https://doi.org/10.4081/aiua.2022.4.420

The impact of prostate biopsy on erectile and ejaculatory function: A prospective study

Vol. 94 No. 4 (2022)
Submitted: September 6, 2022
Accepted: September 16, 2022
Published: December 27, 2022
Prostate cancer, Prostate needle biopsy, Erectile dysfunction, Ejaculatory dysfunction
Abstract Views: 701
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Authors

Michele Morelli
Urology Unit, ASST Ospedale Manzoni, Lecco; University of Milan, Italy.
Gianluca Sampogna
University of Milan; Urology Unit, Niguarda Hospital, Milan, Italy.
Samuele Molteni
Urology Unit, ASST Ospedale Manzoni, Lecco; University of Milan, Italy.
Carmine Sciorio
Urology Unit, ASST Ospedale Manzoni, Lecco, Italy.
Vito Lorusso
University of Milan, Italy.
Lorenzo Romano
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II”, Naples, Italy.
Roberto La Rocca
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II”, Naples, Italy.
Marco Capece
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II”, Naples, Italy.
Assunta Zimarra
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II”, Naples, Italy.
Luigi Napolitano
dr.luiginapolitano@gmail.com
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II”, Naples, Italy.
Paolo Verze
Department of Medicine and Surgery "Scuola Medica Salernitana", University of Salerno, Fisciano, Campania, Italy.
Lorenzo Spirito
Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli,", Naples, Italy.

Objective: To evaluate the impact on erectile and ejaculatory function following transrectal ultrasound-guided biopsies of the prostate (TRUS-Bx) in sexually active men.
Methods: Monocentric prospective study from May 2021 to January 2022 of consecutive patients with suspected prostate cancer [elevated prostate specific antigen (PSA) level and/or abnormal digital rectal examination] undergoing TRUS-Bx. The 15-item version of the International Index of Erectile Function (IIEF-15), Premature Ejaculation Diagnostic Tool (PDET) and short form of Male Sexual Health Questionnaire (MSHQ-EjD Short Form) were assessed before, one and three months after TRUS-Bx. The primary endpoint was to evaluate the risk of temporary post-biopsy erectile and/or ejaculatory dysfunctions. The statistical significance was set as p value < 0.05.
Results: A total of 276 consecutive patients were included in the study. The median age, PSA and biopsy cores were 65 years (IQR 59-69), 7 ng/ml (IQR 5-9.7) and 16 (IQR 12-16), respectively. We compared the IIEF subdomains before TRUS-Bx vs. one or three months: the erectile function (EF) decreased after one month (p<0.001) but recovered after three months (p=0.833); the Orgasmic Function (OF), the Sexual Desire (SD), the Intercourse Satisfaction (IS), the Overall Satisfaction (OS), and Total IIEF decreased significantly after both one and three months compared to pre-biopsy values (p < 0.05). As for ejaculatory function (EjF), PDET, MSHQ-EjD Short Form 1, 2, 3 and MSHQ-EjD Short Form 4 scores decreased significantly after one month (p < 0.001), but they returned to pre-biopsy values after 3 months: p = 0.538, p = 0.071 and p = 0.098, respectively.
Conclusions: Our study proved that EF, assessed through IIEF- 15, and ejaculatory function, assessed through PDET and MSHQ-EjD Short Form, were negatively affected by TRUS-Bx one month after the procedure and recovered after three months. Interestingly, the other IIEF-15 subdomains (OF, SD, IS, OS and Total) resulted as significantly reduced also after 3 months: this issue highlights the importance of carefully considering the indication to TRUS-Bx.

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How to Cite

Morelli, M., Sampogna, G., Molteni, S., Sciorio, C., Lorusso, V., Romano, L., La Rocca, R., Capece, M., Zimarra, A., Napolitano, L., Verze, P., & Spirito, L. (2022). The impact of prostate biopsy on erectile and ejaculatory function: A prospective study. Archivio Italiano Di Urologia E Andrologia, 94(4), 420–423. https://doi.org/10.4081/aiua.2022.4.420
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