Background
Transrectal ultrasonography (TRUS) guided biopsy of the prostate has become the gold standard for prostate cancer biopsy assessment. It is a common procedure with thousands performed every year in the UK. Rectal bleeding following TRUS biopsy of the prostate is a recognised complication with an incidence of 2.2%; however, it is normally self-limiting.1 Severe rectal bleeding has an incidence of 0.7% and may require rectal pressure from a finger, probe, catheter, or endoscopic haemostasis.2 We describe a simple but effective technique to tamponade significant bleeding following the procedure using a Foley catheter and haemostatic rectal sponge.
Technique
A 28Fr Foley catheter is passed through a rectal sponge and inserted with the guidance of a finger into the rectum. The catheter balloon is inflated with 20ml of water and provides effective tamponade of bleeding (Fig 1).
Figure 1.
28Fr Foley catheter inserted in haemostatic rectal sponge with 20ml of water in balloon
Discussion
This is a simple and quick method to try without having to pack the rectum. It is usually tolerated well by the patient. Care must be taken with prolonged tamponade to avoid mucosal necrosis of the rectal wall.
These items are readily available in the theatre department and allow prompt management of significant bleeding following biopsy.
References
- 1.Ecke TH, Gunia S, Bartel P et al. Complications and risk factors of transrectal ultrasound guided needle biopsies of the prostate evaluated by questionnaire. Urol Oncol 2008; 26: 474–478. [DOI] [PubMed] [Google Scholar]
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