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[Complications of prostatic echo-guided transrectal biopsy and tolerance depending on the patient and the operator. Study of 205 patients].

OBJECTIVE
Ultrasound-guided transrectal biopsy of the prostate is generally considered to be well-tolerated and with few complications. The results of a prospective study that evaluated patient and biopsy performer's perception of the foregoing aspects are presented.


METHODS
The records of 305 consecutive patients submitted to ultrasound-guided transrectal biopsy were analyzed. Aspects of the physical examination and biopsy performer's assessment of patient tolerance were recorded in 290 cases. 264 patients filled out a questionnaire on different aspects of the test. A telephone interview was carried out to obtain data on side-effects and complications of the biopsy procedure. Patient and biopsy performer's perception of tolerance and complications of ultrasound-guided transrectal biopsy were analyzed.


RESULTS
Biopsy could not be performed in 1% of the cases due to pain. Before biopsy 34.5% of the patients thought the procedure would be painful, while only 6.8% sustained this view after biopsy. Insertion of the transducer and punction were considered to be painful by 8% and 12.9% of the patients, respectively, and 2.9% considered anesthesia should be used for the procedure. Tolerance of biopsy punction remained unchanged throughout the procedure in 53.2% and became worse as the test proceeded in the remaining patients. Anxiety and increased anal tone were found to be the only factors that had an impact on tolerance. The complications were: fever > 38 degrees C (0.7%), rectal bleeding that required admission to the observation ward (1%), hematuria (51.1%), hemospermia (21.3%), difficulty in voiding (2.5%) and urinary retention (0.3%). Moderate vagal reactions were the most common immediate complications (2.4%).


CONCLUSIONS
Ultrasound-guided transrectal biopsy is generally well-tolerated and with few complications. Rectal bleeding is the complication that most frequently requires management and causes more anxiety to patients, but infection is the most severe.