Primum non nocere (first, to do no harm) in prostate biopsy

摘要

Urological symptoms are very common and could present in a wide variety of forms. 1 2 In this issue of Hong Kong Medical Journal, Cheng et al 3 report on emergency attendances and hospitalisations for complications within 30 days after transrectal ultrasound-guided prostate (TRUS) biopsy in two hospitals in Hong Kong. The recorded complications tend to be those that are more severe and require emergency attendances or hospitalisations. Reported rates of sepsis are more accurate as they usually require hospital care. The reported rates of complications such as per rectal bleeding (0.4%) and gross haematuria (2.1%) were patients that required hospital care, and these are likely much lower than the actual rates. Reported rates of per rectal bleeding and gross haematuria in a systematic review were 11% to 40% and 28% to 64%, respectively. 4 Although most complications subside within 1 to 2 weeks, there are some potential adverse events that patients should acknowledge. Another point to note is that about 50% of biopsies in this series had 10 biopsy cores taken and this might contribute to a lower complication rate.