Sexual Health Q&A

Can a man develop erectile dysfunction (ED) after a prostate biopsy?

Erectile dysfunction (ED) can occur after prostate biopsy, but the reasons for this are unclear. Some men do recover their function in a few months, however.

When a man has a prostate biopsy, small samples (cores) of prostate tissue are removed and checked for cancer cells. To collect the samples, a urologist uses a small needle.

Generally, there are three ways to approach the prostate for a biopsy: through the rectum (the part of the large intestine that ends at the anus), through the urethra (the tube through which a man urinates and ejaculates), and through the perineum (the area between the scrotum and the rectum). The transrectal approach is the most common one.

Several studies have found that men develop ED after prostate biopsy.

In 2015, BJUI International published a study involving 220 men who underwent transrectal prostate biopsy. The men’s erectile function was assessed before the biopsy and again at 1-, 4-, and 12-week time points afterward.

Erections were poorer at all three intervals, especially for men who were age 60 and older and those who had a positive diagnosis of prostate cancer. The scientists were not sure why erectile function declined, but some experts think that the stress associated with the biopsy could be a factor.

Another study, published in 2016 in Actas Urológicas Españolas also examined erectile function after transrectal prostate biopsy. None of the 93 participants had ED before their biopsy. Four weeks after the biopsy, about a third of them had some degree of ED. By twelve weeks, this rate fell to 9%, and at 24 weeks, 7.5% had ED, which was described as mild.

In a third study, published in 2015 in the International Journal of Impotence Research, scientists worked with 1,050 men who underwent a transperineal prostate biopsy. They reported an increased risk of temporary ED after biopsy of approximately 5%. Generally, ED lasted about a month and, three to six months later, had not worsened.

Men who are concerned about their erections after biopsy should talk to their urologist, who can let them know what to expect.