Participants
A total of 419 patients were evaluated retrospectively between January 2015 and December 2020. The patients had undergone TRUS-bx due to prostate cancer suspicion following total prostate-specific antigen (tPSA) of ≥4 ng/mL or digital rectal examination and lesions with a PIRADS score of ≥3 on multi-parametric MRI. Patients with histories of anticoagulant use, uncontrolled diabetes mellitus, urological surgery, prior TRUS-bx, recent hospitalization, recent overseas travel, or prostatitis were excluded from the study. Uncontrolled diabetes was defined as an HgbA1c level of ≥7 (11). Informed consent was obtained from all patients, and all procedures were performed by experienced staff.
Prebiopsy urinary cultures were routinely obtained, and all patients received cephalosporine and aminoglycoside prophylaxis 24 hours before the biopsy which was also continued afterwards for seven days. All biopsies were taken using an 18-gauge prostate biopsy needle with transrectal ultrasound guidance. According to current practice, 12 core samples were obtained in standard fashion. Patients were discharged on the same day in the absence of abnormal rectal or urethral bleeding or urinary retention. Two weeks after the biopsy, patients were called for control, and they were asked to attend the hospital in case of acute symptoms such as high fever, severe rectal bleeding, and general condition disorder.