Effects of Prior Biopsies on Complications of Multiparametric Magnetic Resonance Imaging / Transrectal Ultrasonography Fusion Prostate Biopsy: An Analytic Cross- Sectional Analysis of Prospectively Recorded Data

Objective Insufficient data exists about the examination of the impact of previous biopsies on complications in multiparametric magnetic resonance imaging (Mp-MRI) and transrectal ultrasonography (TRUS) fusion biopsies. We aimed to compare the complications of Mp-MRI / TRUS fusion transrectal prostate biopsy in patients who have not undergone a prostate biopsy before and in patients whose prior biopsy or biopsies. Methods The study consisted of a retrospective review of prospectively recorded data. The cohort of patients (n = 780) was categorized into three groups: group 1 (biopsy naive patients, n = 390), group-2a (consisting of patients who underwent a single biopsy, n = 278), and group-2b (consisting of patients who underwent at least two biopsies, n = 112). The demographic data of the patients, comorbidities, prostate-specific antigen results, Mp-MRI characteristics, biopsy data, and complications were compared between the groups. Results There was no significant difference between the groups in terms of metabolic syndrome, anticoagulant use, urinary infection history in the last 3 months, and antibiotic use in the last 3 months. While there was no difference between the groups in terms of post-procedural complication rates, peri-procedural complications (urethrorrhagia and rectal bleeding) were significantly higher in group 2b than in the other two groups. Conclusion When considering the Mp-MRI / TRUS fusion prostate biopsy for patients with a history of two or more previous biopsies, it is important to consider the risk of bleeding and take proper precautions for this specific group of patients. Alternatively, a transperineal biopsy may be considered.