Formalin disinfection of prostate biopsy needles may reduce post-biopsy infectious complications

N. Singla, J. Walker, S. L. Woldu, N. M. Passoni, K. de la Fuente, Claus Roehrborn

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background:We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).Methods:We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10% formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Our primary outcome was post-biopsy UTI rates, defined as a positive urine culture within 30 days of biopsy. Infection severity was characterized by the need for admission. Patient demographics, prostate size, prior biopsies, prior UTIs, pre-biopsy antibiotics and cultures and post-biopsy cultures were analyzed. Logistic regression was used to assess predictors of post-biopsy UTIs. Statistical significance was defined as P<0.05.Results:A total of 756 patients were included for analysis, including 253 who received formalin disinfection and 503 who did not. Of these, 32 patients (4.2%) experienced post-biopsy UTIs, with 8 requiring admission (all without formalin use). Infection rates were more than double in the group that did not receive formalin (5.2% vs 2.3%, P=0.085). More patients in the formalin group had undergone prior biopsies (73.9% vs 31.8%, P<0.001). On multivariable analysis, prior UTI (odds ratio (OR) 3.77, P=0.006) was a significant predictor for post-biopsy infection, whereas formalin disinfection trended towards a protective effect (OR 0.41, P=0.055).Conclusion:Infectious complications following prostate biopsy may be mitigated by the use of formalin disinfection of the biopsy needle between cores.Prostate Cancer and Prostatic Diseases advance online publication, 24 January 2017; doi:10.1038/pcan.2016.70.

Original languageEnglish (US)
JournalProstate Cancer and Prostatic Diseases
DOIs
StateAccepted/In press - Jan 24 2017

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Disinfection
Needle Biopsy
Formaldehyde
Prostate
Biopsy
Urinary Tract Infections
Large-Core Needle Biopsy
Infection
Odds Ratio
Prostatic Diseases
Ambulatory Care Facilities
Needles
Publications
Prostatic Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research

Cite this

Formalin disinfection of prostate biopsy needles may reduce post-biopsy infectious complications. / Singla, N.; Walker, J.; Woldu, S. L.; Passoni, N. M.; de la Fuente, K.; Roehrborn, Claus.

In: Prostate Cancer and Prostatic Diseases, 24.01.2017.

Research output: Contribution to journalArticle

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title = "Formalin disinfection of prostate biopsy needles may reduce post-biopsy infectious complications",
abstract = "Background:We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).Methods:We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10{\%} formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Our primary outcome was post-biopsy UTI rates, defined as a positive urine culture within 30 days of biopsy. Infection severity was characterized by the need for admission. Patient demographics, prostate size, prior biopsies, prior UTIs, pre-biopsy antibiotics and cultures and post-biopsy cultures were analyzed. Logistic regression was used to assess predictors of post-biopsy UTIs. Statistical significance was defined as P<0.05.Results:A total of 756 patients were included for analysis, including 253 who received formalin disinfection and 503 who did not. Of these, 32 patients (4.2{\%}) experienced post-biopsy UTIs, with 8 requiring admission (all without formalin use). Infection rates were more than double in the group that did not receive formalin (5.2{\%} vs 2.3{\%}, P=0.085). More patients in the formalin group had undergone prior biopsies (73.9{\%} vs 31.8{\%}, P<0.001). On multivariable analysis, prior UTI (odds ratio (OR) 3.77, P=0.006) was a significant predictor for post-biopsy infection, whereas formalin disinfection trended towards a protective effect (OR 0.41, P=0.055).Conclusion:Infectious complications following prostate biopsy may be mitigated by the use of formalin disinfection of the biopsy needle between cores.Prostate Cancer and Prostatic Diseases advance online publication, 24 January 2017; doi:10.1038/pcan.2016.70.",
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N2 - Background:We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).Methods:We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10% formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Our primary outcome was post-biopsy UTI rates, defined as a positive urine culture within 30 days of biopsy. Infection severity was characterized by the need for admission. Patient demographics, prostate size, prior biopsies, prior UTIs, pre-biopsy antibiotics and cultures and post-biopsy cultures were analyzed. Logistic regression was used to assess predictors of post-biopsy UTIs. Statistical significance was defined as P<0.05.Results:A total of 756 patients were included for analysis, including 253 who received formalin disinfection and 503 who did not. Of these, 32 patients (4.2%) experienced post-biopsy UTIs, with 8 requiring admission (all without formalin use). Infection rates were more than double in the group that did not receive formalin (5.2% vs 2.3%, P=0.085). More patients in the formalin group had undergone prior biopsies (73.9% vs 31.8%, P<0.001). On multivariable analysis, prior UTI (odds ratio (OR) 3.77, P=0.006) was a significant predictor for post-biopsy infection, whereas formalin disinfection trended towards a protective effect (OR 0.41, P=0.055).Conclusion:Infectious complications following prostate biopsy may be mitigated by the use of formalin disinfection of the biopsy needle between cores.Prostate Cancer and Prostatic Diseases advance online publication, 24 January 2017; doi:10.1038/pcan.2016.70.

AB - Background:We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).Methods:We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10% formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Our primary outcome was post-biopsy UTI rates, defined as a positive urine culture within 30 days of biopsy. Infection severity was characterized by the need for admission. Patient demographics, prostate size, prior biopsies, prior UTIs, pre-biopsy antibiotics and cultures and post-biopsy cultures were analyzed. Logistic regression was used to assess predictors of post-biopsy UTIs. Statistical significance was defined as P<0.05.Results:A total of 756 patients were included for analysis, including 253 who received formalin disinfection and 503 who did not. Of these, 32 patients (4.2%) experienced post-biopsy UTIs, with 8 requiring admission (all without formalin use). Infection rates were more than double in the group that did not receive formalin (5.2% vs 2.3%, P=0.085). More patients in the formalin group had undergone prior biopsies (73.9% vs 31.8%, P<0.001). On multivariable analysis, prior UTI (odds ratio (OR) 3.77, P=0.006) was a significant predictor for post-biopsy infection, whereas formalin disinfection trended towards a protective effect (OR 0.41, P=0.055).Conclusion:Infectious complications following prostate biopsy may be mitigated by the use of formalin disinfection of the biopsy needle between cores.Prostate Cancer and Prostatic Diseases advance online publication, 24 January 2017; doi:10.1038/pcan.2016.70.

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