Erectile function after repeat saturation prostate biopsy: Our experience in 100 patients

Abstract

Repeat transperineal SPBx under sedation did not significantly worsened erectile function; the minimal risk of temporary post-biopsy ED could be previously discussed (not emphasised) with potent patients.

The impact of repeated prostate biopsies on sexual function and urinary symptoms in patients with diagnosis of Atypical Small Acinar Proliferation (ASAP): Can ecoDoppler reduce side effects?

“…So far is not clearly defined by the international literature whether serial PNBx predispose to a permanent ED over time: nevertheless only few studies, as the one leaded by Hilton et al, showed a total absence of correlation between this side effect and the procedure (14). In the majority of the examined studies, the investigators demonstrated a short-term (30 days) impact on EF, asso- ciated to psychological factors as anxiety and diagnosis of PCa (8,10) rather than to use of periprostatic nerve block and flogosis linked to the procedure. Some authors considered PNBx follow-up at 1 and 6 months: Akbal et al showed a worsened EF 1 month after PNBx that returns at baseline level at 6 months (3): in this study the authors analyzed specifically only PCa-free patients, avoiding bias due to the cancer detection.…”

“…Besides this well-documented side-effects, an increasing number of articles is showing a possible role of PNBx to cause Erectile Dysfunction (ED) (4)(5)(6). Some studies described this effect as temporary (7)(8)(9), and attributed to anxiety (9) rather than a real organic injury (6). Moreover, this studies often investigated Erectile Function (EF) in patients on active surveillance, that is to say with a diagnosis of prostate cancer, a potential negative psychological confounder that may influence their EF (10).…”

Serial transperineal sector prostate biopsies: impact on long-term erectile dysfunction

“…Pepe et al reported on erectile function in 100 men who underwent repeated TPSBx, and concluded that serial TPSBx did not significantly worsen erectile function in the short to medium-term [ 9 ]. In contrast, our data suggests that serial TPSBx increases the risk of ED at one, three, and six months postbiopsy.…”

“…Short-term complications of TPSBx typically include haematuria, acute urinary retention, and dysuria [ 5 , 8 ]. There have been relatively few reports on ED after serial sector biopsies performed via the transperineal route [ 9 ].…”

What false-negative rates of non-invasive testing are active surveillance patients and uro-oncologists willing to accept in order to avoid prostate biopsy?

“…Others have not corroborated this observation. 8,9 In conducting this survey, we felt it important to define the needed test characteristics for an alternative to serial TRUS-BX among men on AS, as the scientific biomarker and imaging breakthroughs continue to emerge and improve. When we began this study, we expected that a particular value of false-negativity (i.e., the chance of missing a significant cancer via a biopsy alternate) would emerge to guide patients, physicians, and biomarker companies.…”