Decrease in Infection Rate Following Use of Povidone-Iodine During Transrectal Ultrasound Guided Biopsy of the Prostate: A Double Blind Randomized Clinical Trial

Background: Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication cannot completely eliminate infection after biopsy. Objectives: We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection. Patients and Methods: Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. Results: The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, or = 2.4, 95% CI = 1.4-4.1). Conclusion: Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate.