Clinical Value of Routine Urine Culture in Non-Febrile Patients on Transperineal Prostate Biopsy

<b><i>Purpose</i></b><i>:</i> Transperineal prostate biopsy has been widely recommended because of its low post-operative complications. We aim to evaluate the clinical value of routine urine culture in non-febrile patients on transperineal prostate biopsy, particularly in terms of infection-related complications and cancer detection rates. <b><i>Materials and Methods</i></b><i>:</i> A retrospective analysis was conducted on patients who met the following inclusion criteria: (a) no fever, and (b) no antimicrobials in the 7-day period prior to transperineal prostate biopsy. Patients were categorized based on urine culture results: negative urine culture group, urine culture contamination group, and positive urine culture group. <b><i>Results</i></b><i>:</i> Infectious complications were more common in the positive urine culture group (11.8%, p < 0.05) than the others. There were no sepsis or death events. In multi-variable logistic regression analysis, patients in the positive urine culture group had 6.54 times higher the odds of developing infection-related complications compared to those in the negative group (95% confidence interval [CI]: 1.805-23.731, p = 0.004). The cancer detection rate was higher in the negative urine culture group than the positive group (49% vs. 33.8%, p < 0.05). Patients in the negative urine culture group had 2.12 times higher the odds of cancer detection rate than patients in the positive group (95% CI: 1.175-3.83, p = 0.013). <b><i>Conclusion</i></b><i>:</i> Urine culture prior to prostate biopsy remains clinically relevant. Furthermore, for patients with positive urine culture, who are non-febrile and have not received antibiotic treatment or prophylaxis, it would be meaningful to explore whether attempted antibiotic therapy could improve prostate cancer detection rates or avoid unnecessary prostate biopsies.