Transient drop in erectile function seen after prostate biopsy


By Reuters Staff

NEW YORK (Reuters Health) - Undergoing prostate biopsy appears to lead to a brief reduction in erectile function which may resolve within months, although data are scarce and more study is needed, according to a new review and meta-analysis.

Biopsy-related complications such as infection, bleeding and pain are well documented, but there is no consensus on the effect on erectile function, Dr. Kamran Ahmed of King's College Hospital, in London, and colleagues note in Urology.

The researchers conducted a systematic review of the literature and identified 47 full-text articles, involving 9,545 patients, which were included in the narrative synthesis. Of these, the team included seven in the meta-analysis, excluding case reports, studies with less than 10 patients, those using non-validated measures such as self-reported erectile dysfunction or lacking data on the timing of erectile function.

The mean difference in International Index of Erectile Function-5 (IIEF5) compared with baseline scores were pooled at one, three and six months using a random-effects model to overcome "significant" heterogeneity in the results.

In five studies involving 556 patients included in one analysis the team found a significant reduction in mean IIEF5 of 4.61 at one month after biopsy. "This resolved with non-significant differences at three- and six-months post procedure," they note.

The team had hoped to conduct further subgroup analyses including factors such as the effect of anesthetics, but "Unfortunately, due to low study numbers utilizing the same outcome measures and varying timeframes reported for subgroup analysis outcomes, only a narrative synthesis of these was possible," the researchers explain.

In addition, they point out that "it is difficult to separate the psychological role of the event from the biopsy itself with anxiety surrounding diagnosis known to impact EF post biopsy."

In view of current heterogeneity in the data on erectile function and biopsy, the researchers stress that "high-quality studies are required to further investigate this negative relationship."

They conclude that "current evidence allows for little assessment on the impact of biopsy technique or repeat biopsies on EF post biopsy. Further investigation is required on patient and biopsy factors which act as predictors for poorer erectile function outcomes post biopsy."

Dr. Ahmed did not respond to requests for comments.

SOURCE: Urology, online January 28, 2021.

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