Erectile dysfunction has been reported following prostate biopsy. However, there has been significant controversy as to whether prostate biopsies predispose patients to erectile dysfunction. Some well studied factors that may influence erectile dysfunction after prostate biopsy include patient age,neurovascular bundle damage during injection of local anesthesia, compression of the neurovascular bundle from hematoma formation or edema, the number of biopsies taken, anxiety related to the biopsy,the type of biopsy (either transperineal or transrectal) and time interval after the procedure.
In a recently published research report in the Journal of Urology , it has been suggested that prostate biopsy does cause a mild, transient decrease in average IIEF-5 scores at 1-month post-biopsy. It has been further confirmed that it resolves at 3 months on average, and average IIEF-5 remains at baseline at 6 months post-biopsy.
Because the association between erectile dysfunction and prostate biopsy is variable in the available literature, a team of researchers sought to perform a systematic review and meta-analysis of sexual dysfunction in males within 6 months of prostate biopsy.
Researchers conducted a systematic literature search in 4 databases: MEDLINE® (via PubMed®), Embase® (via Ovid®), Web of Science™ and the Cochrane Library. They included studies focused on sexual dysfunction in men of all age groups undergoing transrectal or transperineal prostate biopsy for suspicion of prostate cancer;studies with International Index of Erectile Function 5 scores pre-biopsy and post-biopsy at 1, 3 or 6 months. They performed an effect size meta-analysis comparing patient baseline International Index of Erectile Function 5 (IIEF-5) scores with post-biopsy IIEF-5 scores.
Data analysis revealed the following facts.
We identified 9 studies that met our inclusion criteria, of which 6 examined transrectal prostate biopsy, 2 examined transperineal prostate biopsy and 1 examined both.
At 1 month after biopsy, the mean IIEF-5 score decreased by approximately 2.2 points as determined by the effect size (−0.43, p=0.002). However, at 3 and 6 months after biopsy, there was no difference compared to baseline (effect size=−0.08, p=0.52 and effect size=−0.11, p=0.18, respectively).
An exploratory subgroup analysis examining transrectal prostate biopsy at 3 months showed a statistically significantly lower mean IIEF-5 score compared to baseline (p=0.047), corresponding to an approximately 1.25-point decrease in IIEF-5.
For full article follow the link: https://doi.org/10.1097/JU.0000000000001398
Primary source: Journal of Urology