Module 9

Complications and their management

Sepsis, bleeding, retention and vasovagal: recognising them and knowing when to worry.

Most biopsies are uneventful, but you must know the complications cold, because the serious one moves fast. This is the module that keeps your patients safe.

MRI slices live

The raw multi-parametric scan.

3D reconstruction live

Segmented gland, zones and lesion as a rotatable model.

Beside-patient spatial teaching future spatial workflow

Future spatial-computing workflows for placing the anatomy model in clinical space.

01 Sepsis: the one to fear 4 min

Fever and rigors after a biopsy are an emergency until proven otherwise, and far more likely after TRUS. Act fast: the sepsis pathway, blood cultures, and prompt broad-spectrum antibiotics.

Do not wait Post-biopsy fever or shaking chills means treat as sepsis now, not in a few hours.

You will not hesitate when a post-biopsy patient spikes a temperature.

A man has fever and rigors the evening after a TRUS biopsy. You should?

02 Bleeding 4 min

Bleeding is common and usually benign, but set expectations.

Haematuria: very common, usually settles over days.
Haematospermia: blood in the semen for several weeks. Harmless, but alarming if not warned about.
Rectal bleeding (after TRUS): usually self-limiting, rarely needs intervention.

You can tell a patient what bleeding is normal and what is not.

Blood in the semen for a few weeks after biopsy is?

03 Retention and vasovagal 3 min

Some men cannot pass urine afterwards, more likely with a large gland or after transperineal work. That is acute retention and needs a catheter. A vasovagal faint during the procedure is managed with positioning and reassurance.

Key point Can't pass urine after biopsy = retention. Catheterise.

You know the two common, manageable problems and how to handle them.

A man cannot pass urine after his biopsy. The likely problem?

04 Safety-netting 3 min

Every patient leaves knowing the three things that mean seek urgent help: fever or rigors, inability to pass urine, and heavy bleeding. Give it in writing as well as verbally.

The non-negotiable Fever or rigors is the one that kills if missed. Make sure it lands.

You can safety-net a biopsy patient properly. End of Module 9.

The single most important safety-net symptom to stress is?

That is Module 9. You can recognise and respond to the complications that matter.

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