Contemporary prostate biopsy complication rates in community-based urology practice.

OBJECTIVES: To evaluate whether the increased number of rectal perforations associated with contemporary transrectal ultrasound-guided, 12-core prostate biopsy, with a periprostatic block, is associated with a greater rate of postprocedural complications. METHODS: We prospectively studied 1000 patients undergoing contemporary transrectal ultrasound-guided prostate biopsy and compared the rates of complicated urinary tract infection and significant rectal bleeding with the rates in our previous report of complications using a then-standard, 6-core biopsy technique, without a periprostatic block. RESULTS: Three patients developed complicated urinary tract infections, two of which were with ciprofloxacin-resistant organisms. This was not a significant different statistically from our earlier report. Seven patients had significant rectal bleeding requiring endoscopic intervention. This rate also was not significantly different statistically from our earlier report. CONCLUSIONS: Our infection and rectal bleeding complications associated with contemporary transrectal ultrasound-guided prostate biopsy were low. We experienced a small, nonstatistically significant, increase in the complicated urinary tract infection rate and a small, nonstatistically significant, increase in the rectal bleeding rate in association with the transition from an eight-core, no periprostatic block, technique to the contemporary technique.

Role of type 1 fimbria- and P fimbria-specific adherence in colonization of the neurogenic human bladder by Escherichia coli.

Recent clinical studies suggest that the deliberate colonization of the human bladder with a prototypic asymptomatic bacteriuria-associated bacterium, Escherichia coli 83972, may reduce the frequency of urinary tract infection in individuals with spinal cord injuries. However, the mechanism by which E. coli 83972 colonizes the bladder is unknown. We examined the role in bladder colonization of the E. coli 83972 genes papG and fimH, which respectively encode P and type 1 receptor-specific fimbrial adhesins. E. coli 83972 and isogenic papGDelta and papGDelta fimHDelta mutants of E. coli 83972 were compared for their capacities to colonize the neurogenic human bladder. Both strains were capable of stable colonization of the bladder. The results indicated that type 1 class-specific adherence and P class-specific adherence, while implicated as significant colonization factors in experiments that employed various animal model systems, were not required for colonization of the neurogenic bladder in human beings. The implications of these results with regard to the selection of potential vaccine antigens for the prevention of urinary tract infection are discussed.