Older age at transperineal template prostate biopsy (TTPB) is a significant predictor of immediate erectile dysfunction (ED) in sexually active men following the procedure, investigators reported at the European Association of Urology 2020 virtual congress.

They also observed the association among men with no preexisting ED.

Jo-Lynn Tan, MD, of St. Vincent’s Hospital Melbourne in Victoria, Australia, and colleagues studied 576 men (median age 65 years) who provided Sexual Health Inventory for Men (SHIM) scores before and after TTPB. Of these, 450 (78%) had a first-time biopsy. The median pre- and post-biopsy SHIM scores were 23 and 21, respectively.

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Age was a strong predictor of drop in SHIM category, with a significantly higher proportion of men older than 70 years than those younger than 60 years experiencing a drop in category (39% vs 22%), Dr Tan’s team reported in a poster presentation. Similarly, among men with no prior ED, 39% of those older than 70 years experienced a drop in category compared with 18% of those younger than 60 years.

In a multivariable model, each 5-year increase in age was significantly associated with 25% and 33% increased odds of a decline in SHIM category overall and in the subgroup of men without prior ED, respectively.

Furthermore, the predicted probability of a decline in SHIM category at age 50 was 10%, increasing to 32% at age 60 and then flattening with increasing age to 36% at age 70, according to the investigators. The corresponding predicted probabilities of new-onset ED immediately following biopsy were 6.7% at age 50, 26% at age 60, and 31% at age 70.


Tan JL, Kalapara A, Papa N, et al. Predictors of erectile dysfunction after transperineal template prostate biopsy. Presented at: EAU20 Virtual Congress; July 17 to 19, 2020. Poster 046.