A prospective study on patient's erectile function following transrectal ultrasound guided prostate biopsy

This study is intended to assess variation of sexual function in 222 patient at different treatment stages of prostate cancer with the aid of a validated questionnaire in comparison with patients diagnosed with a benign lesion. The questionnaire covers the period before carrying out prostate biopsy, the disclosure of histological examination, and the recovery period.

240 patients who were to undergo trans-rectal ultrasound guided prostate biopsy due to suspected prostate cancer were consecutively and prospectively studied between January 2008 and January 2009. Patients were asked to complete an IIEF-15 questionnaire to assess sexual function during the initial consultation (T0), generally whilst they waited to be called forward for an ECG or to provide blood samples. The same questionnaire was re-administered 30 days following disclosure of results (T30) and, in all cases of confirmed malignancy, at pre-surgical admission (T pre-op).

In this study we examined results on perceived sexual function following transrectal ultrasound guided prostate biopsy for suspected neoplasia. Eighteen of the 240 consecutive patients suitable for the study were excluded due to their inability to reliably complete the IIEF-15 questionnaires provided. Histological results led to the selection of 98 patients (44.1%) with neoplastic pathology, group A, and 124 (55.8%) with benign pathology, group B. At T0 a normal level of erectile function was evident in 50 group A patients (51%) and in 50 group B patients (40.3%), while ED has been reported in 48 individuals (49%) in group A and in 74 (59.7%) in group B. At T30 we observed in group A a decrease of the mean IIEF-15 score from 53.6 to 37.8 (p = 0.0013). We observed similar results in group B, where 10/50 patients developed ED with a consequent reduction of the IIEF average score from 55.9 to 48.3 (p = 0.04). Of the 16 patients in group A who developed ED after biopsy only 2 were eligible for surgery and there were no statistical differences in the IIEF scores comparing T30 with T-pre-surgery (p = 0.36).

In this study, as previously documented in literature, no direct correlation was observed between ED in patients and the diagnosis of prostate cancer. The only seemingly correlative factor between ED and prostate cancer is biopsy itself. Further specific studies should be carried out to assess whether ED is a psychological result of an emotional stressful event or whether resulting physical damage following the biopsy procedure is to blame.