2023 ARRS ANNUAL MEETING - ABSTRACTS

RETURN TO ABSTRACT LISTING


E1671. Does a Disposable Transrectal Ultrasound Needle Guide Result in a Higher Rate of Postprocedural Rectal Bleeding Requiring Hospitalization?
Authors
  1. Jineet Patel; Virginia Commonwealth University School of Medicine
  2. Jinxing Yu; Virginia Commonwealth University School of Medicine
  3. Sarah Winks; Virginia Commonwealth University School of Medicine
Objective:
To compare the rate of postprocedural rectal bleeding requiring hospitalization in patients undergoing prostate biopsies with a disposable versus reusable transrectal ultrasound (TRUS) needle guide.

Materials and Methods:
In this retrospective study, TRUS prostate biopsies conducted in our institute between 2017 and 2020 were included. During an 8-month period between 2017 and 2018, all prostate biopsies were performed utilizing disposable TRUS needle guides. In 2019 and 2020, all prostate biopsies were performed utilizing reusable metal TRUS needle guides. Prostate biopsies included systemic TRUS biopsies, targeted MR-US fusion biopsies, and dual systemic-targeted TRUS & MR-US biopsies. Patients’ charts were reviewed for postprocedural rectal bleeding requiring hospitalization. Patients had a standardized telephone follow-up call 24 - 72 hours after the procedure and/or follow-up clinic visits. Other clinical information including age, PSA at the time of the biopsy, size of the prostate, and number of core biopsy taken for each patient was collected. Statistical analysis was applied to the data collected utilizing t-test and chi-square tests with an alpha level of .05.

Results:
A total of 685 prostate biopsies were included in our study. Out of these, 167 biopsies were performed utilizing a disposable needle guide and 525 biopsies were performed utilizing a reusable needle guide. Within the disposable group, there were 5 patients (3%) that had significant rectal bleeding requiring hospitalization. 3 of the 5 had active bleeding within hours of the biopsy and all 5 required surgical and/or endoscopic intervention to stop the bleeding and hospitalization. Within the reusable group, there were only 2 patients (0.38%) requiring hospitalization; neither of which involved active bleeding the same day as the biopsy. There was a significantly increased rate of rectal bleeding requiring hospitalization in the disposable group when compared to the rate in the reusable group (p < 0.01). There was no significant difference between the mean age, PSA, size of the prostate, and core biopsy numbers between the disposable and reusable groups. There was no difference in technique or operators between the disposable and reusable groups.

Conclusion:
Although the gold standard of diagnosis, TRUS also comes with risks such as infection, urinary obstruction, hematospermia, and rectal bleeding. Rectal bleeding, although usually minor, can also manifest as life-threatening and require hospitalization in patients. After we realized the potential connection of significant rectal bleeding when utilizing a disposable needle guide, we switched back to the reusable needle guide and rarely encountered rectal bleeding requiring hospitalization. Our study suggests that usage of a disposable needle guide for TRUS prostate biopsies may be associated with an elevated risk of significant rectal bleeding requiring hospitalization compared to usage of a reusable needle guide.