A Prospective Surveillance Program A Prospective Surveillance Program to Track Complication Rates Post to Track Complication Rates Post TRUS and Biopsy in the Urology TRUS and Biopsy in the Urology

Service atService atTallaght Hospital.Tallaght Hospital.

Liz Mcevoy

IAUN Jan 2014

Aims Aims • Identify causes and cost of admission post TRUS and

biopsy.• Methods - 587 patients had TRUS and Biopsy

between January 2012 – December 2012.• Results – 3 patients presented to GP

- 19 patients - 5 hospitals.

- 11 patients to Tallaght = 47 days

• Cost to Tallaght Hospital € 37,882 • Cost per patient = € 3,156.

Results Overall 2.3 % (14) - suspected infection Possible infection - 0.68% (4) Probable infection - 0.34% (2) Definite infection – 1.3% (8)• UTI - Escherichia coli, main cause of UTI (n=7), 1 ESBL

producer. • 2 post-biopsy bacteraemia. • High Quinolone resistance (Nalidixic acid 100%).

Ciprofloxacin 70%)• Peak time for presentation – 4 days• Rate of urinary retention was 1.5%.• Peak time for presentation – within 1 day.• Increased cost to hospitals expected.

Conclusion• Definite rates of infection low.• The minimal date set required to audit biopsy related

infections includes; temperature, pulse, BP, WCC, CRP, urine and blood cultures.

• Greater communication and ease of access between hospitals/GP to obtain this data.

• Greater resistance to antibiotic prophylaxis• Retention urine higher than expected.• Patients with large prostate should have: Up-to- date International Prostate Symptoms Score.

(IPPS). High IPPS/ large prostate - start alpha-blocker. Cost of complications are high – from financial and bed

management perspective.

Thank You

IAUN

Staff GU OPD and Lane Ward Tallaght

Marjorie White - Flynn- Research Secretary

David Addie – Finance Department.

Tom Walsh – Photography Department