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A Novel Enema Method Can Prevent Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Single-Center Experience
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  • Fatih Gokalp,
  • Omer Koras,
  • Didar GURSOY,
  • Hakan Sigva,
  • Sefa Burak PORGALI,
  • Nezih TAMKAC,
  • Bilal Kulak,
  • Ferhat Uçurmak,
  • Sadik GORUR
Fatih Gokalp
Hatay Mustafa Kemal University

Corresponding Author:fatihgokalp85@gmail.com

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Omer Koras
Mustafa Kemal University Faculty of Medicine
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Didar GURSOY
Hatay Mustafa Kemal University
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Hakan Sigva
Hatay Mustafa Kemal University
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Sefa Burak PORGALI
Hatay Mustafa Kemal University
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Nezih TAMKAC
Hatay Mustafa Kemal University
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Bilal Kulak
Hatay Mustafa Kemal University
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Ferhat Uçurmak
Hatay Mustafa Kemal University
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Sadik GORUR
Hatay Mustafa Kemal University
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Abstract

Background: Transrectal ultrasound biopsy is the preferred method for diagnosing prostate cancer, but it can cause infectious complications as a result of fluoroquinolone resistance. We aimed to explore the potential protective effect of a second rectal enema before biopsy. Methods: Between January 2015 and December 2020, 419 patients were assessed retrospectively. Patients with a history of anticoagulant use, uncontrolled diabetes, urological surgery, prostate biopsy, or recent hospitalization or overseas travel, as well as those with previous prostatitis, were excluded from the study. The patients were subsequently divided into two groups: Group 1 (n=223) had received one enema, on the morning of the biopsy, and Group 2 (n=196) had received two, with the additional enema administered half an hour before the procedure. Results: There was no significant difference between the groups in terms of age, BMI, diabetes, prostate-specific antigen (PSA) level, and prostate size (p=0.076, p=0.489, p=0.265, p=0.193, and p=0.661, respectively) or in relation to cancer detection (p=0.428). The median hospitalization date was significantly higher in Group 1 (p=0.003) as was UTI development (p=0.004). However, there was no significant difference in terms of fever and sepsis (p=0.524 and p=0.548, respectively). Additionally, subgroup analysis demonstrated that UTI was significantly lower in patients with diabetes mellitus who had received a second enema (p=0.004), though there was no significant difference in UTI between the groups in those without diabetes mellitus (p=0.215). Multivariable analysis showed that age and diabetes were significant risk factors for the development of UTI (p=0.002andp=0.003, respectively). Furthermore, the second enema was a significant protective factor for preventing UTI (p<0.001). Conclusion: Older age and the presence of diabetes mellitus are independent risk factors for UTI after prostate biopsy. A second enema procedure before biopsy may protect patients from related infectious complications and could therefore be used as an alternative preventative method.
10 Aug 2021Submitted to International Journal of Clinical Practice
10 Aug 2021Submission Checks Completed
10 Aug 2021Assigned to Editor
27 Aug 2021Reviewer(s) Assigned
03 Sep 2021Review(s) Completed, Editorial Evaluation Pending
10 Sep 2021Editorial Decision: Revise Major
17 Sep 20211st Revision Received
20 Sep 2021Submission Checks Completed
20 Sep 2021Assigned to Editor
20 Sep 2021Review(s) Completed, Editorial Evaluation Pending
20 Sep 2021Reviewer(s) Assigned
23 Sep 2021Editorial Decision: Accept
04 Oct 2021Published in International Journal of Clinical Practice. 10.1111/ijcp.14923