The impact of prostate biopsy on patient well-being: A prospective study of pain, anxiety and erectile dysfunction

Purpose: We prospectively studied the impact of transrectal ultrasound guid ed prostate biopsy on patient well-being. Materials and Methods: We enrolled 211 consecutive men who underwent a tota l of 218 biopsy events in a questionnaire based survey focusing on pain, an xiety and erectile dysfunction risk factors. Surveys were administered befo re, and immediately, 1 week and 1 month after biopsy. Quantitative informat ion on the intensity of symptoms and signs was obtained using a uniform gra ding system. Results: Intraoperative pain considered severe in 20% of the biopsy events was associated with pain in the first 24 hours postoperatively, leading to analgesic use in 10%. Inflammatory infiltrate in the biopsy core and younge r patient age correlated with persistent pain on days 2 and 7 after biopsy, respectively. Preoperative anxiety was reported in 64% of biopsy events an d predictive of intraoperative pain. Anxiety peaked before result disclosur e. Erectile dysfunction attributed to anxiety in anticipation of biopsy was reported in 7% of cases. At days 7 and 30, 15% of previously potent patien ts reported erectile dysfunction. Conclusions: The impact of prostate biopsy on patient well-being begins whi le waiting for the scheduled procedure. Shortening the anticipation period before results are disclosed and administering pre-biopsy anxiety decreasin g measures may benefit patients. Analgesic therapy is recommended in younge r patients, those reporting moderate to severe intraoperative pain and thos e with known prostatic inflammatory infiltrate. The risk of acute erectile dysfunction should be discussed cautiously with patients who are potent bef ore biopsy.