Transperineal Biopsy Carries Erectile Dysfunction Risk

Researchers observe a short-term significant decline that fully recovers by 6 months.
Researchers observe a short-term significant decline that fully recovers by 6 months.

ORLANDO—Transperineal prostate biopsy is associated with significant short-term erectile dysfunction (ED), according to study findings presented at the American Urological Association 2014 annual meeting. Erectile function recovers fully by 6 months post-biopsy.

Janette Kinsella, MSc, of Guy's Hospital in London, and colleagues studied 278 men with presumed low-risk prostate cancer on transrectal biopsy who underwent confirmatory transperineal biopsy within 3-6 months of their diagmosis prior to entering an active surveillance program. The number of biopsies taken ranged from 24-38, depending on prostate volume. Investigators evaluated erectile function using the International Index of Erectile Function-5 (IIEF-5) prior to and 1, 3, and 6 months after transperineal biopsy.

The mean biopsy time was 4.1 minutes.  The mean pre-biopsy IIEF-5 score was 20.2. This declined to 10.4 at 1 month post-biopsy, a 49% decrease. The mean IIEF-5 score rose to 19.6 by 3 months and 20.4 by 6 months. In addition, 28 patients (10%) had an improvement in erectile function, possibly due to alleviation of anxiety, according to the investigators.

The potential impact of transperineal biopsy on erectile function should be emphasized during the informed consent process, the authors concluded.

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