Prostatic biopsy-related rectal bleeding refractory to medical and endoscopic therapy definitively managed by catheter-directed embolotherapy: a case report

INTRODUCTION: Ultrasound-guided transrectal prostatic biopsy is generally a well-tolerated radiological technique with low overall complication ratio. If post-biopsy rectal bleeding occurs, conservative management is effective in the majority of cases. Endoscopic or interventional treatment is rarely required. CASE PRESENTATION: We report the case of an 82-year-old white man presenting with massive rectal bleeding after ultrasound-guided prostatic biopsy. Medical and endoscopic management were not effective. Angiographic evaluation revealed a prostatic arteriovenous fistula, and definitive treatment was provided in the form of catheter-directed superselective embolotherapy. CONCLUSION: Transrectal prostatic biopsy may be associated with massive rectal bleeding. Transcatheter embolotherapy can be effective in definitively stopping the bleeding.