Tan Jo Lynn, Papa Nathan, Hanegbi Uri, Snow Ross, Grummet Jeremy, Mann Sarah, Cuthbertson Adam, Frydenberg Mark, Moon Daniel
Department of Urology, St. Vincent's Hospital Melbourne, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
Investig Clin Urol. 2021 Mar;62(2):159-165. doi: 10.4111/icu.20200236.
To investigate the incidence and possible contributing factors of erectile dysfunction (ED) after transperineal template prostate biopsy (TTPB).
Males undergoing TTPB were prospectively administered a Sexual Health Inventory for Men (SHIM) questionnaire before biopsy and one month after. SHIM questionnaires were repeated at 3- and 9-months for males not receiving interventional treatment. Sexually inactive males were excluded. Interval change in SHIM categories based upon baseline characteristics were evaluated. Multivariable logistic regression models were used to evaluate predictors of change in SHIM score category.
A total of 576 males were included in our sample. Of these, 450 (78%) males underwent their first biopsy. A decline in SHIM category within the immediate 4-weeks post-biopsy was reported by 167 males (31% of total eligible sample). Age was the strongest predictor of decline in SHIM category, the predicted probability of a decline in SHIM at age 50 was 10% (95% confidence interval [CI], 1%-19%), 32% at age 60 (95% CI, 25%-40%) and 36% at age 70 (95% CI, 29%-44%). For new onset ED, the predicted probability of ED within 4-weeks post-TTPB were 6.7% at age 50 (95% CI, 0%-15%), 26% at age 60 (95% CI, 17%-34%) and 31% at age 70 (95% CI, 21%-40%).
Older age at biopsy is an independent predictor of immediate ED after TTPB in sexually active males. This association was observed in the subgroup with no pre-existing ED. These findings provide useful information when counselling males undergoing TTPB.
探讨经会阴模板引导前列腺穿刺活检（TTPB）后勃起功能障碍（ED）的发生率及可能的相关因素。
对接受TTPB的男性在活检前及活检后1个月前瞻性地进行男性性健康量表（SHIM）问卷调查。对于未接受介入治疗的男性，在3个月和9个月时重复进行SHIM问卷调查。排除无性生活的男性。根据基线特征评估SHIM类别随时间的变化。采用多变量逻辑回归模型评估SHIM评分类别变化的预测因素。
我们的样本共纳入576名男性。其中，450名（78%）男性接受了首次活检。167名男性（占总合格样本的31%）报告在活检后即刻4周内SHIM类别下降。年龄是SHIM类别下降的最强预测因素，50岁时SHIM类别下降的预测概率为10%（95%置信区间[CI]，1%-19%），60岁时为32%（95%CI，25%-40%），70岁时为36%（95%CI，29%-44%）。对于新发ED，TTPB后4周内ED的预测概率在50岁时为6.7%（95%CI，0%-15%），60岁时为26%（95%CI，17%-34%），70岁时为31%（95%CI，21%-40%）。
活检时年龄较大是性活跃男性TTPB后即刻发生ED的独立预测因素。在无既往ED的亚组中也观察到了这种关联。这些发现为接受TTPB的男性提供咨询时提供了有用信息。
