A prospective study of erectile function after transrectal ultrasonography‐guided prostate biopsy

Murray, Katie S.; Bailey, Jason J.; Zuk, Keegan; Lopez-Corona, Ernesto; Thrasher, J. Brantley

doi:10.1111/bju.13002

Cited by 35 publications

(38 citation statements)

References 17 publications

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“…Several studies have investigated the effect of TP or TRUS biopsies on erectile function and the relationship of prostate biopsies and associated anxiety, with the conclusion that prostate biopsies cause anxiety and temporary erectile dysfunction,27 which may be worse after multiple biopsy episodes 162829. Finally, we did not account for co-morbidity, but given this is a relatively young patient cohort, suitable for treatment with curative intent, we would expect these not to be a significant confounder.…”

Section: Discussionmentioning

confidence: 99%

Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures

et al. 2017

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We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0–10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.

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Section: Discussionmentioning

confidence: 99%

Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures

et al. 2017

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“…Murray et al showed 34% of patients with no ED at baseline had a decrease in IIEF score at 1 week; 20% and 24% continued to have lower scores at 1 and 3 months, respectively. Age ≥60 years or above, the first biopsy setting and a diagnosis of PCa were the main predictors of IIEF score impairment at 1 and 3 months 31 . It has been hypothesized that extensive sampling during saturation PB could affect erectile function, but in multiple series the IIEF score impairment resolved within 6 months after biopsy, and no correlation was found between number of cores and IIEF scores 28,32 .…”

Section: Erectile Dysfunctionmentioning

confidence: 97%

Complications After Systematic, Random, and Image-guided Prostate Biopsy

et al. 2017

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Evidence Synthesis: The most frequent complication after PB is minor and self-limiting bleeding (hematuria and hematospermia), irrespective of the biopsy approach. Occurrence of rectal bleeding was comparable among traditional TRUS-guided and image-guided PB. Almost 25% of patients experience lower urinary tract symptoms, but only a few have urinary retention, with higher rates after transperineal approach. Temporary erectile dysfunction is not negligible, with a return to baseline after 1-6 months. The incidence of infective complications is being increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, irrespective of biopsy technique. Conclusions:Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. Still, a careful appraisal of 3 patient's general health status, risk factors and likelihood of antimicrobial resistance should be done before scheduling a PB. Patient Summary:In this paper we reviewed the variety and incidence of complications after prostate biopsy. Even if frequent, seldom represent a problem for the patient. The most troublesome complications are infections. In order to minimize this risk, a careful evaluation of patient's medical condition must be done before biopsy.4

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“…Transrektal USG eşliğinde yapılan prostat biopsiden sonra belirli oranlarda hematüri, Prostat biopsisinden sonra ED oranını saptamak için yapılan çalışmalarda istatistiksel anlamlı artış olmadığını söyleyen çalışmalar olsa da son zamanlarda bu durumun aksini söyleyen birçok yayınlanmış makale bulunmaktadır (6)(7)(8). Erektil disfonksiyon prostat biopsisinden sonra erken zamanlarda görülüp sıklıkla zamanla iyileşmektedir (9).…”

Section: Discussionunclassified

“…Erektil disfonksiyon prostat biopsisinden sonra erken zamanlarda görülüp sıklıkla zamanla iyileşmektedir (9). Periprostatik sinir bloğunun nörovasküler demette yarattığı hematom, ödem nedeniyle daha fazla erektil fonksiyon kaybı yarattığı görüşü diğer prospektif çalışmalarla desteklenmemiştir (4,8,9). Diğer bir çalışma ağrı skorunun daha az olmasının erektil fonksiyondaki değişime etkisi olmadığını yayınlamıştır (10).…”

Section: Discussionunclassified