Erectile Dysfunction is a Transient Complication of Prostate Biopsy: A Systematic Review and Meta-Analysis

Area of Science:

• Urology
• Sexual Medicine
• Oncology

Background:

• Erectile dysfunction (ED) prevalence and its association with prostate biopsy outcomes are inconsistently reported in medical literature.
• Understanding the impact of prostate biopsy on sexual function is crucial for patient counseling and management.

Purpose of the Study:

• To systematically review and meta-analyze the incidence of sexual dysfunction in men following prostate biopsy.
• To evaluate changes in erectile function using the International Index of Erectile Function 5 (IIEF-5) scores at various time points post-biopsy.

Main Methods:

• A comprehensive literature search was conducted across major databases including MEDLINE, Embase, Web of Science, and the Cochrane Library.
• Included studies focused on sexual dysfunction in men undergoing transrectal or transperineal prostate biopsy, with pre- and post-biopsy IIEF-5 scores recorded at 1, 3, or 6 months.
• An effect size meta-analysis was performed to compare baseline IIEF-5 scores with post-biopsy scores.

Main Results:

• Nine studies met the inclusion criteria, encompassing various biopsy techniques.
• A statistically significant decrease in mean IIEF-5 scores was observed at 1 month post-biopsy (effect size = -0.43, p=0.002), indicating mild, transient ED.
• No significant differences in IIEF-5 scores were found at 3 or 6 months compared to baseline (p > 0.05), although an exploratory analysis of transrectal biopsy at 3 months showed a slight decrease.

Conclusions:

• Prostate biopsy is associated with a mild and transient reduction in erectile function one month after the procedure.
• Erectile function, as measured by IIEF-5 scores, generally recovers to baseline levels by three months post-biopsy.
• The findings suggest that most men experience temporary sexual dysfunction following prostate biopsy, with recovery typically occurring within months.