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Biopsy complication rates

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Posted 2/5/2010 6:01 PM (GMT 0)
http://prostatecancerinfolink.net/2010/02/05/complication-rates-after-trus-guided-biopsies-in-canada/
Posted 2/5/2010 6:34 PM (GMT 0)

I am one of the people who got an infection from the biopsy.  It was an E-coli infection resistant to the first two antibiotics they tried.  I was hospitalized and finally had to have a PIC placed in my arm and IV antibiotic adminstered by my wife at home for 7-10 days.  Until they found the right antibiotic I was really sick.  Unfortunately, there doesn't seem to be any way around this.  The biopsy is necessary to confirm the PC and the number of men getting infections is small.  Perhaps in the future they will give a pre-biopsy antibiotic that the bacteria have not bult up a reistance to. Everybody has the E-coli in their digestive system and I guess it isn't hard for the biopsy needles to grab it and move it someplace where it shoudn't be.  Plus, I must be an infection magnet because part of my surgical incision got infected.  Bacteria seem to love me!! 

Posted 2/5/2010 7:02 PM (GMT 0)
I was given an antibiotic prior to the biopsy so I'm surprised that that isn't routine. I continued on anti-biotics after the procedure for a period of time. No infection of any kind.
Posted 2/5/2010 7:05 PM (GMT 0)
What is the current thinking of the chances of the biopsy actually causes any cancer cells to escape the prostate?
Posted 2/5/2010 7:09 PM (GMT 0)
Will just add one more tidbit to the equation.

TRUS biopsy can also create adhesions between the prostate and the rectal wall afterwards. This will somewhat complicate the surgery if it occurs. If I had one of those assembly line surgeons that was anxious to get to his next surgical patient, I would have ended up with part of the rectal wall removed and possibly a permenant coloscopy bag. Instead my surgeon spent the extra time (2 1/2 hours) being as careful as possible not to damage the rectal wall. Left me with a positive margin, but I will take that any day of the week.
Posted 2/5/2010 7:23 PM (GMT 0)
A template guided biopsy (taken though the perineum) is likely to be more accurate than a standard TRUS biopsy and incurs less risk of infection.

Jeremy

Posted 2/5/2010 7:25 PM (GMT 0)
I was given an antibiotic to take the day of the biopsy.  I think it was ciprofloxin.  The E-coli just ate it up, as it did with the second antibiotic I got.  I asked my Urologist specifically if the actual biopsy could result in the movement of cancer cells out of the prostate and he he stated "it is virtually impossible", "highly unlikely".  That seems to be the general concensus among the urologists. You would think that if the procedure can move bacteria from one place to another (rectum into the prostate), that it could move cells out and deposit them along the way.  I guess we have to take the word of the docs that the procedure is mostly safe.

Posted 2/5/2010 7:45 PM (GMT 0)
Prostate Biopsy complications and/or infections are rare in the US. Can they happen? Of course, even the simplest medical procedure has standard risks associated with it. But I would hope this information would never stop a man from getting a biopsy if warranted. Also, the pain issue has been discussed in depth here, but for the new guys, if your uro won't work with you on the pain factor in a way that is favorable to your wishes, you already have the wrong doctor in my opinion. Once you have a positive DRE or suspicious and/or rising PSA numbers, then a prostate biopsy (or more than one if needed over time) is imperative. Early detection between PSA screening, DRE's on a regular basis, and biopsies if needed, is still the best way to save lives concerning Prostate Cancer in my opinion.

David in SC
Posted 2/5/2010 8:02 PM (GMT 0)
I agree that the prostate biopsy is necessary. Without mine, I would not have had confirmation on the cancer. The procedure was basically painless for me and the fact that I got an infection is just a rare fluke that almost nobody else has to worry about.
Posted 2/5/2010 10:24 PM (GMT 0)
LV-TX ...

Yikes .. 2.5 hours for BIOPSY?

Was he playing chess with you while he did it ("Your Move Doc " --- KATCHACK .. "OK your move LV" ... etc ...)

Mine was in and out in 5-10 minutes --- one of those assembly line guys --

KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK KATCHACK

... like that ...
Posted 2/5/2010 11:49 PM (GMT 0)
I was one of the rare cases to get a septicemia infection from a biopsy. From all sources I've read, a strong oral antibiotic should be administered for a day or so leading up to the biopsy. I did not get one. It was a mix up in communication between the doctor and the hospital. I had my biopsy done at the hospital under anesthesia for two reasons: 1) I'm a wimp and 2) I had a flexible cystoscopy done at the same time to check for bladder cancer, which, fortunately, came back negative. The symptoms of the infection came on approximately 30 hours after the biopsy but once they hit, they literally had me floored within one hour. I called 911, was rushed to an emergency clinic where they had to insert a catheter due to swelling from the biopsy and not being able to urinate. I spent four days in the hospital (2 of those in ICU). I was told I had a gram-negative organism. They said I dodged a bullet. Then, on the day I was released from the hospital, I was told my biopsy was positive.
Posted 2/7/2010 7:04 PM (GMT 0)
BigG,
To avoid annual biopsies look into getting a color doppler. Once a base line is established a biopsy is only give if a change is seen. It is an excellent method to monitor AS without the risk of biopsy complications.
JT
Posted 2/7/2010 10:00 PM (GMT 0)
The most common side effect of ordinary biopsies is bleeding.

Cancer cells will surely leave the prostate gland getting into  the blood stream, but chances for metastasies are considered negligable.

Occasionally infections will occur  which  is very serious and  life-threatening.

I had my ordinary biopsy in 2001,  for side effect just bleeding. I am now on AS. No way I will agree to have another such biopsy.

Instead of the ordinary biopsy I had two fine-needle aspiration biopsies, their complication rate being just 0.9%.

Ordinary biopsies have a complication rate of 19.8%.

Ordinary biopsies extract tissue that is examined for cancer, establiishing gleason.

Fine-needle aspiration biopsies scan the whole prostate for cancer cells.

From cancer cells you can get a DNA-Analysis showing  cancer yes or no and malignancy.

Unfortunately I had to travel a long way to get this done as urologists are not trained in the technique.

Reinardo

 

Posted 2/8/2010 12:11 AM (GMT 0)

My husband was treated with oral anitbiotic before his biopsy and also after the biopsy.   He had the biopsy at 11:00 on a Thursday and awakened on Sunday morning with raging fever.  He was septic and spent nearly a week in the hospital on IV antibioics.  Our urologist told us that there was a 1% chance of this type of infection.     He is spinal cord injured resulting in para plegia which always complicates things.   He had his surgery 6 weeks later....his surgery was on a Monday and he didn't " wake up" from the surgery until Thursday.   He likes to keep me on my toes!!!!

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