Office Urologic Procedures Pose Little Risk

Total patient event rate for cystoscopy, transrectal prostate biopsy only 0.76 percent

21 june 2009-- Cystoscopy and transrectal ultrasound-guided prostate biopsy performed in the office setting appear to pose minimal risk to patients, according to research published in the June issue of Urology.

Surena F. Matin, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues analyzed data from 554 patients who underwent cystoscopy and 367 who underwent the biopsy procedure in 2006 to 2008. The authors initiated the study with a Joint Commission patient-safety universal protocol in mind, which excludes certain minimal-risk procedures.

The investigators discovered that the total patient event rate was 0.76 percent; the most significant adverse event was a case of acute bacterial prostatitis, and others included non-tolerance of a procedure and vasovagal and possible vasovagal response. The total system event rate was 10.97 percent, most often a delay of more than 15 minutes in starting the procedure.

"Although seemingly simple and intuitively obvious, this publication is nevertheless of critical importance for urologists in both academic and private practice. The Joint Commission, as noted, has published the 'Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery' to help prevent medical errors and improve accountability in both diagnostic and therapeutic procedures. These requirements are becoming increasingly onerous for many practices," writes the author of an accompanying editorial. "The classification of these less-invasive procedures in the same category as major surgery causes significant problems for patient care and efficient patient flow."

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