Anxiety and Depression are Two Important Causes of Erectile Dysfunction after Saturation Biopsy: A Pilot Study

Objective To evaluate the role of the patient's mood as a possible cause of erectile dysfunction (ED) following transrectal ultrasound-guided saturation biopsy. Materials and Methods One hundred and thirty five patients who underwent a saturation biopsy due to persistently elevated levels of prostate specific antigen (PSA) were included in the study. Group 1 included 78 patients for whom the biopsy indicated that they were cancer-free, and group 2 included 57 patients for whom the biopsy indicated that they had prostate cancer and were thus on a waiting list for a radical treatment. Patients were evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Hospital Anxiety-Depression Scale (HADS). Results Among the cancer-free group, 17% of patients exhibited a decline in erectile function after the biopsy according to their IIEF-5 scores. The anxiety or depression rate according to the HADS was 69% in the patients exhibiting a decrease in erectile function, which was greater than that of the rest of the cancer-free patients who had no erectile function deterioration. Patients who learned that they had cancer exhibited a statistically significant average decrease in IIEF-5 scores (p=0.04). Their scores on the HADS were significantly higher. Conclusion Although a saturation biopsy of the prostate is a safe procedure in terms of erectile function, the risk of ED after a biopsy should be discussed with patients who have had previous normal erectile function and have been diagnosed with cancer