Complication of trans-rectal prostate biopsy based on Clavien index: 5 years of experience

Adhitya Fajar Prasetya(1*), Johan Renaldo(2)

(1) Department of Urology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
(2) Department of Urology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Hospital, Surabaya, Indonesia
(*) Corresponding Author


Trans-rectal prostate biopsy has become the gold standard for early diagnosis
of prostate cancer in developing countries. Despite its low risk, there are
some post-procedural complications. The complications are classified by
using a modified Clavien-Dindo system. The study aimed to recognize
complications of trans-rectal prostate biopsy procedure by using Clavien-
Dindo classification index. All patients undergoing trans-rectal prostate
biopsy procedure in the Department of Urology, Dr. Soetomo General Hospital
between January 2015-December 2019, were retrospectively analyzed in
terms of post-procedural complaints, underlying comorbidities and ongoing
additional examinations. The complaints were compiled into Clavien-Dindo
classification. Univariate analysis of various predictors of post-procedural
complications was also conducted. It was found 98 complication events from
400 patients (24.5%). Most complications were 1st degree (dysuria, hematuria,
urinary retention, fever, rectal pain and bleeding, erectile dysfunction, and
constipation).  In univariate analysis, positive results of urinary culture
correlated to the emergence of post-procedural complications. In conclusion,
the incidence of post-trans-rectal prostate biopsy complication in Dr. Soetomo
General Hospital reached 24.5%. From all of the risk factors, positive urinary
culture is related to the post-biopsy complication. Most complications are in
the 1st grade of Clavien index, suggesting that the procedure is relatively safe
and has a low risk


Clavien; complication; trans-rectal prostate biopsy; dysuria; hematuria

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