Office Cystoscopy and Transrectal Ultrasound-guided Prostate Biopsies Pose Minimal Risk: Prospective Evaluation of 921 Procedures

Objectives: To examine the outcomes of 2 commonly performed urologic office procedures as a part of a process to align these with the Joint Commission standards to ensure patient safety. We determined whether cystoscopy and transrectal ultrasound-guided prostate biopsy performed in the office setting pose minimal risk to patients. Methods: An evaluation of urologic office procedures in the office clinic setting of an academic medical center was prospectively performed during 3 different periods to document patient and system events. The patients included those undergoing cystoscopy for workup of hematuria, history of bladder cancer, or other indicated conditions (n = 554) and patients undergoing transrectal ultrasound-guided prostate biopsy for suspicion of prostate cancer (n = 367). All consecutive patients were evaluated. Results: A total of 7 patient events (0.76%) and 101 system events (10.97%) were documented. The most significant adverse patient event was 1 case of acute bacterial prostatitis due to quinolone-resistant Escherichia coli. In most cases, the system event rate reflected a delay of >15 minutes in the initiation of the procedure. No patient experienced significant bleeding, perforation, or a major cardiopulmonary event. Conclusions: The results of our study have shown that cystoscopy and transrectal ultrasound-guided prostate biopsy procedures performed in the office setting pose a minimal risk to patients. This information could be useful for hospitals and practices that are undergoing efforts to align their individual policies with current Joint Commission standards.