The impact of robotic-assisted transperineal biopsy of the prostate on erectile function.

Prostate biopsy represents one of the most frequently performed urologic procedures worldwide and therefore presupposes knowledge on potential effects like on erectile function, especially in extensive or repeated biopsies. The robotic assisted biopsy system (Mona Lisa) offers a minimal invasive approach via only two incision points ensuring maximal accuracy combined with protection of the neurovascular bundle of the prostate.

Our purpose was to analyse the impact of of robotic-assisted transperineal biopsy of the prostate on erectile function.

Our prospective study analyses the outcomes of 210 patients, who had undergone minimal-invasive, transperineal robotic assisted biopsy of the prostate at the University Hospital Basel from January 2020 - March 2023 and provided sufficient data. Of these, 157 (74.8%) were included in final analysis.

Mean (range) age, prostate volume, PSA and IIEF-5 score at baseline were 63.8 years (46.1 - 83.6), 46.4 ml (9 - 310), 13.2 ng/ml (0.2 - 561) and 18.8 points (6 - 25), respectively. EF before and one month after intervention was assessed with the IIEF-5 questionnaire for the whole cohort. No significant change of IIEF-5 was observed for the whole cohort with a mean (± SD) decrease of 0.4 (± 3.1) points. Except for patients > 69 years, subgroup analysis revealed no change of IIEF-5 in statistically significant manner for all subgroups. Number of biopsy cores (< 20 and ≥ 20), previous biopsies and active surveillance showed no significant influence.

Our results suggest that the minimally invasive and highly precise robotic technique can spare erectile function without limiting the extent of biopsy and without compromising diagnostic accuracy. This article is protected by copyright. All rights reserved.

Andrology. 2022 Nov 25 [Epub ahead of print]

Pawel Trotsenko, Manuel Walter, Christian Hermann Engesser, Keller Nicola, Alargkof Anagnostou Viktor, David Jean Winkel, Hanns-Christian Breit, Anja Meyer, Hans-Helge Seifert, Christian Wetterauer

Department of Urology, University Hospital Basel, Basel, Switzerland., Department of Urology, Cantonal Hospital St. Gallen, St, Gallen, Switzerland., Department of Radiology, University Hospital Basel, Basel, Switzerland.

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