Fatal Rectal Bleeding after Prostate Biopsy

Transrectal ultrasound (TRUS)-guided biopsy of the prostate is a gold-standard for diagnosing the prostatic cancer. It is a relatively less invasive technique and known to be fast, safe, and effective method, because post biopsy complications including gross hematuria, rectal bleeding, hematospermia, fever and chill are mostly self-limiting and the rate of major complications are low. Rare major complications include acute prostatitis, acute urinary retention, epididymitis, severe hematuria, sepsis, abscess formation, urinary tract infection, tumor tracking, vasovagal syncope, and significant rectal bleeding. 2) A nation-wide survey in Japan reported that the 5.9% of 212,065 men undergone rectal bleeding after the procedure. And a large prospective series of prostatic biopsies showed the 8.2% of patients reported moderate to severe rectal bleeding after the biopsy. Chiang et al. reported that the rate of rectal bleeding needed hospitalization is 0.2%. The major ones occur very rarely but if they occur, it could be life-threatening. We herein present an autopsy case of fatal rectal bleeding after prostate biopsy to share how we handle this rare case and review the reported similar cases by analyzing the papers.