Assessment of the influence of transrectal and transperineal prostate biopsies on erectile function: A prospective observational single‐center study

Abstract

Objectives To assess the impact of transrectal versus transperineal prostate biopsy on erectile function. Methods This was a single‐center, observational, prospective study of consecutive patients who underwent a prostate biopsy (transrectal or transperineal/fusion biopsy). Study participants completed the International Index of Erectile Function‐5 questionnaire before the procedure, and 3 and 6 months after. Prostatic biopsies were carried out following the standard procedure for both techniques. Results The study included 135 male patients with a mean age of 63.5 years. At baseline, 28 patients (21%) presented normal erectile function, whereas 107 patients (82%) presented erectile dysfunction, which was severe in four (3%), moderate in 49 (36%) and mild in 54 (40%), with an overall mean International Index of Erectile Function‐5 score of 17.70. After 3 months, the rates were 29%, 3%, 27% and 38%, respectively (mean International Index of Erectile Function‐5 score 17.95). At 6 months, the rates were 30%, 6%, 28% and 34%, respectively (mean International Index of Erectile Function‐5 score of 17.77). No significant differences between pre‐ and post‐biopsy International Index of Erectile Function‐5 scores at 3 and 6 months were observed, even when analyzing transrectal and transperineal separately. The number of biopsy cores and number of previous biopsies did not influence the International Index of Erectile Function‐5 scores. Conclusions Our findings suggest that prostate biopsy technique, number of biopsy cores and history of previous biopsy do not significantly impact erectile function in the medium term up to 6 months.

The effect of transrectal ultrasound-guided prostate biopsy on erectile function and lower urinary tract symptoms: a prospective study

“…In contrast, the current study discovered that TRUS-guided PB had no significant effect on erectile function. Similarly, in a study by García Rojo et al, there were no significant differences between pre-biopsy and post-biopsy IEEF-5 scores at 3 and 6 months, and neither the number of biopsy cores nor the number of previous biopsies influenced IEEF-5 scores [18]. The majority of studies, however, suggest that TRUS-guided PB only has a temporary impact on erectile function [19][20][21].…”

Editorial Comment to Assessment of the influence of transrectal and transperineal prostate biopsies on erectile function: A prospective observational single‐center study

“…4 In the present study, although no data were collected until 1 month after the biopsies, the PBs had no influence on erectile function. 5 In addition, there was no significant difference in erectile function between the transrectal and transperineal approaches at 3 and 6 months. 5 This information would be a factor in deciding the best approach to PB for patients.…”

“…5 In addition, there was no significant difference in erectile function between the transrectal and transperineal approaches at 3 and 6 months. 5 This information would be a factor in deciding the best approach to PB for patients.…”

Effect of transperineal template prostate biopsy on perioperative and functional outcomes following robotic-assisted radical prostatectomy

“…24 In addition, Garcia et al showed that TTP biopsy does not impact on erectile function compared to TR biopsy at least in the medium term up to six months. 27 Another possible explanation is that the higher median age in the transperineal group contributed to the findings. However, there was only a small age difference, and the biopsy group remained a predictor of EFR on multivariate analysis accounting for age.…”