Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
BJU Int. 2013 Jan;111(1):38-43. doi: 10.1111/j.1464-410X.2012.11268.x. Epub 2012 May 28.
To evaluate prospectively the characteristics, erectile function and lower urinary tract symptoms (LUTS) of men undergoing prostate needle biopsy (PNBx).
From 2008 to 2011, 134 men were prospectively administered the International Index of Erectile Function (IIEF), American Urological Association Symptom Index (AUA-SI), and quality-of-life (QoL) questionnaires before and after undergoing a single 12-core PNBx. Comparisons of IIEF and AUA-SI scores before and after PNBx, based upon baseline characteristics and prostate cancer (PCa) diagnosis, were performed. Univariable and multivariable logistic regression models were used to characterize predictors of change in IIEF scores.
In the 85 men who fulfilled the inclusion criteria, there were no significant differences between the mean (sd) total pre-biopsy and the mean (sd) post-biopsy IIEF scores: 57.8 (12.9) vs 54.3 (17.2). Subgroup analysis showed that men who had biopsy-proven PCa had significantly greater changes in their post-biopsy IIEF scores compared with men without (-10.1 vs. 1.0; P < 0.001). After specific analyses of the IIEF domains in these groups we found significant decreases in every domain, including erectile function (P = 0.01). On multivariate analyses, only PCa diagnosis was associated with a significant change in IIEF (odds ratio 7.2; P = 0.003). There were no differences in AUA-SI or QoL scores in the overall population or in subgroups.
Cancer diagnosis appears to have an adverse effect on the erectile function of men undergoing PNBx but no effect on LUTS. This study highlights a potential negative psychological confounder that may influence erectile function before the treatment of PCa. Additional prospective trials evaluating these relationships are warranted.
前瞻性评估行前列腺穿刺活检（PNBx）男性的特征、勃起功能和下尿路症状（LUTS）。
2008 年至 2011 年，134 名男性在接受单次 12 针 PNBx 前和后，前瞻性地接受了国际勃起功能指数（IIEF）、美国泌尿外科学会症状指数（AUA-SI）和生活质量（QoL）问卷。基于基线特征和前列腺癌（PCa）诊断，比较了 PNBx 前后 IIEF 和 AUA-SI 评分的差异。使用单变量和多变量逻辑回归模型来描述 IIEF 评分变化的预测因素。
在符合纳入标准的 85 名男性中，活检前和活检后平均（标准差）总 IIEF 评分无显著差异：57.8（12.9）vs 54.3（17.2）。亚组分析显示，与无 PCa 诊断的男性相比，活检证实有 PCa 的男性在活检后 IIEF 评分的变化显著更大（-10.1 对 1.0；P < 0.001）。在这些组的 IIEF 域的具体分析中，我们发现每个域的功能都有显著下降，包括勃起功能（P = 0.01）。在多变量分析中，只有 PCa 诊断与 IIEF 显著变化相关（比值比 7.2；P = 0.003）。在总体人群或亚组中，AUA-SI 或 QoL 评分无差异。
癌症诊断似乎对行 PNBx 的男性勃起功能有不利影响，但对 LUTS 无影响。本研究强调了一种潜在的负面心理混杂因素，可能会影响 PCa 治疗前的勃起功能。需要进一步的前瞻性试验来评估这些关系。
