How Safe is a Prostate Biopsy?

It’s considered a routine procedure, used to diagnose prostate cancer, and to monitor men in active surveillance. But new research at Hopkins suggests that at many hospitals, prostate biopsy may be slightly riskier than doctors realized. “This is an extremely common procedure,” says urologist Edward Schaeffer, M.D., Ph.D. “But since the early 1990s, when it first came into widespread use, antibiotic-resistant bacteria have emerged as a menace in hospitals nationwide.” Because of this, Schaeffer, along with urologists H. Ballentine Carter, M.D., and Stacy Loeb, M.D., recently wondered whether the procedure is as safe as it used to be.


“ We found that the rate of infectious
complications after prostate biopsy
has increased over time.”

To examine this question, the investigators looked at the rates of hospitalization for serious complications in male Medicare patients across the country who underwent prostate biopsy, and in similar patients who did not undergo biopsy. “Surprisingly, nearly 7 percent — almost three times as many as in the comparison group — of men who had a prostate biopsy were hospitalized within 30 days,” says Schaeffer. After taking into account other risk factors, the investigators found that the increased hospitalizations in the biopsy group were due both to biopsyrelated problems and to exacerbations of underlying medical conditions.

“We found that the rate of infectious complications after prostate biopsy has increased over time,” Schaeffer adds. The scientists believe that drug-resistant bacteria may be driving some of these complications. “These results suggest that prostate biopsy is not always a benign procedure, and this should be taken into account by patients and physicians before a man undergoes a biopsy.

“At Johns Hopkins, we take several measures to ensure that prostate biopsy is as safe as possible, and have a low rate of complications. The findings of this analysis were surprising to us.” The next step, the investigators say, is to figure out how to make biopsies even safer, at Hopkins and elsewhere.

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