The Effect of Targeted Antibiotic Prophylaxis on Lower Urinary Tract Symptoms Following Prostate Biopsy: A Prospective Randomized Trial

Abstract

Objective: Targeted antibiotic prophylaxis in prostate biopsy is recommended for patients at risk due to increased complication rates seen in recent years. Lower urinary tract symptoms (LUTS) is currently one of the most prevalent complications with a rate of more than 40%. The study examined the effects of targeted antibiotic prophylaxis on biopsy-related LUTS and to compare the results with standard prophylaxis.Materials and Methods: A total of 240 patients were included in the study, 120 of whom had been administered targeted antibiotic prophylaxis and 120 of whom had received ciprofloxacin treatment between January 2021-Januray 2023. Patients' results before the procedure, on the 7th day, and in the first month were prospectively recorded and compared.Results: While Qmax mean values were measured as 18.3 +/- 5.1 mL/s in the targeted prophylaxis group and 17.4 +/- 4.6 mL/s in the control group (p=0.157) before the procedure, these values were found to be 14.6 +/- 3.3 mL/s and 11.7 +/- 4.1 mL/s (p<0.001) on the 7th day and 16.8 16.8 +/- 4.3 mL/s and 14.9 +/- 3.5 mL/s (p=0.013) in first month, respectively. IPSS mean scores of the groups were calculated as 16.8 +/- 4.3 mL/s and 14.9 +/- 3.5 mL/s (p=0.013) before the procedure, respectively, while these scores were found to be 18.12 +/- 6.1 and 22.97 +/- 7.4 (p<0.001) on the 7th day and 17.5 +/- 5.5 and 22.8 +/- 7.5 (p<0.001) in the first month, respectively.Conclusion: In this study, we found that targeted antibiotic prophylaxis had a significant effect on preventing biopsy-related LUTS. We believe that routine application of targeted antibiotic prophylaxis can be effective in reducing the rates of biopsy-related LUTS.