Rates and Determinants of Complications Following Trans-Rectal Prostate Biopsy in Enugu, Nigeria
F. O. Ugwumba *
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
I. I. Nnabugwu
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
K. N. Echetabu
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
A. D. Okoh
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
E. I. Udeh
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aims: Analysis of the complications of trans rectal prostate biopsy to establish their rates and determinants.
Study Design: Retrospective study.
Place and Duration of Study: Departments of Urology University of Nigeria Teaching Hospital, Saint Mary’s Hospital, Mother of Christ Specialist Hospital, Royal Hospital, and East Side Hospital Enugu between January 2009 and December 2015.
Methodology: One hundred and twenty four patients who had transrectal prostate biopsy were assessed. Complications were graded according to the Clavien-Dindo classification. Grade 1 was regarded as minor and grade 2 classified as major.
Statistical analysis used: simple means and percentages. Categorical variables were analyzed with the Chi square test. P-value was < 0.05.
Results: Age range was 44 to 90 years, mean (66.6±9.96). Mean PSA value was 13.1ng/ml.
Mean prostate volume was 88.7ml (46 – 210). Minor complications were mostly hemorrhagic, with primary macroscopic hematuria occurring in 43/124 patients (34.6%) and acute urinary retention in 8/124 patients (6.45%).
Major complications seen include urosepsis in 5/124 patients (4.03%) and severe haematuria in 2/124 patients (1.61%).The occurrence of major complications were analyzed by Chi square test against potential determinants; age group, prostate specific antigen (PSA) level and prostate volume (PV).
For age and AUR, there is a significant difference in occurrence of AUR (p=0.01).
For age and urosepsis, the result is significant at (p=0.01). For PSA and AUR, the result is significant at (p=.00). For PSA and urosepsis, the result is significant at (p=.00). For prostate volume and AUR, the result is significant at (p=.00). For PV and urosepsis the result is significant at (p=.03). There was no mortality.
Conclusion: Transrectal Prostate biopsy has a low incidence of major complications.
The occurrence of AUR and urosepsis showed significant associations with age, PSA, and prostate volume.
Keywords: Transrectal, prostate biopsy, complications, determinants, Nigeria.