A prospective study of the short-term quality of life outcomes of patients undergoing transperineal prostate biopsy.

Abstract

A prospective, observational study to investigate whether transperineal prostate biopsy (TPbx) results in patient-reported quality of life changes from baseline in the first three-months after the procedure. PATIENTS AND METHODS: Consenting patients completed the Expanded Prostate cancer Index Composite (EPIC-26), the Sexual Health Inventory for Men (SHIM), the International Prostate Symptom Score (IPSS), the Generalised Anxiety Disorder (GAD-7), the Patient Health Questionnaire (PHQ-9) and a global question about willingness to have a repeat TPbx in a years' time. The instruments were scored using published scoring methods. Wilcoxon signed ranks tests and Mann-Whitney U tests were used to investigate statistically significant differences. Clinically significant differences were also investigated defined by published minimal important differences for the EPIC and changes in established categorical groups for the other instruments. RESULTS: Fifty-three participants consented to participate and completed the baseline questionnaire in addition to at least one of the 1- or 3-month follow-up questionnaires. We found that most patients having a TPbx had no clinically significant change in quality of life in the first three months following the procedure. However, 24% exhibited clinically worse urinary function and 18% had worse sexual function at one-month. At three-months, 3% of patients had clinically worse urinary function and 25% continued to have worse sexual function compared with baseline. Patients who were subsequently diagnosed with cancer on the basis of the results of the TPbx exhibited statistically significantly reduced quality of life for the EPIC urinary scales and reduced improvements in scores on the psychological scales at one-month follow-up compared with those who were not diagnosed with cancer. CONCLUSIONS: Most patients having a TPbx had no clinically significant change in quality of life in the first three months following the procedure. However, patients should be advised that a quarter may have clinically worse urinary function and nearly 20% have clinically worse sexual function in the first month and that sexual function deficits may continue up to three-months. The results of this study provide a resource that the clinician can use when discussing TPbx with patients.