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Comprehensive Evaluation of the Health-Related Quality of Life after Ultrasound-Guided Prostate Needle Biopsy: A Prospective Study

Takeo Nomura, Yuko Fukuda, Sadaaki Sakamoto, Nobuyoshi Nasu, Yoshihisa Tasaki, Tadamasa Shibuya, Fuminori Sato and Hiromitsu Mimata

Objectives: Prostate biopsy is considered a common procedure for the diagnosis of prostate cancer, with few major complications. There are some reports on complications, voiding function, and health-related quality of life (HRQOL) after prostate biopsy, but the association between prostate biopsy and erectile function, anxiety, and depression has been only sparsely investigated. With the aim of improving patient counseling and informed consent, we prospectively evaluated HRQOL outcomes, including sexual function and mental health, after prostate biopsy.

Methods: In total, 207 patients who underwent initial prostate needle biopsy were evaluated. All patients completed the following measurements before and 2-4 weeks after the procedure: Medical Outcomes Study Short- Form 8 (SF-8), Expanded Prostate Cancer Index Composite (EPIC), International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Self-Rating Depression Scale (SDS).

Results: No significant differences were evident between baseline and post biopsy scores for SF-8. The EPIC scores for the general urinary domain and all its subscales dropped significantly, and the scores for the general sexual domain and its function decreased significantly after biopsy. Positive correlations between function and bother subscales within domains, including urinary and bowel components were high, but no positive correlation was observed between sexual function and bother. The IPSS was not significantly increased, but the QOL score was significantly decreased after biopsy. A significant difference between baseline and post biopsy was noted for the IIEF-5 score, and in particular, patients who were initially potent significantly developed erectile dysfunction (ED) after biopsy. The SDS score was significantly different between baseline and post biopsy, and patients aged 73 years or older showed clinically significant depression after the procedure.

Conclusion: Based on these data, urologists should pay attention not only to physical and short-lasting complications related to the biopsy procedure but also to HRQOL, including sexual function and mental health after prostate biopsy.