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2015, Número 6

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Rev Med Inst Mex Seguro Soc 2015; 53 (6)


Iodopovidona intrarrectal y riesgo de infección genitourinaria posterior a biopsia prostática transrectal

Moreno-Palacios J, Espinosa-Guerrero A, Torres-Anguiano JR, Montoya- Martínez G, López-Samano V, Serrano-Brambila E

Idioma: Español
Referencias bibliográficas: 23
Paginas: 728-731
Archivo PDF: 307.40 Kb.


RESUMEN

Introducción: el objetivo de este estudio es comparar dos preparaciones distintas en pacientes sometidos a la toma de biopsias prostáticas transrectales (BPTR) y evaluar la prevalencia de infecciones genitourinarias (IGU).
Métodos: se compararon dos grupos de pacientes con sospecha de cáncer de próstata sometidos a Biopsia Prostática Transrectal (BPTR): Con jalea lubricante endorrectal (grupo l, cohorte histórica) y con jalea lubricante más iodopovidona (grupo II, cohorte prospectiva). Se evaluaron las complicaciones a las tres semanas. Se realizó un análisis bivariado, calculando su OR (IC: 95 %) para determinar si la iodopovidona endorrectal adicional previa a la BPTR disminuye las IGU y otras complicaciones.
Resultados: Se evaluaron 185 pacientes (Grupo I n = 86; grupo II n = 96). Tuvieron infección del tracto genitourinario el 45 y 25 % (OR: 0.4, IC: 0.2-0.9, p = 0.004); la fiebre se presentó en el 21 y 10 % respectivamente (OR: 0.42, IC: 0.1-0.9, p = 0.04).
Conclusiones: Se observó una reducción en la presencia de infecciones genitourinarias en pacientes a quienes se aplicó en su preparación iodopovidona intrarrectal.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.

  2. Herranz-Amo F, Díez-Cordero JM, Cabello-Benavente R. Evolución de la Técnica de Biopsia Transrectal Ecodirigida de la Próstata. Arch. Esp. Urol. 2006; 59 (4):385-396.

  3. Levine MA, Ittman M, Melamed J, Lepor H. Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 1998;159(2):471-5.

  4. Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, et al.: Safety and morbidity of first andrepeat transrectal ultrasound guided prostate needle biopsies: Results of a Prospective European Prostate Cancer Detection Study. J Urol. 2001;166 (2):856-60.

  5. Pepe P, Aragona F.: Morbidity after transperineal prostate biopsy in 3000 patients Undergoing 12 vs 18 vs more than 24 needle cores. J. Urol.2013;81(6):1142-6.

  6. Collins GN, Lloyd SN, Hehir M. McKelvie GB: Multiple transrectal ultrasound guided prostatic biopsies— true morbidity and patient acceptance. Br J Urol.1993;71(4):460-3.

  7. Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Complications after prostate biopsy Data from Seer-Medicare. J Urol. 2001;186(5):1830-1834.

  8. Zayotoun OM, Anil T, Moussa AS, Jianabo L, Fareed K, Jones JS. Morbidity of prostate biopsy after simplified versus complex preparation protocols: assessment of risk factors. Urology 2011;77(4):910-4.

  9. Carey JM, Korman HJ. Transrectal ultrasound guided biopsy of the prostate. Do enemas decrease clinically sifnificant complications?. J Urol.2001;166(1):82-85.

  10. Abughosh Z, Margolick J, Goldenberg SL, Taylor SA, Afshar K, Bell R et al.: A prospective randomized trial of povidone-iodine prophylactic cleansing of the rectum before transrectal ultrasound guided prostate biopsy. J Urol 2013;189(5):1326-31.

  11. Gil-Vernet Sedo JM, Alvarez-Vijande García R. Effect of intrarectal povidone-iodine in the incidence of infectious complications after transrectal prostatic biopsy. Arch. Esp. Urol.2012;65(4):463-466.

  12. Ghafoori M, Shakiba M, Seifmanesh H, Hoseini K. Decrease in infection rate following use of povidoneiodine during transrectal ultrasound guided biopsy of the prostate: a double blind randomized clinical trial. Iran J Radiol. 2012; 9(2):67-70.

  13. Kanjanawongdeengam P, Viseshsindh W, Santanirand P, PrathombutrP, Nilkulwattana S. Reduction in bacteremia rates after rectum sterilization before transrectal, ultrasound-guided prostate biopsy: a randomized controlled trial. J Med Assoc Thai.2009;92(12):1621-6.

  14. Rees M. Povidone-iodine antisepsis for transrectal prostatic biopsy. Br Med J. 1980;281(6241):650.

  15. Lachapelle JM, Castel O, Fueyo Casado A, Leroy B, Micali G, Tennstedt D, et al. Antiseptics in the era of bacterial resistance: a focus on povidone iodine. Clin Pract. 2013;10(5):579-592.

  16. Pu Ch, Bai Y, Yuan H, Li J, Tang Y, Huang J et al. Reducing the risk of infections for transrectal prostate biopsy with povidone-iodine: a systematic review and meta-analysis. Int Urol Nephrol 2014;46:1691-1698.

  17. Park DS, Oh JJ, Lee JH, Jang Wk, Hong YK, Hong SK. Simple use of the suppository type povidone-iodinecan prevent infectious complications in transrectal ultrasound-guided prostate biopsy. Adv Urol2009; Article ID 750598, 4 pages. Doi:10.1155/2009/750598.

  18. Liss MA, Nakamura KK, Meuleners R, Kolla SB, Dash A, Pterson EM. Screening rectal culture to identify fluoroquinolone-resistant organisms before transrectal prostate biopsy: do the culture results between office visit and biopsy correlate?. Urology.2013;82(1):67-71

  19. Batura D, Rao GG, Nielsen PB. Prevalence of antimicrobial resistance in intestinal flora of patients undergoing prostatic biopsy: implications for prophylaxis and treatment of infections after biopsy. BJU Int;2010;107(7):1017-20.

  20. Nam RK, Saskin R, Lee Y, Liu Y, Law C, Klotz LH, et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 2013;189:S12-S18.

  21. Steensels D, Slabbaert K, De Wever L, Vermeersch P, Van Poppel H, Verhaegen J. Flouroquinoloneresistant E. Coli in intestinal flora of patients undergoing transrectal ultrasound guided prostate biopsy— should we reassess our practices for antibiotic prophylaxis?. Clin Microbiol Infect 2012;18:575-581.

  22. Liss MA, Chang A, Santos R, Nakama-Peeples A, Peterson EM, Osannn K, et al. Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients underogoing transrectal ultrasound guided prostate needle biopsy. J Urol.2001;185(4)1283-8.

  23. Zaytoun OM, Vargo EH, Rajan R, Berglund R, Gordon S, Jones JS. Emergence of fluorquinoloneresistant Escherichia coli as cause of postprostate biopsy infection: Implications for prophylaxis and treatment. Urology 2011; 77 (5): 1035-41




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