CHANGES IN ERECTILE FUNCTION BEFORE AND AFTER PROSTATE BIOPSY

Objective: To evaluate erectile function before and after transrectal ultrasound (TRUS) guided prostate biopsy using International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) instrument. Material & Method: We conducted a study on 17 BPH LUTS patients who underwent TRUS guided prostate biopsy from January to April 2011 in Urological Minimal Invasive Installation (IIU) Dr. Soetomo Hospital. Out of 17 patients, three patients had mild ED, while 14 other patients had normal erectile function before the procedure. After TRUS guided prostate biopsy, we performed erectile function assessment using the IIEF-5 and EHS at weeks I, II, and IV. Results: Pathological examination of all specimens from prostate biopsy results revealed BPH. There were 2 patients with hematuria and 1 patient with rectal bleeding shortly after the biopsy, which resolved spontaneously less than 24 hours. Based on the IIEF-5 there were 4 patients (23,5%) with decreased erectile function in the evaluation of first week after prostate biopsy, and it reduced to 2 patients (11,7%) whose erectile function was still decreasing in the evaluation week II, while in fourth week evaluation there was 1 patient (5,9%) with decreased erectile function. Based on EHS data obtained, there were 5 patients (29,4%) with decreased scores in evaluations week II, and in the evaluation of week IV there were no patients having erectile function problems compared with EHS data before prostate biopsy. Conclusion: TRUS guided prostate biopsy can have temporary effect on erectile function.Keywords: Erectile dysfunction, prostate biopsy, international index of erectile function-5, erection hardness score.

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When should the evaluation of erectile function be done before radical prostatectomy?

Urologia Journal ◽

10.1177/0391560319842956 ◽

2019 ◽

Vol 86 (3) ◽

pp. 148-151

Author(s):

Ali Yıldız ◽

Kaan Karamık ◽

Yasin Aktaş ◽

Hakan Anıl ◽

Ekrem İslamoğlu ◽

...

Keyword(s):

Erectile Dysfunction ◽

Surgical Treatment ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Erectile Function ◽

Transrectal Ultrasound ◽

Before And After

The aim of this study is to assess the erectile function of patients before and after transrectal ultrasound prostate biopsy comparatively in order to determine the appropriate time to evaluate erectile function before radical prostatectomy. A total of 44 patients underwent transrectal ultrasound biopsy. We used the International Index of Erectile Function-5 questionnaire to assess all the patients. In total, 44 volunteered patients were included in this study. All patients were evaluated with the International Index of Erectile Function-5 questionnaire before the biopsy and at 4 weeks after the transrectal ultrasound biopsy. A total of 50% of patients were potent before the biopsy was done. A month after the biopsies, erectile dysfunction was reported by 29 of 44 patients (66%) as mild in 10 (22.7%), as mild-moderate in 14 (31.8%), as moderate in 4 (9.1%), and severe in 1 (2.3%). The differences were statistically significant in the first month of the biopsy ( p < 0.05). The effect of prostate biopsy upon the erectile function is non-negligible. However, this situation is temporary and transient. Therefore, it is recommended that the International Index of Erectile Function-5 questionnaire is to be administered prior to prostate biopsy rather than before surgical treatment.

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Erectile function after repeat saturation prostate biopsy: Our experience in 100 patients

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2013.3.130 ◽

2013 ◽

Vol 85 (3) ◽

pp. 130 ◽

Cited By ~ 5

Author(s):

Pietro Pepe ◽

Francesco Pietropaolo ◽

Giuseppe Dibenedetto ◽

Francesco Aragona

Keyword(s):

Erectile Dysfunction ◽

Sexual Activity ◽

Prostate Biopsy ◽

Erectile Function ◽

Minimal Risk ◽

Before And After ◽

Benign Histology ◽

Total Psa

Introduction: Erectile dysfunction (ED) incidence following repeat saturation prostate biopsy (SPBx) was evaluated. Materials and methods: From January 2011 to June 2012 295 patients underwent repeat transperineal SPBx (median 28 cores) under sedation. The indications for biopsy were: abnormal DRE, PSA > 10 ng/mL or included between 4.1-10 with free/total PSA < 25%. All patients were prospectively evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) at baseline and 1, 3 and 6 months from SPBx. Results: 100/200 men with benign histology and normal sexual activity completed the study; median IIEF-5 score before and after SPBx was equal to 18.3 (baseline) vs 17.8 (1 month later) vs 18 (3 months later) vs 18.1 (6 months later) (p > 0.05); in detail, 1 month from biopsy 5 (5%) men referred a mild ED that disappeared at 3 and 6 months evaluation. Conclusions: Repeat transperineal SPBx under sedation did not significantly worsened erectile function; the minimal risk of temporary post-biopsy ED could be previously discussed (not emphasised) with potent patients.

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Impact of anxiety on erectile dysfunction after transrectal ultrasound guided prostate biopsy

European Urology Supplements ◽

10.1016/s1569-9056(17)31348-9 ◽

2017 ◽

Vol 16 (5) ◽

pp. e2199-e2200

Author(s):

S. Aykan ◽

E. Ates ◽

O. Kose ◽

H. Gulmez ◽

M. Yilmaz ◽

...

Keyword(s):

Erectile Dysfunction ◽

Prostate Biopsy ◽

Transrectal Ultrasound ◽

Ultrasound Guided

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The Comparison of Penile Doppler Ultrasonography Findings with Serum Lipid Parameters in Hyperlipidemic Patients with Erectile Dysfunction

Grand Journal of Urology ◽

10.5222/gju.2021.65376 ◽

2021 ◽

Author(s):

Mustafa Taşdemir ◽

Ünal Öztekin ◽

Mehmet Canikoğlu ◽

Hafize Aktaş

Keyword(s):

Erectile Dysfunction ◽

Erectile Function ◽

Doppler Ultrasonography ◽

Oral Treatment ◽

Post Treatment ◽

Cholesterol Levels ◽

Before And After ◽

Function Domain ◽

Lipid Parameters ◽

High Triglyceride

Objective: The aim of this study is to investigate the effect of hyperlipidemia on the development of erectile dysfunction (ED) in hyperlipidemic patients with ED. Materials and Methods: Twenty-five patients who applied to the radiology clinic were included in the study. All patients have only hyperlipidemia as a risk factor of ED. The patients were evaluated in terms of ED by using International Index of Erectile Function (IIEF) form. Before and after oral treatment with daily doses of 10 mg atorvastatin, all parameters were measured. Paired t-test was used to compare vascular velocities between lipid profiles and Erectile Function Domain Scores (EFDS) and IIEFs, before and after treatment separately. Results: Cholesterol levels of 96% of patients were higher than 200 mg/dl and 52% of them had abnormal penile Doppler ultrasonography (PDU) findings. Patients with abnormal PDU findings had lower cholesterol levels than those with normal PDU findings. Significant differences existed between patients with normal and abnormal PDU in the high triglyceride group as for pre-, and post-treatment values . Pre-, and post-treatment EFD and IIEF scores were comparable. Conclusion: It can be said that a relationship exists between hyperlipidemia and erectile dysfunction. Therefore, lipid profile of a patient admitted with ED may be analyzed routinely

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Preservation of erectile function after permanent radioactive seed implantation for treatment of prostate cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.15596 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 15596-15596

Author(s):

R. D. Steinmetz ◽

W. L. Barrett

Keyword(s):

Prostate Cancer ◽

Erectile Function ◽

Retrospective Chart Review ◽

Prostate Brachytherapy ◽

Testosterone Levels ◽

Before And After ◽

Adenocarcinoma Of The Prostate ◽

Pretreatment Score ◽

Function Assessment

15596 Purpose: Assess erectile function before and after prostate brachytherapy. Materials and Methods: A total 241 patients were treated with permanent I-125 prostate brachytherapy for T1 and T2 adenocarcinoma of the prostate. A retrospective chart review was undertaken to assess erectile function before and after treatment using the scoring system of, 1- complete inability to have erections, 2 - can sometimes have erections sufficient for intercourse with or without medication, and 3 - has normal erectile function. Pretreatment testosterone levels were reviewed for correlation with pretreatment erectile function. Results: The median age was 68. At presentation, the median age of patients with erectile scores of 1, 2 and 3 was 70, 67 and 67 respectively. The median time of follow-up was 48 months. Pretreatment erectile function assessment revealed scores of 1 in 28%, 2 in 27% and 3 in 45% of patients. Median pretreatment testosterone levels were 296 ng/dl in the patients with pretreatment score of 1 compared to 360 ng/dl in patients with a score of 2 and 370 ng/dl in patients with a score of 3. The normal testosterone range for this age group is 165 ng/dl to 830 ng/dl. After 12 months erectile function assessment revealed scores of 1 in 29%, 2 in 42% and 3 in 29% of patients. After 24 months erectile function assessment revealed scores of 1 in 30%, 2 in 41% and 3 in 29% of patients. After 36 months erectile function assessment revealed scores of 1 in 32%, 2 in 45% and 3 in 23% of patients. After 48 months erectile function assessment revealed scores of 1 in 39%, 2 in 36% and 3 in 25% of patients. After 48 months, the median age of patients with erectile scores of 1, 2 and 3 was 75, 69 and 66 respectively. After 60 months erectile function assessment revealed scores of 1 in 32%, 2 in 47% and 3 in 21% of patients. After 72 months erectile function assessment revealed scores of 1 in 24%, 2 in 52% and 3 in 24% of patients. 49% of patients were given sildenafil, vardenafil, or tadalafil to improve erectile function. Conclusion: The rate of potency preservation in this cohort declined in an expected manner after permanent brachytherapy for prostate cancer. No significant financial relationships to disclose.

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Complications and risk factors in transrectal ultrasound-guided prostate biopsies

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000400005 ◽

2006 ◽

Vol 124 (4) ◽

pp. 198-202 ◽

Cited By ~ 24

Author(s):

Carlos Márcio Nóbrega de Jesus ◽

Luiz Antônio Corrêa ◽

Carlos Roberto Padovani

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Rectal Bleeding ◽

Prostate Biopsy ◽

Transrectal Ultrasound ◽

Infectious Complications ◽

Indwelling Catheter ◽

Prostate Biopsies ◽

Major Complications ◽

Biopsy Complications

CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS) guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE) or levels higher than 4 ng/ml in prostate-specific antigen (PSA) tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%), while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%). Urinary tract infection (UTI) occurred in 16 patients (9.2%). Sepsis was observed in three patients (1.7%). The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05). Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05). The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

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The management of rectal bleeding following transrectal prostate biopsy: A review of the current literature

Canadian Urological Association Journal ◽

10.5489/cuaj.4660 ◽

2017 ◽

Vol 12 (3) ◽

pp. E146-53 ◽

Cited By ~ 2

Author(s):

Mark R. Quinlan ◽

Damien M. Bolton ◽

Rowan G. Casey

Keyword(s):

Rectal Bleeding ◽

Prostate Biopsy ◽

Specific Antigen ◽

Transrectal Ultrasound ◽

Endoscopic Sclerotherapy ◽

Trus Biopsy ◽

Surgical Methods ◽

Transrectal Prostate Biopsy ◽

Life Threatening ◽

The Common

Introduction: Since the advent of prostate-specific antigen (PSA)-based testing, transrectal ultrasound (TRUS)-guided prostate biopsy has become a standard part of the diagnostic pathway for prostate cancer (PCa). Rectal bleeding is one of the common side effects of this transrectal route. While rectal bleeding is usually mild and self-limiting, it can be life-threatening. In this article, we examine rectal bleeding post TRUS-guided prostate biopsy and explore the literature to evaluate techniques and strategies aimed at preventing and managing this common and important complication.Methods: A PubMed literature search was carried out using the keywords “transrectal-prostate-biopsy-bleed.” A search of the bibliography of reviewed studies was also conducted. Additionally, papers in non-PubMed-listed journals of which the authors were aware were appraised.Results: Numerous modifiable risk factors for this bleeding complication exist, particularly anticoagulants/antiplatelets and the number of core biopsies taken. Successfully described corrective measures for such rectal bleeding include tamponade (digital/packs/catheter/tampon/condom), endoscopic sclerotherapy/banding/clipping, radiological embolization, and surgical intervention.Conclusions: We advocate early consultation with the colorectal/gastroenterology and interventional radiology services and a progressive, stepwise approach to the management of post-biopsy rectal bleeding, starting with resuscitation and conservative tamponade measures, moving to endoscopic hemostasis ± radiological embolization ± transanal surgical methods. Given the infrequent but serious nature of major rectal bleeding after TRUS biopsy, we recommend the establishment of centralized databases or registries forthwith to prospectively capture such data. To the best of our knowledge, this is the first comprehensive look specifically at the management of post-TRUS biopsy rectal bleeding.

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