (p=1.000). No statistical difference was found between the groups in terms of hospitalization rates due to infection (Group 1: 1.54% vs. Group 2: 1.21%) (p=1.000). Sepsis did not develop in either group during the study period.

Conclusion: Routine urine culture screening and sterilization follow-up may not be routinely necessary in asymptomatic patients before prostate biopsy when current prophylaxis and antisepsis rules are followed. However, these results need to be supported by larger and prospective randomized studies.

Keywords

• Prostate biopsy
• urine culture
• prophylaxis
• infection

Ethical Statement

This study was approved by the Duzce University Clinical Research Ethics Committee (Decision No: 2025/176; Decision date: 28.07.2025) and was conducted in accordance with the ethical standards of the Declaration of Helsinki.

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