Login to Access Video or Poster Abstract: MP97-14
Sources of Funding: None

Introduction

To analyse functional outcome of radical prostatectomy (RP) in patients with repeat prostate biopsies (Bx). We investigated whether there is an association between the number of prior Bx and erectile dysfunction (ED) and incontinence after RP.

Methods

In all, 12,218 patients who underwent RP between January 2007 and March 2015 after a known number of prior Bx were included in the analysis. Number of Bx sessions (range 1 to ≥3) was examined as categorical (1, 2 and ≥3) variable. The association between number of prior Bx sessions and erectile function, measured by IIEF-score as well as the association between number of prior Bx sessions and continence, measured as use of no or only one security pad was analyzed using multivariable logistic regression model.

Results

Of the 12,218 men 10,771 (88.2%) had only 1 Bx, 1,004 (8.2%) had 2 Bx and 443 (3.6%) had ≥3 Bx. More Bx sessions were associated with higher age at surgery (median 65, 65 and 67 yrs, p<0.001). PSA preoperatively was significantly higher in patients with multiple Bx (median 6.6, 7.6 and 10.2 ng/ml, p<0.001) and patients were significantly more often classified as high-risk according to D&[prime]Amico (18.2, 16.7, 28.2%, p<0.001). Prostate volume was significantly higher (median 38, 42 and 45ccm, p<0.001) in patients with multiple Bx._x000D_ IIEF-5 score prior surgery did not differ among Bx groups. Robotic assisted RP was performed more often in patients with multiple Bxs (p<0.001). More Bx sessions were associated with more often performed bilateral nerve sparring (67, 73.5 and 77.6%, p<0.001). In multivariable logistic regression predicting incontinence at 1 year after surgery, patients with 2 vs 1 Bx had a significantly higher likelihood of incontinence (OR 1.26, p=0.08). No difference was seen between patients with ≥3 vs 1 Bx session. No difference among groups occurred 2 and 3 yrs after surgery. _x000D_ In multivariable logistic regression predicting ED using IIEF-5 score at 1, 2 and 3 yrs after surgery, no differences occurred among Bx groups._x000D_

Conclusions

Multiple biopsy sessions are not associated with worse erectile function in men undergoing radical prostatectomy. Recovery to continence is slightly prolonged in patients with multiple Biopsies. 3 years after surgery, almost no differences occur among biopsy groups.

Funding

None