Predictors of erectile dysfunction after transperineal template prostate biopsy.

To investigate the incidence and possible contributing factors of erectile dysfunction (ED) after transperineal template prostate biopsy (TTPB).

Males undergoing TTPB were prospectively administered a Sexual Health Inventory for Men (SHIM) questionnaire before biopsy and one month after. SHIM questionnaires were repeated at 3- and 9-months for males not receiving interventional treatment. Sexually inactive males were excluded. Interval change in SHIM categories based upon baseline characteristics were evaluated. Multivariable logistic regression models were used to evaluate predictors of change in SHIM score category.

A total of 576 males were included in our sample. Of these, 450 (78%) males underwent their first biopsy. A decline in SHIM category within the immediate 4-weeks post-biopsy was reported by 167 males (31% of total eligible sample). Age was the strongest predictor of decline in SHIM category, the predicted probability of a decline in SHIM at age 50 was 10% (95% confidence interval [CI], 1%-19%), 32% at age 60 (95% CI, 25%-40%) and 36% at age 70 (95% CI, 29%-44%). For new onset ED, the predicted probability of ED within 4-weeks post-TTPB were 6.7% at age 50 (95% CI, 0%-15%), 26% at age 60 (95% CI, 17%-34%) and 31% at age 70 (95% CI, 21%-40%).

Older age at biopsy is an independent predictor of immediate ED after TTPB in sexually active males. This association was observed in the subgroup with no pre-existing ED. These findings provide useful information when counselling males undergoing TTPB.

Investigative and clinical urology. 2021 Mar [Epub]

Jo Lynn Tan, Nathan Papa, Uri Hanegbi, Ross Snow, Jeremy Grummet, Sarah Mann, Adam Cuthbertson, Mark Frydenberg, Daniel Moon

Department of Urology, St. Vincent's Hospital Melbourne, Victoria, Australia. ., School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Australian Urology Associates, Malvern, Victoria, Australia., Department of Urology, Epworth Healthcare, Melbourne, Victoria, Australia.