Editing Prostate Biopsy (section)

== Complications[https://pubmed.ncbi.nlm.nih.gov/28363690/] ==
# '''<span style="color:#ff0000">Bleeding</span>'''
##'''<span style="color:#ff0000">Hematuria''' '''(≈50%)</span>'''
##*'''Needs intervention (e.g. clot retention) in <1%'''
##'''<span style="color:#ff0000">Hematospermia''' '''(≈50%)</span>'''
##*'''Can persist >4 week after biopsy in ≈30%'''
##'''<span style="color:#ff0000">Rectal bleeding''' '''(≈30%)</span>'''
##*Needs intervention in ≈2.5%
##*'''Avoided with transperineal biopsy'''
#'''<span style="color:#ff0000">Infection''' (prostatitis, fever, epididymitis) 
#*'''</span>Transrectal (≈5-7%) higher than transperineal'''
#*'''Transrectal'''
#**'''<span style="color:#ff0000">Infection requiring hospitalization: ≈1-3%</span>'''
#***'''Rates of hospital admission and mortality after TRUS-biopsy[https://pubmed.ncbi.nlm.nih.gov/23234616/]'''
#****Population: Population-based cohort study of 75,190 men who underwent a transrectal ultrasound guided biopsy in Ontario, Canada, between 1996 and 2005
#****Results:
#*****The 30-day hospital admission rate increased significantly from 1% in 1996 to 4% in 2005, the majority (72%) of which were for infection related reasons.
#*****The overall 30-day mortality rate was 0.09% but did not change during the study period.
#****Conclusions: Hospital admission rates for complications following TRUS guided prostate biopsy have increased dramatically during the last 10 years primarily due to an increasing rate of infection related complications.
#***'''Risk factors for prostate biopsy-related infection (6):'''
#***#'''Non-White race'''
#***#'''Increased number of comorbidities'''
#***#'''Diabetes mellitus'''
#***#'''Prostate enlargement'''
#***#'''Foreign travel'''
#***#'''Recent antibiotic use'''
#'''<span style="color:#ff0000">Transient (≈1 month) lower urinary tract symptoms''' '''6-25%</span>'''
#'''<span style="color:#ff0000">Urinary retention''' '''<1%</span>'''
#'''<span style="color:#ff0000">Transient (≈1 month)  erectile dysfunction</span> <1%'''
# '''<span style="color:#ff0000">False-negative (variable rate based on PSA)</span>'''
#* Initial cancer detection rate for patients with a PSA between 4 and 10 μg/mL is 22%; subsequent biopsies for an elevated PSA result in a cancer detection rate of 10% on the second biopsy, 5% on the third, and 4% on the forth
#* Data from the large European screening study suggested that as the number of biopsy sessions increased to ultimately diagnose prostate cancer, the cancers diagnosed after several biopsy sessions were generally of lower grade and stage
#'''<span style="color:#ff0000">Identifying prostate cancer that does not require treatment</span>'''
##Discussing this risk prior to biopsy may optimize use of AS