Rates and Determinants of Complications Following Trans-Rectal Prostate Biopsy in Enugu, Nigeria

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.