scholarly journals Catastrophic sepsis and hemorrhage following transrectal ultrasound guided prostate biopsies

2013 ◽  
Vol 4 (1) ◽  
pp. 12 ◽  
Author(s):  
Paul Toren ◽  
Roshan Razik ◽  
John Trachtenberg
Keyword(s):  
Septic Shock ◽  
Surgical Management ◽  
Prostate Biopsy ◽  
Rare Events ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Prostate Biopsies

We report 2 cases of catastrophic complications following routinetransrectal ultrasound guided prostate biopsy. The first patientincurred near-fatal septic shock due to multi-resistant Escherichiacoli. Due to the severity of his shock, he developed bilateral leggangrene requiring amputations. The second patient incurred significanthemorrhage eventually requiring an emergent generalanesthesia and surgical management to control hemorrhage afterother measures failed. While rare events, these reports emphasizethe caution needed for physicians who routinely order prostatebiopsies.

Disinfection of a Probe Used in Ultrasound-Guided Prostate Biopsy

2007 ◽  
Vol 28 (8) ◽  
pp. 916-919 ◽  
Author(s):  
William A. Rutala ◽  
Maria F. Gergen ◽  
David J. Weber
Keyword(s):  
Prostate Biopsy ◽  
Bacterial Load ◽  
Transrectal Ultrasound ◽  
Diagnostic Procedures ◽  
Ultrasound Probe ◽  
Ultrasound Guided ◽  
Biopsy Needle ◽  
Prostate Biopsies ◽  
Colony Forming Units ◽  
High Level

Background.Transrectal ultrasound (TRUS)-guided prostate biopsies are among the most common outpatient diagnostic procedures in urology clinics and carry the risk of introducing pathogens that may lead to infection.Objective.To investigate the effectiveness of procedures for disinfecting a probe used in ultrasound-guided prostate biopsy.Method.The effectiveness of disinfection was determined by inoculating 107 colony forming units (cfu) of Pseudomonas aeruginosa at the following 3 sites on the probe: the interior lumen of the biopsy needle guide, the outside surface of the biopsy needle guide, and the interior lumen of the ultrasound probe where the needle guide passes through the transducer. Each site was investigated separately. After inoculation, the probe was immersed in 2% glutaraldehyde for 20 minutes and then assessed for the level of microbial contamination.Results.The results demonstrated that disinfection (ie, a reduction in bacterial load of greater than 7 log10 cfu) could be achieved if the needle guide was removed from the probe. However, if the needle guide was left in the probe channel during immersion in 2% glutaraldehyde, disinfection was not achieved (ie, the reduction was approximately 1 log10 cfu).Conclusions.Recommendations for probe disinfection are provided and include disassembling the device and immersing the probe and the needle guide separately in a high-level disinfectant.

scholarly journals Echoskopu kontroliuojamų transrektalinių priešinės liaukos biopsijų komplikacijos

2005 ◽  
Vol 3 (4) ◽  
pp. 0-0
Author(s):  
Gintaras Budrius ◽  
Henrikas Šimkevičius
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Prophylactic Antibiotic ◽  
Well Being ◽  
Safe Procedure ◽  
City Hospital ◽  
Ultrasound Guided ◽  
Substantial Impact ◽  
Prostate Biopsies ◽  
Hospital Patients

Gintaras Budrius, Henrikas ŠimkevičiusVšĮ Šiaulių ligoninės Urologijos skyrius,Kudirkos g. 99, LT-76304 ŠiauliaiEl paštas: [email protected] Tikslas Pateikti 2003–2004 m. Šiaulių ligoninėje atliktų transrektalinių sekstantinių priešinės liaukos biopsijų komplikacijų analizę. Ligoniai ir metodai Nuo 2003 m. sausio iki 2004 m. gruodžio VšĮ Šiaulių ligoninėje atliktos 687 sekstantinės priešinės liaukos biopsijos, iš jų 15 pacientų anksčiau buvo atliktas viršgaktinis drenažas dėl šlapimo susilaikymo, 18 ligonių tai buvo pakartotinės biopsijos, keturiems buvo prostatos cistos (0,5–2 cm). Prieš biopsiją visi pacientai profilaktiškai gydyti antibakteriniais preparatais. Rezultatai 104-iems (15,1%) pacientams pasireiškė komplikacijų. Dažnesnės komplikacijos buvo tiems, kurių priešinės liaukos tūris buvo didesnis nei 40 ml. Sunkios komplikacijos – retesnės. 3,5% vyrų karščiavo, 0,6% – susilaikė šlapimas. Keturi (0,6 %) pacientai, sergantys ūminiu prostatitu, ir keturi (0,6%) – urosepsiu, po biopsijos buvo hospitalizuoti. Vienas pacientas nuo urosepsio mirė. Padidėjusios rizikos grupė – tai pacientai, turintys prostatos cistų. Išvados Transrektalinės sekstantinės priešinės liaukos biopsijos išlieka saugi procedūra prostatos vėžiui diagnozuoti. Tačiau prostatos biopsijos neretai sukelia daug įvairių komplikacijų ir tai gali turėti įtakos paciento sveikatai. Reikšminiai žodžiai: sekstantinė priešinės liaukos (prostatos) biopsija, komplikacijos Complications after ultrasound-guided prostate biopsy Gintaras Budrius, Henrikas ŠimkevičiusDepartment of Urology, Šiauliai City Hospital,Kudirkos str. 99, LT-76304 Šiauliai, LithuaniaE-mail: [email protected] Objective The paper reviews the complications after transrectal sextant ultrasound-guided prostate biopsies performed in 2003–2004 in Šiauliai Hospital. Patients and methods We performed 687 biopsies. 104(15.1%) were associated with complications. All participants received prophylactic antibiotic therapy. Results Complications are more frequent in patients with a prostate lager than 40 ml. Severe complications were far less frequent. 3.5% of patients developed fever after biopsy. Urinary retention was seen in 4 (0.6%) cases. Four (0.6%) men were admitted because of sings of prostatitis and 4 (0.6%) of urosepsis. One patient died from progressed urosepsis. Risk factors are analysed for men who had prostatic cyst. Conclusions Transrectal ultrasound-guided sextant prostate biopsy remains a safe procedure for the diagnosis of prostate cancer. However, prostate biopsy commonly causes a vast variety of complications and has a substantial impact on the patient’s well-being. Keywords: sextant prostate biopsy, complications

scholarly journals Prostatos biopsija, kontroliuojama transrektaliniu ultragarsu

2005 ◽  
Vol 3 (4) ◽  
pp. 0-0
Author(s):  
Deimantas Šukys ◽  
Sergejus Gaižauskas ◽  
Robert Jankovski ◽  
Andrius Gaižauskas ◽  
Edgaras Stankevičius
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Peripheral Zone ◽  
Cancer Diagnostics ◽  
Ultrasound Guided ◽  
Keywords Prostate Cancer ◽  
Prostate Biopsies ◽  
Keywords Prostate ◽  
Medical University

Deimantas Šukys1, Sergejus Gaižauskas1, Robert Jankovski1, Andrius Gaižauskas1, Edgaras Stankevičius21 Vilniaus greitosios pagalbosuniversitetinės ligoninėsBendrosios chirurgijos centras,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Kauno medicinos universitetoFiziologijos katedra,A. Mickevičiaus g. 9, Kaunas Prostata yra viena dažniausių vėžio lokalizacijų vyrams. Prostatos biopsija, kontroliuojama transrektiniu ultragarsu, yra pagrindinis metodas diagnozuojant prostatos vėžį ir pasirenkant gydymo taktiką. Pagrindinės indikacijos atlikti biopsiją yra PSA > 4 ng/ml ir pirštu čiuopiami prostatos karcinomai būdingi pakitimai. Yra pasiūlyta daug prostatos biopsijos atlikimo metodikų. Įrodyta, jog vietoje klasikinės sekstantinės biopsijos taikant daugiau mėginių turinčias ir labiau į periferinę prostatos zoną orientuotas schemas, randama iki 30% daugiau prostatos vėžio atvejų. Atliekant daugiau mėginių, tampa aktuali nuskausminimo problema. Dar nėra visuotinai priimtų prostatos biopsijos indikacijų ir jos atlikimo schemos. Reikšminiai žodžiai: prostatos vėžys, prostatos biopsija Transrectal ultrasound-guided prostate biopsies Deimantas Šukys1, Sergejus Gaižauskas1, Robert Jankovski1, Andrius Gaižauskas1, Edgaras Stankevičius21 Center of General Surgery,Vilnius Emergency Hospital,Šiltnamių str. 29,LT-04130 Vilnius, LithuaniaE-mail: [email protected] Department of Physiology,Kaunas Medical University,A. Mickevičiaus str. 9,LT-44307 Kaunas, Lithuania Prostate cancer is one of the most frequent cancer localizations in men. Transrectal ultrasound-guided prostate biopsy is the main method in prostate cancer diagnostics and deciding tactics of treatment. The main indications for prostate biopsy are PSA over 4 ng/ml and characteristic palpable lesions. There are a lot of methods to perform prostate biopsy. It is proven that using multicore schemes directed closer to the peripheral zone of the prostate instead of the classic sextant prostate biopsy increases prostate cancer detection by up to 30%. Anesthesia becomes the problem when performing more extended biopsies. So far, there is no strict generally adopted indications and prostate biopsy performing schemes. Keywords: prostate cancer, prostate biopsy

scholarly journals Multicentre clinical evaluation of the safety and performance of a simple transperineal access system for prostate biopsies for suspected prostate cancer: The CAMbridge PROstate Biopsy DevicE (CamPROBE) study

2020 ◽  
pp. 205141582093277
Author(s):  
Vincent J Gnanapragasam ◽  
Kelly Leonard ◽  
Michal Sut ◽  
Cristian Ilie ◽  
Jonathan Ord ◽  
...  
Keyword(s):  
United Kingdom ◽  
Prostate Biopsy ◽  
Local Anaesthetic ◽  
Transrectal Ultrasound ◽  
Procedure Time ◽  
Ultrasound Guided ◽  
Prostate Biopsies ◽  
Patient Reported ◽  
Biopsy Device ◽  
Lead Site

Objectives: To report the prospective multicentre clinical evaluation of a first-in-man disposable device, Cambridge Prostate Biopsy Device, to undertake local anaesthetic outpatient transperineal prostate biopsies. Material and methods: Disposable single-use Cambridge Prostate Biopsy devices were manufactured based on a previous prototype. The lead site developed a user training course and disseminated the method to other sites. The Cambridge Prostate Biopsy Device (CamPROBE) was offered as an alternative to transrectal ultrasound guided biopsy to men due for a biopsy as part of their clinical management. Data on safety (infections and device performance), clinical utility, patient reported experience, biopsy quality and cancer detection were collected. Procedure time and local anaesthetic use was recorded in the lead site. The study was funded by a United Kingdom National Institute for Health Research (NIHR) i4i product development award. Results: A total of 40 patients were recruited (median age 69 y) across six sites; five sites were new to the procedure. Overall, 19/40 were first prostate biopsies and 21/40 repeat procedures. Both image-targeted and systematic biopsy cores taken. There were no infections, device deficiencies or safety issues reported. The procedure was well tolerated with excellent patient-reported perception and low pain scores (median of 3, scale 0–10). Histopathology quality was good and the overall cancer diagnosis rate (first diagnostic procedures) was 68% (13/19) and for significant cancers (⩾ histological Grade Group 2), 47% (9/19). In the lead centre (most experienced), median procedure time was 25 minutes, and median local anaesthetic use 11 ml ( n=17). Conclusions: Data from this device evaluation study demonstrate that the United Kingdom-developed Cambridge Prostate Biopsy Device/method for transperineal biopsies is safe, transferable and maintains high diagnostic yields. The procedure is well tolerated by patients, suited to the local anaesthetic outpatient setting and could directly replace transrectal ultrasound guided biopsy. Level of evidence: Level III

Risk of Infections Associated with Improperly Reprocessed Transrectal Ultrasound–Guided Prostate Biopsy Equipment

2008 ◽  
Vol 29 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Fernanda Lessa ◽  
Sangwoo Tak ◽  
Shannon R. DeVader ◽  
Rekha Goswami ◽  
Mary Anderson ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Bacterial Infections ◽  
Transrectal Ultrasound ◽  
Healthcare Facility ◽  
Pathogen Transmission ◽  
Ultrasound Guided ◽  
Prostate Biopsies ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Potential Pathogen

Objective.A hospital discovered a lapse in the reprocessing procedures for transrectal ultrasound-guided prostate biopsy equipment. An investigation was initiated to assess the risks of transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and bacteria during prostate biopsies.Methods.We offered testing for HBV, HCV, and HIV infection to patients who had undergone prostate biopsies from January 30, 2003, through January 27, 2006. We reviewed their medical records and obtained information on the reprocessing procedures that were in use at the time for the prostate biopsy equipment.Setting.A healthcare facility in Maine.Results.Of the 528 patients exposed to improperly reprocessed prostate biopsy equipment, none tested positive for HIV or HCV. Sixteen patients (3%) tested positive for past HBV infection but had no prebiopsy HBV serologic test results available (ie, transmission from improperly reprocessed biopsy equipment was possible), and 11 (2%) had evidence of postbiopsy bacterial infections. The number of cases of HBV and bacterial infections were within reported ranges for this population and were not clustered in time. Review of the reprocessing procedures in use at the time revealed that the manufacturer-recommended brushes for cleaning the reusable biopsy needle guide were never used. Brushes did not come with the equipment and had to be ordered separately.Conclusions.Despite the lack of evidence of pathogen transmission in this investigation, it is critical to review the manufacturer's reprocessing recommendations and to establish appropriate procedures to avert potential pathogen transmission and subsequent patient concerns. This investigation provides a better understanding of the risks associated with improperly reprocessed transrectal ultrasound prostate biopsy equipment and serves as a methodologic tool for future investigations.

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