If your doctor has recommended a prostate biopsy procedure to help determine if you have prostate cancer, should you be worried about the biopsy as a potential cause of erectile dysfunction? Yes, according to some researchers, but the good news is that the erectile dysfunction may be a temporary side effect only.
Results of a study published in the Journal of Urology reported that among men who undergo prostate biopsy, one of the risks is temporary erectile dysfunction; another is urinary incontinence, which may last longer.
The risk of erectile dysfunction appears to be associated with the number of needle sticks used to take the tissue samples: the more sticks used, the greater the risk. For example, 198 men who were randomly assigned to undergo one of three forms of prostate biopsy were evaluated: a standard biopsy (one needle taking no more than 10 samples), a 10-sample biopsy along with a nerve block to reduce pain; and a “saturation” biopsy that involved 20 tissue samples.
Among men who had a saturation or standard biopsy, 25% said they had erectile dysfunction before the biopsy, but that number rose to just more than 50% one week after the procedure. In the group of men who had the nerve block, the rate of erectile dysfunction rose from 11% before to 39% after the prostate biopsy. By week 12, however, problems with erectile dysfunction had dropped to nearly pre-biopsy levels in all three groups of men.
What if your doctor recommends several prostate biopsies over a period of months and years? What is your risk of erectile dysfunction then? A study in the Journal of Urology reported on 231 men with prostate cancer who were undergoing active surveillance over a 10-year period. All the men in the study had had at least one 10- to 12-core prostate biopsy, and had been advised to have a yearly biopsy.
The men completed the 5-item Sexual Health Inventory for Men (SHIM) and the International Prostate Symptom Score (I-PSS) questionnaires. The researchers found that the number of prostate biopsies was significantly associated with a decrease in the SHIM score, and men who had three or more biopsies had a significantly greater decline in SHIM score when compared with men who had 2 or less biopsies. Men who had not experienced erectile dysfunction before they ever underwent a prostate biopsy found there was a trend toward greater decreases in SHIM scores after having three or more biopsies when compared with men who had mild to moderate erectile dysfunction before their biopsies.
If you are a man who is considering a prostate biopsy, or who may need more than one prostate biopsy over time, be aware that erectile dysfunction may be a temporary side effect. The important word here is “temporary,” although the risk of erectile dysfunction appears to increase as the number of biopsies rises, and the impact is most dramatic when men have three or more prostate biopsies.
Sources
Fujita K et al. Serial prostate biopsies are associated with an increased risk of erectile dysfunction in men with prostate cancer on active surveillance. J Urol 2009; 182: 2664-69
Klein T et al. The impact of prostate biopsy and periprostatic nerve block on erectile and voiding function: a prospective study. J Urology 2010 Oct; 184(4): 1447-52
