Evaluating the efficacy of transrectal povidone-iodine application for infection prevention in transrectal ultrasound-guided prostate biopsy: A single-center retrospective study.

INTRODUCTION: Prostate cancer diagnosis via transrectal ultrasound-guided (TRUS) biopsy carries a significant risk of infectious complications due to potential contamination from the rectal microbiome. This study aimed to evaluate the efficacy of transrectal 10% povidone-iodine application, in combination with antibiotic prophylaxis, in reducing infectious complications following TRUS biopsy. MATERIALS AND METHODS: A retrospective analysis was conducted on 643 patients who underwent TRUS biopsy at a single center in a tertiary hospital in Kuala Lumpur between January 2017 and December 2023. Patient records were reviewed for demographic data, biopsy indications, type of antibiotic prophylaxis, and post-biopsy complications. Patients were categorized into two groups: those who received antibiotic prophylaxis alone and those who received both antibiotic prophylaxis and transrectal povidone-iodine. Statistical analyses, including chi-square tests and logistic regression, were performed to compare outcomes and assess the impact of povidone-iodine on infection rates. RESULTS: Of the 643 patients, 285 received antibiotic prophylaxis combined with transrectal povidone-iodine, was associated with a significantly lower infection rate from 2.23% to 0.7% (P < 0.05). There were no significant differences between the povidone-iodine and non- povidone-iodine groups in terms of patient demographics, including age, prostate volume, Prostate Specific Antigen (PSA) levels, and histopathological findings. Logistic regression analysis further confirmed the significant effect of povidone-iodine in reducing post-biopsy infections presenting as fever >37.5 within 30 days after TRUS biopsy. CONCLUSION: The results indicate that the use of transrectal 10% povidone-iodine alongside antibiotic prophylaxis is an effective approach for reducing infectious complications following TRUS biopsy.