A Prospective Surveillance Program to Track Complication Rates Post TRUS and Biopsy in the Urology Service at Tallaght Hospital. Liz Mcevoy IAUN Jan 2014

Aims Identify causes and cost of admission post TRUS and biopsy. Methods patients had TRUS and Biopsy between January 2012 – December Results – 3 patients presented to GP - 19 patients - 5 hospitals 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 % (4)  Probable infection % (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