DOI: 10.33631/sabd.1853135 ISSN: 2792-0542

Is Routine Urine Culture Necessary Before Transrectal Prostate Biopsy Under Current Prophylaxis and Antisepsis Practices? A Retrospective Cohort Study

Ahmet Yıldırım Balık, Emre Ediz, Burak Ayvacık, Arda Taşkın Taşkıran, Ekrem Başaran, Dursun Baba, Muhammet Ali Kayıkçı
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Aim: To evaluate the effect of routine urine culture screening before prostate biopsy on post-procedural infectious complications in patients undergoing transrectal prostate biopsy (TRUS-PB) performed under cephalosporin-based prophylaxis and modern antisepsis protocols.Material and Methods: 295 consecutive patients who underwent TRUS-PB in our clinic between January 2024 and June 2025 were retrospectively reviewed. Patients were divided into two groups: Group 1 (n=130), patients who did not have a urine culture in the last month, and Group 2 (n=165), patients who did. All patients received cephalosporin prophylaxis, rectal povidone-iodine cleaning during the procedure, and formalin disinfection of the needle tip after each core. Data were recorded retrospectively from the hospital information management system and patient files. Post-biopsy infectious complications were recorded.Results: No significant differences were observed between the groups regarding serum PSA levels (p=0.251), total number of cores (p=0.200), and diabetes mellitus rates (p=0.345). The total infection rate was 2.03% (n=6); it was 2.31% (n=3) in Group 1 and 1.82% (n=3) in Group 2 (p=1.000). Post-biopsy urine culture positivity was detected in a total of 3 patients (1.02%); it was 0.77% (n=1) in Group 1 and 1.21% (n=2) in Group 2 (p=1.000). No statistical difference was found between the groups in terms of hospitalization rates due to infection (Group 1: 1.54% vs. Group 2: 1.21%) (p=1.000). Sepsis did not develop in either group during the study period.Conclusion: Routine urine culture screening and sterilization follow-up may not be routinely necessary in asymptomatic patients before prostate biopsy when current prophylaxis and antisepsis rules are followed. However, these results need to be supported by larger and prospective randomized studies.

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