Is there any effect of long term alpha-adrenergic blocker and a single dose antibiotic usage in reducing febrile urinary tract infections after prostate biopsy?

Abstract

Aim: To investigate whether the using long term alpha-adrenergic blockers before biopsy has an effect on preventing febrile urinary tract infections (FUI) secondary to biopsy in patients undergoing prostate biopsy due to elevated prostate specific antigen (PSA) .Material and Method: The data of 2558 patients who underwent transrectal ultrasonography-guided prostate biopsy (TRUS+BX) due to elevated PSA in our clinic between January 2008 and July 2021 were analyzed retrospectively. The patients were divided into two groups as those who used alpha-blockers for a minimum of three months or longer before biopsy (Group 1) and those who did not use alpha-blockers before applying to the outpatient clinic (Group 2) . Demographic data of the groups and post-biopsy FUI development rates were compared.Results: It was observed that 1340 (52.4%) of the patients were using alpha-blockers (Group 1) and 1218 (47.6%) did not (Group 2) . The median age of the patients in the pre-biopsy groups was similar [Group 1=68 (IQR=9) years and Group 2=68 (IQR=9) years, p=0.887]. There was no significant difference between the groups in terms of median prostate volume [Group1=57 (31) ml and Group 2=58 (34) ml, p=0.199]. The median PSA value was found to be significantly higher in Group 1 than in Group 2 [10.50 (5.40) ng/dl vs 10.35 (6.80) ng/dl, p=0.026]. Postvoid residual urine volume (PVR) was found to be significantly higher in Group 2 [Group 1=40 (30) ml and Group2=60 (90) ml, p<0.001]. Similarly, the frequency of FUI development after biopsy was found to be significantly higher in Group 2 [Group 1=17 (1.3%) and Group 2=65 (5.3%) , p<0.001].Conclusion: The use of alpha-adrenergic blockers for a minimum of three months or longer before prostate biopsy significantly reduces the incidence of FUI that may develop secondary to biopsy.