title: A prospective study of erectile function after transrectal ultrasonography-guided prostate biopsy.
abstract: OBJECTIVE
  To prospectively evaluate the effect of transrectal ultrasonography (TRUS)-guided prostate biopsy on erectile and voiding function at multiple time-points after biopsy.
  
  
  METHODS
  All men who underwent TRUS-guided prostate biopsy completed a five-item version of the International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) before and at 1, 4 and 12 weeks after TRUS-guided biopsy. Statistical analyses used were a general descriptive analysis, continuous variables using a t-test and categorical data using chi-square analysis. A paired t-test was used to compare each patient's baseline score to their own follow-up survey scores.
  
  
  RESULTS
  In all, 220 patients were enrolled with a mean age of 64.1 years and PSA level of 6.7 ng/dL. At initial presentation, 38.6% reported no erectile dysfunction (ED), 22.3% mild ED, 15.5% mild-to-moderate ED, 10% moderate ED, and 13.6% severe ED. On paired t-test there was a statistically significant reduction in IIEF-5 score at 1 week after biopsy compared with before biopsy (18.2 vs 15.5; P < 0.001). This remained significantly reduced at 4 (18.4 vs 17.3; P = 0.008) and 12 weeks (18.4 vs 16.9, P = 0.004) after biopsy.
  
  
  CONCLUSIONS
  The effects of TRUS-guided prostate biopsy on erectile function have probably been underestimated. It is important to be aware of these transient effects so patients can be appropriately counselled. The exact cause of this effect is yet to be determined.
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Katie S
authors.initials: KS
authors.lastname: Murray
authors.affiliation: Kansas City University of Medicine and Biosciences, Kansas City, KS, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Bailey
authors.affiliation: University of Kansas School of Medicine, Kansas City, KS, USA.
authors.forename: Keegan
authors.initials: K
authors.lastname: Zuk
authors.affiliation: Kansas City Veterans Administration Medical Center, Kansas City, KS, USA.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Lopez-Corona
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.|Kansas City Veterans Administration Medical Center, Kansas City, KS, USA.
authors.forename: J Brantley
authors.initials: JB
authors.lastname: Thrasher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000009:adverse effects*
keywords: erectile dysfunction; prostate biopsy; urinary symptoms