Serial transperineal sector prostate biopsies: impact on long-term erectile dysfunction

We wanted to determine whether serial transperineal sector prostate biopsies have a long-term effect on erectile dysfunction (ED). A total of 64 men with prostate cancer entered our active surveillance (AS) programme after a transrectal prostate biopsy as well as a confirmatory initial transperineal sector prostate biopsy (TPSBx). A repeat TPSBx was performed 24 months later as part of our active surveillance protocol. The International Index of Erectile Function-5 (IIEF-5) questionnaire assessed ED at baseline prior to each TPSBx, and at one, three, and six months after first and second TPSBx. There was a significant short-term deterioration in erectile function on mean IIEF-5 score between baseline (19.5), when compared to one month (10.5) (P <0.001) and three months (18.7) (P = 0.001) following first TPSBx. This resolved at six month follow-up (19.6) (P = 0.681). Following second TPSBx, there was a deterioration in erectile function between baseline (16.6), compared to one month (7.3), three months (13.8), and six months (15.9) (P <0.05) following second TPSBx. Initial TPSBx caused significant short-term ED, which resolved by six months. Serial TPSBx appears to have an adverse impact on erectile function in men monitored on AS, increasing the risk of long-term ED. This risk should be highlighted and discussed during the consent process.

Ecancermedicalscience. 2016 May 23*** epublish ***

James Jy Chong, Mieke Van Hemelrijck, Declan Cahill, Janette Kinsella

Faculty of Life Sciences and Medicine, King's College London, London SE1 1UL, UK., Division of Cancer Studies, Cancer Epidemiology Group, Research Oncology, King's College London, London SE1 9RT, UK., Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK., Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.