The Risks of TRUS Biopsy

By: Dan Sperling, MD

I have to credit the content of this blog to a fellow blogger. He is the Sitemaster at The “New” Prostate Cancer Infolink[i], a site dedicated to informing prostate cancer patients about their disease and their options, as well as other facets of living with prostate cancer. Although the posting I’m about to describe is a few years old, I thank the Sitemaster for drawing my attention to an important study.

On September 23, 2011, an article was posted that was essentially a summary of a journal-published study[ii] on the risks of TRUS-guided prostate biopsy.  The design of this retrospective study is very good, because it’s based on a 5% random sample of Medicare patients drawn from the national SEER database from 1991-2007. The sampling resulted in 30-day hospitalization rates (and diagnostic codes) for 17,472 men who had a TRUS biopsy, compared with 134,977 controls who did not. These are respectable numbers from which to draw conclusions.

The authors reported that 6.9% of the biopsy patients were admitted to inpatient care after their procedure, compared with 2.7% in the control group. As summarized on Infolink, “After adjusting for age, race, SEER region, year, and comorbidities, prostate biopsy was associated with a 2.65-fold increase in risk of hospitalization within 30 days compared to the control population.” In addition, the study’s authors warned about an increase in the rates of serious infectious complications, possibly due to antibiotic-resistant strains of infection-causing organisms. They also recommend that serious thought  be given to patients who might be spared the risks of TRUS biopsy, such as men with other comorbidities and less than 10 years of life expectancy. What about men older than 75 who might be diagnosed with early stage, low risk cancer that would not require immediate treatment—is the potential risk level from the biopsy worth finding out that such a patient can forego treatment?

Naturally, at our center we are happy that we offer an alternative to TRUS biopsy in the form of our 3TmpMRI-guided targeted biopsy. This approach has far lower infection risk (minimal number of needles) while producting the greatest yield.

Our hat’s off to The “New” Prostate Cancer Infolink for enlightening men, and those who love them.

 



[ii] Loeb S, Carter HB, Berndt SI et al. Complications after prostate biopsy: data from SEER-Medicare. J Urol. 2011 Nov;186(5)1830-4.