Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy

International Journal of Impotence Research volume 24, pages 161–164 (2012)Cite this article

Subjects

Abstract

Active surveillance of prostate cancer patients involves subjecting them to multiple prostate biopsies, and we sought to investigate the effects of this on functional outcomes after robotic-assisted radical prostatectomy (RARP). Between May 2009 and December 2009, 367 patients who consecutively underwent RARP by a single surgeon were divided into two groups, one that had single prostate biopsy and another multiple biopsies before RARP. The groups were matched for significant clinicopathologic preoperative variables, and only premorbidly potent low-risk cases that underwent nerve sparing were included. This left 50 and 23 patients for analysis in the single and multiple biopsy groups, respectively. The primary endpoint was potency and continence at 3 and 6 months after surgery. We found continence rates of 84% (83%) and 94% (96%) for single (multiple) biopsy groups at 3 and 6 months, respectively (P=0.88, P=0.77). Multiple biopsy patients had worse postoperative erectile function at 6 months (57% versus 80%, P=0.03). Men subject to multiple preoperative biopsies are more likely to become impotent postoperatively than those who undergo surgery after a single biopsy. This should be borne in mind when counseling men regarding repeat biopsy as part of an active surveillance strategy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Xu J, Ward E . Cancer statistics, 2010. CA Cancer J Clin 2010; 60: 277–300.

    Article  Google Scholar 

  2. Fujita K, Landis P, McNeil BK, Pavlovich CP . Serial prostate biopsies are associated with an increased risk of erectile dysfunction in men with prostate cancer on active surveillance. J Urol 2009; 182: 2664–2669.

    Article  Google Scholar 

  3. Zisman A, Leibovici D, Kleinmann J, Siegel YI, Lindner A . The impact of prostate biopsy on patient well-being: a prospective study of pain, anxiety and erectile dysfunction. J Urol 2001; 165: 445–454.

    Article  CAS  Google Scholar 

  4. Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH . Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology 2002; 60: 826–830.

    Article  Google Scholar 

  5. Zisman A, Leibovici D, Kleinmann J, Cooper A, Siegel Y, Lindner A . The impact of prostate biopsy on patient well-being: a prospective study of voiding impairment. J Urol 2001; 166: 2242–2246.

    Article  CAS  Google Scholar 

  6. Ochiai A, Babaian RJ . Update on prostate biopsy technique. Curr Opin Urol 2004; 14: 157–162.

    Article  Google Scholar 

  7. Eichler K, Hempel S, Wilby J, Myers L, Bachmann LM, Kleijnen J . Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. J Urol 2006; 175: 1605–1612.

    Article  Google Scholar 

  8. Ikonen S, Karkkainen P, Kivisaari L, Salo JO, Taari K, Vehmas T et al. Endorectal magnetic resonance imaging of prostatic cancer: comparison between fat-suppressed T2-weighted fast spin echo and three-dimensional dual-echo, steady-state sequences. Eur Radiol 2001; 11: 236–241.

    Article  CAS  Google Scholar 

  9. Lavery HJ, Levinson AW, Brajtbord JS, Samadi DB . Candidacy for active surveillance may be associated with improved functional outcomes after prostatectomy. Urol Oncol 2011, e-pub ahead of print.

  10. Tuncel A, Kirilmaz U, Nalcacioglu V, Aslan Y, Polat F, Atan A . The impact of transrectal prostate needle biopsy on sexuality in men and their female partners. Urology 2008; 71: 1128–1131.

    Article  Google Scholar 

  11. Akbal C, Turker P, Tavukcu HH, Simsek F, Turkeri L . Erectile function in prostate cancer-free patients who underwent prostate saturation biopsy. Eur Urol 2008; 53: 540–544.

    Article  Google Scholar 

Download references

Acknowledgements

Dr Prasanna Sooriakumaran is an Intuitive Surgical Clinical Fellow; Dr Ashutosh Tewari is the endowed Ronald P Lynch Professor of Urologic Oncology, the Director of the Prostate Cancer Institute, and Director of the Lefrak Center for Robotic Surgery, and has received grants in the past from Intuitive Surgical Inc. and the National Institute of Health. However, this work was not supported by such grants.

Author information

Authors and Affiliations

  1. James Buchanan Brady Foundation Department of Urology, LeFrak Center of Robotic Surgery, and Prostate Cancer, Weill Cornell Medical College of Cornell University, New York Presbyterian Hospital, NY, New York, USA

    P Sooriakumaran, A Calaway, D Sagalovich, S Roy, A Srivastava, J Joneja, M Shevchuk & A K Tewari

Authors
  1. P Sooriakumaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A Calaway
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D Sagalovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Roy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J Joneja
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M Shevchuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A K Tewari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to P Sooriakumaran or A K Tewari.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sooriakumaran, P., Calaway, A., Sagalovich, D. et al. The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy. Int J Impot Res 24, 161–164 (2012). https://doi.org/10.1038/ijir.2012.9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2012.9

Keywords

This article is cited by

Search

Advanced search

Quick links