einstein (São Paulo). 13/fev/2026;24:eCE2121.
Comment on: Transrectal prostate biopsy complications: a prospective single center study in a mid-income country
DOI: 10.31744/einstein_journal/2026CE2121
Dear Editor,
We read the article by Dr. Schollemberg et al. with great interest.() In their prospective cohort study, they assessed the complications and associated risk factors following transrectal ultrasound-guided prostate biopsy (TRUSB) at a Brazilian public reference center. A total of 1,043 consecutive patients were assessed using the Global Prevalence of Infections in Urology form, and complications were classified based on the Clavien-Dindo system. Most bleeding events were mild (Grade 1), whereas 1.5% were of Grades 2–3 and were significantly associated with hypertension, younger age, and anticoagulant use (p<0.001). Infectious complications occurred in 4.7% of patients (Grades 2, 3, and 4: 0.5, 3.6, and 0.6%, respectively), with indwelling catheter use, recent urinary tract infection (p<0.001), and quinolone use (odds ratio [OR] = 3.01, 95% confidence interval (95%CI) 1.15–7.80, p=0.03) identified as risk factors. Urinary retention was observed in 4.1% of cases and was associated with severe lower urinary tract symptoms (p=0.009), prostate volume >89mL (p=0.001), and prostatic protrusion ≥10mm (p=0.001). This study demonstrates that although life-threatening complications are uncommon, TRUSB should not be considered completely risk-free.
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