The influence of transperineal template-guided prostate saturation biopsy on erectile function

Abstract

Objective To evaluate the erectile function following transperineal template-guided prostate saturation biopsy (TTPSB). Methods From June 2013 to October 2015, patients underwent prostate biopsy. All patients were indicated for biopsy according to the criteria of Guidance on diagnosis and treatment of urology in China . Exclusion criteria include medical history of PCa, severe urinary tract infection, severe cardiovascular and cerebrovascular diseases or abnormal blood coagulation .All patients were divided into observation group (TTPSB) or control group (traditional trans-perineal template-guided prostate biopsy, TTPB) according to patients′ condition, pubic anatomy, PSA abnormality, rectal examination, imaging examination and pain tolerance, etc. Patients were evaluated for pre-biopsy erectile function with the international index of erectile function (IIEF-5). All pathology confirmed prostate cancer patients were excluded. Concomitant systemic diseases and medications that would interfere with erectile function were recorded. Patients who withdrew from the trial or used the drugs such 5-phosphodiesterase inhibitors for sexual activity improvement were excluded. Ninety-seven patients in observation group and 84 patients in control group underwent further evaluation with the IIEF-5 questionnaire at 1, 3 and 6 months post-biopsy. Results The average age of the observation group and the control group were (64.1±7.9 )years and (61.8±8.9) years, PSA were (7.2±3.7) ng/ml and (6.7±3.4) ng/ml, prostate volume were (47.8±21.5)ml and (49.2±22.2)ml, and the BMI were (21.4±3.1)kg/m2 and (20.6±3.4) kg/m2, respectively. There was no significant difference between the two groups (P>0.05) in term of above patients' characteristics. The pre-biopsy IIEF-5 score of the observation group and the control group were 19.1±4.5 and 19.7±4.3, which had no significant difference (t=-0.890, P=0.375 ). One month after biopsy, the IIEF-5 of two groups were 17.4±4.8 and 18.2±4.5 respectively and both group had statistically significant difference when compared with pre-biopsy (both P<0.05), however, there was no statistical significance at 3 and 6 months after biopsy. Besides, no significant difference of the IIEF-5 score was detected between two groups in 1, 3 and 6 months. Conclusions Although TTPSB may resulted in temporary (1 month) post-biopsy erection dysfunction, the erectile function recovered to pre-biopsy level at 3-6 months post-biopsy. TTPSB did not increase the risk of ED compared with traditional TTPB. Key words: Prostatic neoplasms; Saturation biopsy; Erection dysfunction