The Impact of Prostate Biopsy on Patient Well-Being: : A Prospective Study of Pain, Anxiety and Erectile Dysfunction

Abstract

The impact of prostate biopsy on patient well-being begins while waiting for the scheduled procedure. Shortening the anticipation period before results are disclosed and administering pre-biopsy anxiety decreasing measures may benefit patients. Analgesic therapy is recommended in younger patients, those reporting moderate to severe intraoperative pain and those with known prostatic inflammatory infiltrate. The risk of acute erectile dysfunction should be discussed cautiously with patients who are potent before biopsy.

The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy

“…4 Recently, there have been studies investigating urinary and erectile function after prostate biopsy. 2,3,5 There are few publications on preoperative and postoperative impact of serial prostate biopsies on active surveillance patients who ultimately undergo RARP. 5 This is especially relevant as one-third of men enrolled in AS may eventually require definitive surgical treatment.…”

“…Results indicated a statistically significant difference between the prebiopsy IIEF-5 scores and postbiopsy scores at 1 and 6 months (Po0.001). The authors postulated that ED in their cohort could be attributed to The impact of multiple biopsies P Sooriakumaran et al direct neurovascular-bundle damage or secondary trauma such as nerve compression caused by hematoma or edema, a previous theory offered by Zisman et al 3 Studies by Akbal et al 11 investigated ED after saturation prostate biopsy. The median number of cores taken during prostate biopsy was 22 (range: 20--30).…”

“…It is unclear why this saturation group showed improvement in comparison to patients receiving 10-core biopsy, as one would expect an increased number of cores sampled would lead to worse potency outcomes based on Zisman's hypothesis. 3 It would be beneficial for a future study to evaluate whether the number of cores obtained during prostate biopsy affects potency outcomes.…”

“…Some authors have suggested that multiple biopsies per se can cause nerve damage and subsequent ED. 2,3 The other, even less investigated event, is the impact of multiple biopsies on the operative ability to perform nerve sparing if such patients end up having surgery in the future. To our knowledge, there have been no studies investigating these effects of multiple biopsies on patients undergoing robotic-assisted radical prostatectomy (RARP).…”

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

“…5 Nijs et al 42 reported that the idea of undergoing a prostate biopsy already caused anticipated pain and discomfort. Zisman et al 43 found that undergoing a prostate biopsy can have an impact on the patient's well-being due to causing pain and anxiety. Macefield et al 44 reported that although most men coped well with undergoing a biopsy, a minority experienced elevated distress at the time of biopsy and after receiving a negative result.…”