title: A prospective study of the short-term quality-of-life outcomes of patients undergoing transperineal prostate biopsy.
abstract: OBJECTIVE
  To investigate in a prospective, observational study whether transperineal prostate biopsy (TPbx) results in patient-reported quality-of-life (QoL) changes from baseline in the first 3-months after TPbx.
  
  
  METHODS
  Consenting patients completed the 26-item Expanded Prostate cancer Index Composite (EPIC-26), the Sexual Health Inventory for Men, the International Prostate Symptom Score, the Generalised Anxiety Disorder seven-item scale, the Patient Health Questionnaire nine-item scale, and a global question about willingness to have a repeat TPbx in a years' time. The instruments were scored using published scoring methods. Wilcoxon signed-rank tests and Mann-Whitney U-tests were used to investigate statistically significant differences. Clinically significant differences were also investigated defined by published minimal important differences for the EPIC-26 and changes in established categorical groups for the other instruments.
  
  
  RESULTS
  In all, 53 patients consented to participate and completed the baseline questionnaire, in addition to at least one of the 1- or 3-month follow-up questionnaires. We found that most patients having a TPbx had no clinically significant change in QoL in the first 3 months after TPbx. However, 24% had clinically worse urinary function and 18% had worse sexual function at 1 month. At 3 months, 3% of patients had clinically worse urinary function and 25% continued to have worse sexual function compared with baseline. Patients who were subsequently diagnosed with cancer based on the results of the TPbx, had statistically significantly reduced QoL for the EPIC-26 urinary scales and reduced improvements in scores on the psychological scales at the 1-month follow-up compared with those who were not diagnosed with cancer.
  
  
  CONCLUSIONS
  Most patients having a TPbx had no clinically significant change in QoL in the first 3 months after TPbx. However, patients should be advised that a quarter may have clinically worse urinary function and nearly 20% have clinically worse sexual function in the first month, and that sexual function deficits may continue up to 3 months. The results of this study provide a resource that the clinician can use when discussing TPbx with patients.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.
authors.forename: Adam S
authors.identifier: http://orcid.org/0000-0002-5224-3106
authors.initials: AS
authors.lastname: Dowrick
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.|Australian Prostate Cancer Research Centre Epworth, Melbourne, Vic., Australia.
authors.forename: Addie C
authors.initials: AC
authors.lastname: Wootten
authors.affiliation: Australian Prostate Cancer Research Centre Epworth, Melbourne, Vic., Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Howard
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Peters
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.|Peter MacCallum Cancer Centre, Division of Cancer Surgery, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Declan G
authors.initials: DG
authors.lastname: Murphy
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D010537:Peritoneum; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011788:Quality of Life; D013997:Time Factors
keywords: anxiety; erectile dysfunction; lower urinary tract symptoms; prostate biopsy; quality of life; transperineal