Association between pre-biopsy white blood cell count and prostate biopsy - related sepsis

Cent European J Urol. 2015;68(1):86-90. doi: 10.5173/ceju.2015.01.508. Epub 2015 Mar 13.

Abstract

Introduction: Despite all preventive measures and improved biopsy techniques, serious, life-threatening complications of prostate biopsy, including sepsis, still exist. In the present study, in order to identify the risk factors that may be associated with sepsis development after prostate-biopsy, we aimed to analyze retrospectively the data of our patients who underwent transrectal ultrasound-guided prostate biopsy.

Material and methods: We retrospectively reviewed the data of 889 patients who underwent prostate biopsy at our clinic. We compared pre-biopsy parameters (age, prostate volume, white blood cell (WBC) count, fasting blood glucose, free and total prostate specific antigen levels) between patients who developed sepsis and those who were sepsis-free following prostate biopsy.

Results: 28 patients (3.1%) developed sepsis. Among the risk factors evaluated, only pre-biopsy WBC count was found to be a significant risk factor for biopsy-related sepsis. A 5.1 fold increase was detected in the risk for sepsis development, when the cut-off value of WBC was accepted as 11.165/μL, OR: 5.1 (95% CI: 2.3-11.5). The post-biopsy sepsis development rate in patients with pre-biopsy WBC count greater and less than 11.165/μL was 13.7% (n = 10) and 3% (n = 18) respectively.

Conclusions: Patients with a pre-biopsy WBC count greater than 11.165/μL should be informed of the increased risk of developing post-biopsy sepsis.

Keywords: biopsy; leukocytosis; prostate; sepsis.