Symbolic illustration of prostate health and potential challenges

Prostate Biopsies and Erectile Dysfunction: What Men Need to Know

Jordan Keane in Health & Wellness November 2025 • 4 min read.

"Navigating the impact of serial transperineal sector prostate biopsies on long-term sexual health"

Active surveillance (AS) has become an increasingly common approach for managing low-risk prostate cancer. This strategy allows men to delay or avoid radical treatments like surgery or radiation, which can have significant side effects, including erectile dysfunction (ED). However, AS isn't without its own set of considerations. Regular prostate biopsies are a crucial part of monitoring the disease, but emerging research suggests these procedures might also impact sexual health.

A key method for monitoring prostate cancer during AS is the transperineal sector prostate biopsy (TPSBx). This procedure helps doctors assess the cancer's characteristics and detect any signs of progression. While TPSBx is generally considered safe, with short-term complications like hematuria (blood in urine) and urinary retention being relatively well-documented, the long-term effects on erectile function have been less clear. Given that men on AS often undergo multiple biopsies over several years, understanding this potential impact is essential.

A recent study published in ecancer medicalscience sheds light on the relationship between serial TPSBx and erectile dysfunction. Researchers investigated whether repeated biopsies have a lasting negative effect on men's sexual function. By following a group of men undergoing AS, they uncovered important insights that can help patients and healthcare providers make informed decisions about prostate cancer management.

Do Prostate Biopsies Really Affect Erectile Function?

Symbolic illustration of prostate health and potential challenges

The study, led by James JY Chong and colleagues, aimed to determine the long-term impact of serial TPSBx on erectile function. The research involved 64 men with prostate cancer who were enrolled in an AS program. These men had undergone an initial transrectal prostate biopsy (TRBx) and a confirmatory initial TPSBx. As part of the AS protocol, they received a repeat TPSBx 24 months later.

To assess erectile function, the researchers used the International Index of Erectile Function-5 (IIEF-5) questionnaire. This tool measures various aspects of sexual function, providing a standardized score that indicates the severity of ED. Participants completed the IIEF-5 questionnaire at several points:

Baseline: Before each TPSBx
Short-Term: One, three, and six months after the first TPSBx
Long-Term: One, three, and six months after the second TPSBx

By comparing IIEF-5 scores at these different time points, the researchers were able to track changes in erectile function and determine whether the biopsies had a significant impact.

What Does This Mean for Men on Active Surveillance?

The study's findings suggest that serial TPSBx may have an adverse impact on erectile function in men undergoing active surveillance for prostate cancer, potentially increasing the risk of long-term ED. While the initial TPSBx caused short-term ED that resolved within six months, repeated biopsies seemed to have a more sustained negative effect. This information is crucial for both patients and physicians when considering the benefits and risks of active surveillance.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3332/ecancer.2016.643, Alternate LINK

Title: Serial Transperineal Sector Prostate Biopsies: Impact On Long-Term Erectile Dysfunction

Subject: Cancer Research

Journal: ecancermedicalscience

Publisher: Ecancer Global Foundation

Authors: James Y Chong, Mieke Van Hemelrijck, Declan Cahill, Janette Kinsella

Published: 2016-05-23

Everything You Need To Know

What is Active Surveillance (AS) and how do prostate biopsies, specifically transperineal sector prostate biopsy (TPSBx), fit into this management strategy?

Active Surveillance (AS) is a management strategy for low-risk prostate cancer where immediate radical treatments like surgery or radiation are delayed or avoided. The purpose is to minimize the significant side effects of these treatments, such as erectile dysfunction (ED). Regular prostate biopsies, specifically transperineal sector prostate biopsy (TPSBx), are used to monitor the cancer's progression during AS. These biopsies help doctors assess the characteristics of the cancer and detect any signs of it worsening, ensuring timely intervention if needed. The impact of serial TPSBx on erectile function is important to monitor during AS.

What is the International Index of Erectile Function-5 (IIEF-5) questionnaire, and how was it used in the study to assess the impact of prostate biopsies on erectile function?

The International Index of Erectile Function-5 (IIEF-5) questionnaire is a tool used to measure various aspects of sexual function, specifically erectile function. It provides a standardized score that indicates the severity of erectile dysfunction (ED). In the study mentioned, participants completed the IIEF-5 questionnaire at baseline (before each transperineal sector prostate biopsy - TPSBx), short-term (one, three, and six months after the first TPSBx), and long-term (one, three, and six months after the second TPSBx). This allowed researchers to track changes in erectile function and determine the impact of serial biopsies.

What are the key findings regarding the long-term impact of serial transperineal sector prostate biopsies (TPSBx) on erectile function for men undergoing active surveillance (AS)?

A key finding is that serial transperineal sector prostate biopsies (TPSBx) may have an adverse impact on erectile function in men undergoing active surveillance (AS) for prostate cancer. While the initial TPSBx caused short-term erectile dysfunction (ED) that resolved within six months, repeated biopsies seemed to have a more sustained negative effect. The *ecancer medicalscience* study, led by James JY Chong, suggests the risk of long-term ED may increase with repeated biopsies. This is crucial for men considering AS as a management strategy.

Can you describe the methodology used in the ecancer medicalscience study, including the patient population and the types of prostate biopsies performed?

The study by James JY Chong involved 64 men with prostate cancer enrolled in an active surveillance (AS) program. These men had undergone an initial transrectal prostate biopsy (TRBx) and a confirmatory initial transperineal sector prostate biopsy (TPSBx). As part of the AS protocol, they received a repeat TPSBx 24 months later. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire at multiple points to track changes.

What are some of the limitations of current research, and what additional strategies might be explored to minimize the impact of prostate biopsies on long-term sexual health during Active Surveillance (AS)?

While the study focuses on the impact of serial transperineal sector prostate biopsies (TPSBx) on erectile function, it doesn't explicitly delve into specific interventions or preventative measures. However, understanding the potential risk allows for proactive discussions between patients and healthcare providers. Future research could explore the effectiveness of prophylactic treatments, modified biopsy techniques, or alternative monitoring strategies to mitigate the risk of erectile dysfunction (ED) associated with repeated biopsies during active surveillance (AS).