Research Article | | Peer-Reviewed

Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study

Received: 9 January 2026     Accepted: 19 January 2026     Published: 2 February 2026
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Abstract

Introduction: Prostate cancer is a common malignancy affecting men beyond middle age. In developed countries, the life time risk of developing microscopic prostate cancer in men is 30%. Prostate cancer is a slow-growing tumor and the risk of developing clinical disease is 16% with 3% lifetime risk of dying from the disease. Prostate biopsy serves as a means for obtaining specimen for cancer diagnosis. The procedure though relatively simple and safe may result in complications hence the need to take some precautions during patient preparation. There is wide variability in the workup protocol amongst urologist with no consensus. The aim of this study was to compare bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infectious complications following transrectal prostate biopsy. Methodology: Patients who met the inclusion criteria were randomized into two groups. Group I had bowel preparation and antibiotic prophylaxis while group II received antibiotic prophylaxis only. Both groups were followed up and assessed for complications. Data were collected and analyzed using SPSS Version 20. Data were presented using tables and figures and p-value of < 0.05 was considered statistically significant. Results: A total of 106 men were recruited for the study. Subjects were randomized into two groups. Group I had 54 subjects while group II had 52 subjects. Age range was 48-96 years with a mean age of 65.4±10.4 years. Both groups had comparable socio-demographic and clinical characteristics. Overall Infective complication in this study was seen in 72 (67.9%). Incidence of significant complication requiring hospitalization was seen in 5 (4.7%). For group I infective complication was seen in 28 (51.8%) while for group II 47 (90.2%) patients had infective complications (p = 0.009). The incidence of significant complications requiring hospitalization was 2 (3.7%) for group I and 3 (5.8%) for group II (p = 0.675). Conclusion: Overall there is statistically significant difference between the use of bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infective complication following transrectal prostate biopsy.

Published in International Journal of Clinical Oncology and Cancer Research (Volume 11, Issue 1)
DOI 10.11648/j.ijcocr.20261101.13
Page(s) 22-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Prostate, Cancer, Biopsy, Transrectal, Antibiotics, Infections

References
[1] Yeboah E. The prostate gland. In: Badoe E, Archampong E, da Rocha-Afodu J, editors. Principles and Practice of Surgery Including Pathology in the Tropics. 4th ed. Accra: Ghana Publishing Co-operation. 2009. 917–952.
[2] Osegbe DN. Prostate Cancer in Nigerians: Facts and Nonfacts J Urol. 1997; 157(4): 1340–1343.
[3] Brawley OW. Trends in Prostate Cancer in the United States. J Natl Cancer Inst - Monogr. 2012; (45): 152–156.
[4] Wagenlehner FME, Pilatz A, Waliszewski P, Weidner W, Johansen TEB. Reducing Infection Rates after Prostate Biopsy. Nat Rev Urol. 2014; 11(2): 80–86.
[5] Ikuerowo SO, Bioku MJ, Omisanjo OA, Esho JO. Urologic Day case Surgery: A Five Year Experience. Niger J Clin Pract. 2013; 16(1): 28–30.
[6] Aisuodionoe-Shadrach O. Range of Urologic Surgical Procedures in Two District Tertiary Care Hospitals in Abuja, Nigeria. Afr J Urol. 2011; 17(3): 92–96.
[7] Sowande O, Takure A, Salako A, Badmus T, Olajide A, Banjo O, et al. Day Case Urology in a Dedicated Day Case Surgery Unit in a Nigerian Teaching Hospital. Ambul Surg. 2009; 152(2): 24–26.
[8] Tyng C, Maciel M, Moreira B. Preparation and Management of Complications in Prostate Biopsies. Radiol Bras. 2013; 46: 367–371.
[9] Shandera KC, Thibault GP, Deshon GE Jr. Variability in Patient Preparation for Prostate Biopsy among American Urologists. Urology. 1998 Oct; 52(4): 644-6.
[10] Williamson DA, Roberts SA, Paterson DL, Sidjabat H, Silvey A, Masters J, Rice M, Freeman JT. Escherichia Coli Bloodstream Infection after Transrectal Ultrasound-guided Prostate Biopsy: Implications of Fluoroquinolone-resistant Sequence Type 131 as a Major Causative Pathogen. Clin Infect Dis. 2012 May; 54(10): 1406-12.
[11] Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Complications after Prostate Biopsy: Data from SEER-Medicare. J Urol. 2011 Nov; 186(5): 1830-4.
[12] Aron M, Rajeev TP, Gupta NP. Antibiotic Prophylaxis for Transrectal Needle Biopsy of the Prostate: A Randomized Controlled Study. BJU Int. 2000 Apr; 85(6): 682-5.
[13] Enlund AL, Varenhorst E. Morbidity of Ultrasound-guided Transrectal Core Biopsy of the Prostate without Prophylactic Antibiotic Therapy. A Prospective Study in 415 Cases. Br J Urol. 1997 May; 79(5): 777-80.
[14] Agbugui JO, Obarisiagbon EO, Osaigbovo EO, Osime CO, Akumabor PN. Antibiotic Prophylaxis for Transrectal Prostate Biopsy: A Comparison of One-day and Five-day Regimen. Niger Postgrad Med J. 2014 Sep; 21(3): 213-7.
[15] Rodríguez LV, Terris MK. Risks and Complications of Transrectal Ultrasound Guided Prostate Needle Biopsy: A Prospective Study and Review of the Literature. J Urol. 1998 Dec; 160(6 Pt 1): 2115-20.
[16] Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, Rosario DJ, Scattoni V, Lotan Y. Systematic Review of Complications of Prostate Biopsy. Eur Urol. 2013 Dec; 64(6): 876-92.
[17] Sharpe JR, Sadlowski RW, Finney RP, Branch WT, Hanna JE. Urinary Tract Infection after Transrectal Needle Biopsy of the Prostate. J Urol. 1982 Feb; 127(2): 255-6.
[18] Carey JM, Korman HJ. Transrectal Ultrasound Guided Biopsy of the Prostate. Do Enemas Decrease Clinically Significant Complications? J Urol. 2001 Jul; 166(1): 82-5. PMID: 11435829.
[19] Edouard J, Ethan J, Leonard G. Ultrasonography and Biopsy of the Prostate. In: Louis R, et al, Editors. Campbell-Walsh Urology. 10th ed. Philadelphia: WB Saunders Co; 2012. 2735–2747.
[20] El-Hakim A, Moussa S. CUA Guidelines on Prostate Biopsy Methodology. Can Urol Assoc J. 2010 Apr; 4(2): 89-94.
[21] Ecke TH, Gunia S, Bartel P, Hallmann S, Koch S, Ruttloff J. Complications and Risk Factors of Transrectal Ultrasound Guided Needle Biopsies of the Prostate Evaluated by Questionnaire. Urol Oncol Semin Orig Investig. 2008; 26(5): 474–478.
[22] Ezenwa E, Tijani K, Jeje A, Ogunjimi A, Ojewola R. Prevalence Of Prostate Cancer Among Nigerians with Intermediate Total Prostate Specific Antigen Levels (410ng/Ml): Experience At Lagos University Teaching Hospital, Nigeria. J internet Urol. 2012; 9(3): 1.
[23] Chiang IN, Chang SJ, Pu YS, Huang KH, Yu HJ, Huang CY. Major Complications and Associated Risk Factors of Transrectal Ultrasound Guided Prostate Needle Biopsy: A Retrospective Study of 1875 Cases in Taiwan. J Formos Med Assoc. 2007 Nov; 106(11): 929-34.
[24] Williamson DA, Barrett LK, Rogers BA, Freeman JT, Hadway P, Paterson DL. Infectious Complications Following Transrectal Ultrasound-guided Prostate Biopsy: New Challenges in the era of Multidrug-resistant Escherichia coli. Clin Infect Dis. 2013 Jul; 57(2): 267-74.
[25] Shittu O, Kamara T. Transrectal Biopsy of the Prostate Gland in Ibadan. Niger J Surg Res. 2001; 3(3-4): 159–164.
[26] Lee SJ. Infection after Transrectal Ultrasound Guided Prostate Biopsy. Korean Journal of Urology. 2015; 56(5): 346–350.
[27] CDC. Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events. Modul Device-associated. 2015(April): 1–15.
[28] Lindert KA, Kabalin JN, Terris MK. Bacteremia and Bacteriuria after Transrectal Ultrasound Guided Prostate Biopsy. J Urol. 2000; 164(1): 76–80.
[29] Jeon SS, Woo SH, Hyun JH, Choi HY, Chai SE. Bisacodyl Rectal Preparation Can Decrease Infectious Complications of Transrectal Ultrasound-guided Prostate Biopsy. Urology. 2003; 62(3): 461–466.
[30] Ruddick F, Sanders P, Bicknell SG, Crofts P. Sepsis Rates after Ultrasound-guided Prostate Biopsy Using a Bowel Preparation Protocol in a Community Hospital. J Ultrasound Med. 2011; 30(2): 213–216.
[31] Pilatz A, Alidjanov J, Bonkat G, Wagenlehner F. Prostatabiopsie – Bopsy-infection Prophylaxis and Patient Preparation. Urology. 2023 May; 62(5): 459-463. German.
[32] Tsuboi I, Matsukawa A, Parizi MK, Klemm J, Mancon S, Chiujdea S, Fazekas T, Laukhtina E, Kawada T, Katayama S, Iwata T, Bekku K, Wada K, Araki M, Shariat SF. Infection Risk Reduction with Povidone-iodine Rectal Disinfection Prior to Transrectal Prostate Biopsy: An Updated Systematic Review and Meta-analysis. World J Urol. 2024 Apr 23; 42(1): 252.
Cite This Article
  • APA Style

    Felix, M., Kenenna, O., Venyir, R., Oseremen, A., Emeka, A. (2026). Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study. International Journal of Clinical Oncology and Cancer Research, 11(1), 22-31. https://doi.org/10.11648/j.ijcocr.20261101.13

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    ACS Style

    Felix, M.; Kenenna, O.; Venyir, R.; Oseremen, A.; Emeka, A. Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study. Int. J. Clin. Oncol. Cancer Res. 2026, 11(1), 22-31. doi: 10.11648/j.ijcocr.20261101.13

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    AMA Style

    Felix M, Kenenna O, Venyir R, Oseremen A, Emeka A. Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study. Int J Clin Oncol Cancer Res. 2026;11(1):22-31. doi: 10.11648/j.ijcocr.20261101.13

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  • @article{10.11648/j.ijcocr.20261101.13,
      author = {Magnus Felix and Obiatuegwu Kenenna and Ramyil Venyir and Aisuodionoe-Shadrach Oseremen and Alobu Emeka},
      title = {Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study},
      journal = {International Journal of Clinical Oncology and Cancer Research},
      volume = {11},
      number = {1},
      pages = {22-31},
      doi = {10.11648/j.ijcocr.20261101.13},
      url = {https://doi.org/10.11648/j.ijcocr.20261101.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20261101.13},
      abstract = {Introduction: Prostate cancer is a common malignancy affecting men beyond middle age. In developed countries, the life time risk of developing microscopic prostate cancer in men is 30%. Prostate cancer is a slow-growing tumor and the risk of developing clinical disease is 16% with 3% lifetime risk of dying from the disease. Prostate biopsy serves as a means for obtaining specimen for cancer diagnosis. The procedure though relatively simple and safe may result in complications hence the need to take some precautions during patient preparation. There is wide variability in the workup protocol amongst urologist with no consensus. The aim of this study was to compare bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infectious complications following transrectal prostate biopsy. Methodology: Patients who met the inclusion criteria were randomized into two groups. Group I had bowel preparation and antibiotic prophylaxis while group II received antibiotic prophylaxis only. Both groups were followed up and assessed for complications. Data were collected and analyzed using SPSS Version 20. Data were presented using tables and figures and p-value of < 0.05 was considered statistically significant. Results: A total of 106 men were recruited for the study. Subjects were randomized into two groups. Group I had 54 subjects while group II had 52 subjects. Age range was 48-96 years with a mean age of 65.4±10.4 years. Both groups had comparable socio-demographic and clinical characteristics. Overall Infective complication in this study was seen in 72 (67.9%). Incidence of significant complication requiring hospitalization was seen in 5 (4.7%). For group I infective complication was seen in 28 (51.8%) while for group II 47 (90.2%) patients had infective complications (p = 0.009). The incidence of significant complications requiring hospitalization was 2 (3.7%) for group I and 3 (5.8%) for group II (p = 0.675). Conclusion: Overall there is statistically significant difference between the use of bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infective complication following transrectal prostate biopsy.},
     year = {2026}
    }
    

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  • TY  - JOUR
    T1  - Bowel Preparation Plus Antibiotic Prophylaxis Versus Antibiotic Prophylaxis Alone for Transrectal Prostate Biopsy: A Comparative Study
    AU  - Magnus Felix
    AU  - Obiatuegwu Kenenna
    AU  - Ramyil Venyir
    AU  - Aisuodionoe-Shadrach Oseremen
    AU  - Alobu Emeka
    Y1  - 2026/02/02
    PY  - 2026
    N1  - https://doi.org/10.11648/j.ijcocr.20261101.13
    DO  - 10.11648/j.ijcocr.20261101.13
    T2  - International Journal of Clinical Oncology and Cancer Research
    JF  - International Journal of Clinical Oncology and Cancer Research
    JO  - International Journal of Clinical Oncology and Cancer Research
    SP  - 22
    EP  - 31
    PB  - Science Publishing Group
    SN  - 2578-9511
    UR  - https://doi.org/10.11648/j.ijcocr.20261101.13
    AB  - Introduction: Prostate cancer is a common malignancy affecting men beyond middle age. In developed countries, the life time risk of developing microscopic prostate cancer in men is 30%. Prostate cancer is a slow-growing tumor and the risk of developing clinical disease is 16% with 3% lifetime risk of dying from the disease. Prostate biopsy serves as a means for obtaining specimen for cancer diagnosis. The procedure though relatively simple and safe may result in complications hence the need to take some precautions during patient preparation. There is wide variability in the workup protocol amongst urologist with no consensus. The aim of this study was to compare bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infectious complications following transrectal prostate biopsy. Methodology: Patients who met the inclusion criteria were randomized into two groups. Group I had bowel preparation and antibiotic prophylaxis while group II received antibiotic prophylaxis only. Both groups were followed up and assessed for complications. Data were collected and analyzed using SPSS Version 20. Data were presented using tables and figures and p-value of < 0.05 was considered statistically significant. Results: A total of 106 men were recruited for the study. Subjects were randomized into two groups. Group I had 54 subjects while group II had 52 subjects. Age range was 48-96 years with a mean age of 65.4±10.4 years. Both groups had comparable socio-demographic and clinical characteristics. Overall Infective complication in this study was seen in 72 (67.9%). Incidence of significant complication requiring hospitalization was seen in 5 (4.7%). For group I infective complication was seen in 28 (51.8%) while for group II 47 (90.2%) patients had infective complications (p = 0.009). The incidence of significant complications requiring hospitalization was 2 (3.7%) for group I and 3 (5.8%) for group II (p = 0.675). Conclusion: Overall there is statistically significant difference between the use of bowel preparation plus antibiotic prophylaxis versus antibiotic prophylaxis alone in reducing the infective complication following transrectal prostate biopsy.
    VL  - 11
    IS  - 1
    ER  - 

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Author Information
  • Department of Surgery, Chivar Specialist Hospital and Urology Center Limited, Abuja, Nigeria

  • Department of Surgery, Federal Medical Center, Abuja, Nigeria

  • Department of Surgery, Jos University Teaching Hospital, Plateau, Nigeria

  • Department of Surgery, University of Abuja Teaching Hospital Gwagwalada, Abuja, Nigeria

  • Department of Surgery, Jos University Teaching Hospital, Plateau, Nigeria

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