The effect of rectal cleaning with povidone iodine and B.T enema mixture before transrectal ultrasonography-guided prostate biopsy on procedure-related infective complications

Aim: We aimed to prospectively examine the effect of rectal cleaning with B.T enema + Povidone Iodine mixture on the infective complications related to the procedure in patients who will undergo transrectal prostate biopsy. Materials and Methods: Patients who applied to the urology clinic between September 2023 and March 2024 after the decision numbered 40600303/604.02 taken by the Hitit University Clinical Research Ethics Committee and who were planned to undergo transrectal prostate biopsy for the first time due to PSA elevation or the presence of a suspicious lesion in DRE, They were prospectively randomized into 2 groups of 60 people each, using the rectal B.T enema and povidone iodine mixture or B.T enema. Antibiotic prophylaxis was started in all patients 1 day before the procedure, and rectal mucosa cleaning was performed with povidone-iodine just before the procedure. While B.T enema was applied rectally to the patients in the control group 1 hour before the procedure, B.T enema and 10cc of povidone iodine were mixed and applied rectally to the patients in the study group 1 hour before the procedure. After the procedure, the patients were evaluated and compared in terms of hematuria, hematospermia, rectal bleeding, fever, acute urinary retention, hospitalization, sepsis, urine culture and blood cultures. Results: 120 patients were included in the study. While the urine culture of 6 patients (10%) in the control group was positive, the urine cultures of the patients in the study group were found to be sterile and were found to be statistically significant (p = 0.046). Due to febrile urinary infection, 6 patients (10%) in the control group and 2 patients (3.3%) in the study group were hospitalized. There was no difference in the rates of hematuria, hematospermia, rectal bleeding and acute urinary retention. Conclusion: In this study, a significant decrease was observed in the rate of positive urine culture after transrectal biopsy in rectal cleaning with B.T enema + Povidone iodine mixture. Although there was a numerical decreasing trend in cases of hospitalization due to febrile urinary infection and sepsis, no statistical difference was observed. More clear data can be obtained in studies with a larger number of patients. Keywords: Prostate biopsy, B.T enema, Povidone iodine, Infection