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• W2011051885 abstract "No AccessJournal of UrologyAdult Urology1 Oct 2012The Impact of Serial Prostate Biopsies on Sexual Function in Men on Active Surveillance for Prostate Cancer Joan F. Hilton, Sarah D. Blaschko, Jared M. Whitson, Janet E. Cowan, and Peter R. Carroll Joan F. HiltonJoan F. Hilton Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author , Sarah D. BlaschkoSarah D. Blaschko Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author , Jared M. WhitsonJared M. Whitson Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author , Janet E. CowanJanet E. Cowan Department of Urology, University of California-San Francisco, San Francisco, California More articles by this author , and Peter R. CarrollPeter R. Carroll Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California Financial interest and/or other relationship with National Cancer Institute, Department of Defense, Abbott, Takeda, Genomic Health and Myriad. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.06.013AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: NCCN Guidelines® recommend annual prostate biopsies for men with low risk prostate cancer on active surveillance. We determined whether erectile function decreases with the number of biopsies experienced. Materials and Methods: During a median 3.2-year followup after prostate cancer diagnosis in 2003 to 2010 at our institution 427 men on active surveillance underwent a total of 1,197 biopsies and provided 1,398 erectile function evaluations via the Sexual Health Inventory for Men questionnaire. For analysis we decomposed the 25-point questionnaire responses into a 5-point erectile function score and a 3-level sexual activity status. We used separate models adjusted for patient characteristics to determine whether either outcome varied with biopsy exposure. Results: At diagnosis the median age was 61 years and median prostate specific antigen was 5.3 ng/ml. Of the cases 70% were clinical stage cT1 and 93% were Gleason score less than 7. Of biopsies followed by evaluations 40% were the first undergone by the patient and 9% were the fifth to ninth. At the first erectile function evaluation 15% of men were inactive, 8% engage in stimulation and 77% engaged in intercourse. Sexual activity level changed in greater than 20% of respondents between evaluations. Adjusted erectile function scores were not associated with biopsy exposure cross-sectionally or longitudinally but they corresponded with the 50th, 63rd and 80th percentiles of erectile function by increasing sexual activity level. Similarly, sexual activity was not associated with biopsy exposure. Separated outcomes were more accurate and informative than Sexual Health Inventory for Men scores. Conclusions: Our study had high power to detect erectile function-biopsy associations but it estimated that the effects were negligible. We recommend erectile function scores over Sexual Health Inventory for Men scores to avoid biased assessment of erectile function. References 1 : Cancer statistics. CA Cancer J Clin2010; 60: 277. Google Scholar 2 : Serum prostate-specific antigen for the early detection of prostate cancer: always, never, or only sometimes?. J Clin Oncol2011; 29: 345. Google Scholar 3 : Active surveillance for early-stage prostate cancer: review of the current literature. Cancer2008; 112: 1650. Google Scholar 4 : Prostate specific antigen best practice statement: 2009 update. J Urol2009; 182: 2232. Link, Google Scholar 5 : Outcomes and follow-up strategies for patients on active surveillance. Curr Opin Urol2009; 19: 258. 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Int J Impot Res1999; 11: 319. Google Scholar 12 : Lower urinary tract symptoms affect one-third of men in a prostate cancer screening population. J Endourol2008; 22: 369. Google Scholar 13 : Can prostate biopsies affect erectile function?. Andrologia2006; 38: 79. Google Scholar 14 : Re: Serial prostate biopsies are associated with an increased risk of erectile dysfunction in men with prostate cancer on active surveillance K. Fujita, P. Landis, B.K. McNeil and C.P. Pavlovich. J Urol 2010; 183: 2471 J Urol2009; 182: 2664. Google Scholar 15 : Erectile function in prostate cancer-free patients who underwent prostate saturation biopsy. Eur Urol2007; 53: 540. Google Scholar 16 : Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med2010; 7: 1362. Google Scholar 17 : The impact of lower urinary tract symptoms on male sexual health: EpiLUTS. BJU Int2009; 103: 33. Google Scholar 18 : Baseline prevalence of erectile dysfunction in a prostate cancer screening population. J Sex Med2008; 5: 428. Google Scholar 19 : Prevalence of erectile dysfunction in men screened for prostate cancer. Urology2009; 74: 89. Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBurns J, Hurwitz L, Levie K, Caumont F, Brand T, Rosner I, Stroup S, Musser J, Cullen J and Porter C (2019) Impact of Subsequent Biopsies on Comprehensive Health Related Quality of Life in Patients with and without Prostate CancerJournal of Urology, VOL. 201, NO. 5, (916-922), Online publication date: 1-May-2019.Whitson J, Murray K and Thrasher J (2018) Prostate Biopsy is Associated with an Increased Risk of Erectile DysfunctionJournal of Urology, VOL. 196, NO. 1, (21-23), Online publication date: 1-Jul-2016.Pham K, Johnston R, Jeldres C, Lewinshtein D and Porter C (2018) The Impact of Multiple Prostate Needle Biopsies on Long-Term Erectile DysfunctionUrology Practice, VOL. 2, NO. 2, (85-89), Online publication date: 1-Mar-2015.Braun K, Ahallal Y, Sjoberg D, Ghoneim T, Dominguez Esteban M, Mulhall J, Vickers A, Eastham J, Scardino P and Touijer K (2018) Effect of Repeated Prostate Biopsies on Erectile Function in Men on Active Surveillance for Prostate CancerJournal of Urology, VOL. 191, NO. 3, (744-749), Online publication date: 1-Mar-2014.Kuru T, Roethke M, Seidenader J, Simpfendörfer T, Boxler S, Alammar K, Rieker P, Popeneciu V, Roth W, Pahernik S, Schlemmer H, Hohenfellner M and Hadaschik B (2018) Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate CancerJournal of Urology, VOL. 190, NO. 4, (1380-1386), Online publication date: 1-Oct-2013. Volume 188Issue 4October 2012Page: 1252-1259 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsquestionnairesprostatic neoplasmsprostateerectile dysfunctionbiopsyAcknowledgmentsDr. Allison Glass and Samuel Washington extracted study data from patient medical records.MetricsAuthor Information Joan F. Hilton Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author Sarah D. Blaschko Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author Jared M. Whitson Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California More articles by this author Janet E. Cowan Department of Urology, University of California-San Francisco, San Francisco, California More articles by this author Peter R. Carroll Department of Urology, University of California-San Francisco, San Francisco, California University of California-San Francisco–Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California Financial interest and/or other relationship with National Cancer Institute, Department of Defense, Abbott, Takeda, Genomic Health and Myriad. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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