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 prostateis a major and potentially life-threatening problem. Using antibiotic premedication cannotcompletely eliminate infection after biopsy.Objectives: We performed this study to determine the value of using povidone-iodine inprevention of post biopsy infection.Patients and Methods: Totally, 280 patients who were referred for TRUS guided biopsyof the prostate were divided randomly into two equal groups. The case group receivedan 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 daysfor 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 controlgroup (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 controlgroup (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1).Conclusion: Simple use of widely available povidone-iodine for cleaning the rectum beforeTRUS guided prostate biopsy can reduce the infection rate.