Effect of Povidone-Iodine Rectal Cleansing on Infectious Complications after Transrectal Ultrasound-Guided Prostate Biopsy

Abstract

To evaluate whether povidone-iodine rectal cleansing reduces infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx). This retrospective study analyzed 2,118 patients who underwent TRUS-Bx between 2018 and 2023. The patients were divided into two groups: Group I (n = 682) received cephalosporins without rectal cleansing, whereas Group II (n = 1,436) received cephalosporins plus povidone-iodine rectal cleansing. The incidence of infectious complications such as fever, acute prostatitis, bacteremia, and sepsis was compared. Group II showed significantly lower rates of fever (0.2% vs. 0.9%), acute prostatitis (0.3% vs. 1.2%), and bacteremia (0.1% vs. 0.6%) than Group I (p < 0.05). However, no significant difference was observed in the incidence of sepsis between the two groups. No immediate or delayed adverse events associated with povidone-iodine rectal cleansing were observed during follow-up. Povidone-iodine rectal cleansing is a safe and effective adjunct to antibiotic prophylaxis for reducing post-TRUS-Bx infectious complications.