Transrektal ultrasonografi eşliğinde prostat biyopsisi öncesinde povidon iodin ve B.T enema karışımı ile rektal temizliğin işleme bağlı enfektif komplikasyonlara etkisi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hitit Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Transrektal prostat biyopsi yapılacak hastalara işlem öncesi B.T enema + Povidon İodin karışımı ile yapılan rektal temizliğin işleme bağlı enfektif komplikasyonlara olan etkisini prospektif olarak incelemeyi amaçladık. Gereç ve Yöntem: Hitit Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından alınan 40600303/604.02 numaralı kararı sonrası Eylül 2023 ve Mart 2024 tarihleri arasında üroloji polikliniğine başvuran, PSA yüksekliği veya PRM'de şüpheli lezyon varlığı nedeniyle ilk kez transrektal prostat biyopsi yapılması planlanan hastalar, rektal mukoza temizliği amacıyla rektal B.T enema + Povidon İodin karışımı veya sadece B.T enema kullanılarak oluşturulan 60'ar kişilik 2 gruba prospektif olarak randomize edildi. Tüm hastalara işlemden 1 gün önce antibiyotik profilaksisi başlandı ve işleme başlamadan hemen önce povidon iodin ile rektal mukoza temizliği uygulandı. Kontrol grubundaki hastalara işlemden 1 saat önce rektal B.T enema uygulanırken çalışma grubundaki hastalara işlemden 1 saat önce B.T enema ile 10cc povidon iodin karıştırılarak rektal olarak uygulandı. İşlem sonrası hastalar hematüri, hematospermi, rektal kanama, ateş, akut üriner retansiyon, hospitalizasyon, sepsis durumu, idrar kültürü ve kan kültürleri açısından değerlendirilip karşılaştırıldı. Bulgular: Çalışmaya 120 hasta dahil edildi. Kontrol grubundaki 6 hastanın (%10) idrar kültürü pozitif iken çalışma grubundaki hastaların idrar kültürleri steril görüldü ve istatistiksel olarak anlamlı bulundu (p=0,046). Ateşli üriner enfeksiyon nedeniyle kontrol grubunda 6 hasta (%10), çalışma grubunda 2 hasta (%3,3) hospitalize edildi. Hematüri, hematospermi, rektal kanama ve akut üriner retansiyon oranları arasında fark görülmedi. Sonuçlar: Bu çalışmada B.T enema + Povidon iodin karışımı ile yapılan rektal temizlik ile transrektal biyopsi sonrası pozitif idrar kültürü oranında anlamlı düşüş görülmüştür. Ateşli üriner enfeksiyon nedeniyle hospitalizasyon ve sepsis durumunda sayısal olarak düşme eğilimi görülse de istatistiksel olarak farklılık izlenmedi. Daha fazla hasta sayısı ile yapılacak geniş hasta sayılı çalışmalarda daha net veriler elde edilebilir. Anahtar Kelimeler: Prostat biyopsi, B.T enema, Povidon iodin, Enfeksiyon
Aim: We aimed to prospectively examine the effect of rectal cleaning with B.T enema + Povidone Iodine mixture on the infective complications related to the procedure in patients who will undergo transrectal prostate biopsy. Materials and Methods: Patients who applied to the urology clinic between September 2023 and March 2024 after the decision numbered 40600303/604.02 taken by the Hitit University Clinical Research Ethics Committee and who were planned to undergo transrectal prostate biopsy for the first time due to PSA elevation or the presence of a suspicious lesion in DRE, They were prospectively randomized into 2 groups of 60 people each, using the rectal B.T enema and povidone iodine mixture or B.T enema. Antibiotic prophylaxis was started in all patients 1 day before the procedure, and rectal mucosa cleaning was performed with povidone-iodine just before the procedure. While B.T enema was applied rectally to the patients in the control group 1 hour before the procedure, B.T enema and 10cc of povidone iodine were mixed and applied rectally to the patients in the study group 1 hour before the procedure. After the procedure, the patients were evaluated and compared in terms of hematuria, hematospermia, rectal bleeding, fever, acute urinary retention, hospitalization, sepsis, urine culture and blood cultures. Results: 120 patients were included in the study. While the urine culture of 6 patients (10%) in the control group was positive, the urine cultures of the patients in the study group were found to be sterile and were found to be statistically significant (p = 0.046). Due to febrile urinary infection, 6 patients (10%) in the control group and 2 patients (3.3%) in the study group were hospitalized. There was no difference in the rates of hematuria, hematospermia, rectal bleeding and acute urinary retention. Conclusion: In this study, a significant decrease was observed in the rate of positive urine culture after transrectal biopsy in rectal cleaning with B.T enema + Povidone iodine mixture. Although there was a numerical decreasing trend in cases of hospitalization due to febrile urinary infection and sepsis, no statistical difference was observed. More clear data can be obtained in studies with a larger number of patients. Keywords: Prostate biopsy, B.T enema, Povidone iodine, Infection
Aim: We aimed to prospectively examine the effect of rectal cleaning with B.T enema + Povidone Iodine mixture on the infective complications related to the procedure in patients who will undergo transrectal prostate biopsy. Materials and Methods: Patients who applied to the urology clinic between September 2023 and March 2024 after the decision numbered 40600303/604.02 taken by the Hitit University Clinical Research Ethics Committee and who were planned to undergo transrectal prostate biopsy for the first time due to PSA elevation or the presence of a suspicious lesion in DRE, They were prospectively randomized into 2 groups of 60 people each, using the rectal B.T enema and povidone iodine mixture or B.T enema. Antibiotic prophylaxis was started in all patients 1 day before the procedure, and rectal mucosa cleaning was performed with povidone-iodine just before the procedure. While B.T enema was applied rectally to the patients in the control group 1 hour before the procedure, B.T enema and 10cc of povidone iodine were mixed and applied rectally to the patients in the study group 1 hour before the procedure. After the procedure, the patients were evaluated and compared in terms of hematuria, hematospermia, rectal bleeding, fever, acute urinary retention, hospitalization, sepsis, urine culture and blood cultures. Results: 120 patients were included in the study. While the urine culture of 6 patients (10%) in the control group was positive, the urine cultures of the patients in the study group were found to be sterile and were found to be statistically significant (p = 0.046). Due to febrile urinary infection, 6 patients (10%) in the control group and 2 patients (3.3%) in the study group were hospitalized. There was no difference in the rates of hematuria, hematospermia, rectal bleeding and acute urinary retention. Conclusion: In this study, a significant decrease was observed in the rate of positive urine culture after transrectal biopsy in rectal cleaning with B.T enema + Povidone iodine mixture. Although there was a numerical decreasing trend in cases of hospitalization due to febrile urinary infection and sepsis, no statistical difference was observed. More clear data can be obtained in studies with a larger number of patients. Keywords: Prostate biopsy, B.T enema, Povidone iodine, Infection
Açıklama
Hitit Üniversitesi, Tıp Fakültesi
Anahtar Kelimeler
Prostat biyopsi, B.T enema, Povidon iodin, Enfeksiyon, Prostate biopsy, B.T enema, Povidone iodine, Infection, Prostat biyopsi, B.T enema, Povidon iodin, Enfeksiyon, Prostate biopsy, B.T enema, Povidone iodine, Infection
