Evidence map›Paper›PMID 41051480›Full record

SynthesisInternational urology and nephrology2026

Erectile dysfunction following prostate biopsy: a comparative analysis of transrectal versus transperineal approaches.

O Ermis, M G Sonmez, A Tozsin, M S Iyisoy, M Yilmaz, G Sonmez, O O Cakir, A Aydin, L Tunc, E Barret and 3 more

Abstract readComparative StudyMeta-AnalysisReview
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In one paragraph

Synthesis in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

O ErmisIstanbul Avcilar Government Hospital, Urology, Istanbul, Türkiye.
M G SonmezNecmettin Erbakan University, Urology, Konya, Türkiye.
A TozsinTrakya University School of Medicine, Urology, Edirne, Türkiye.
M S IyisoyDepartment of Medical Education and Informatics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Türkiye.
M YilmazMediclin Kraichgau Klinik, Urology, Bad Rappenau, Germany.
G SonmezErciyes University School of Medicine, Urology, Kayseri, Türkiye.
O O CakirKing's College Hospital NHS Foundation Trust, Urology, London, UK.
A AydinKing's College Hospital NHS Foundation Trust, Urology, London, UK.
L TuncAcıbadem Hospital, Urology, Ankara, Türkiye.
E BarretDepartment of Urology, Institut Mutualiste Montsouris, Paris, France.
T HerrmannCantonal Hospital Thurgau AG, Urology, Fraunfeld, Switzerland.
K AhmedKing's College Hospital NHS Foundation Trust, Urology, London, UK.
S GuvenNecmettin Erbakan University, Urology, Konya, Türkiye. selcukguven@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION AND

objectivesErectile dysfunction (ED) is a concern for men undergoing prostate biopsy. With the increasing adoption of transperineal (TP) biopsy over transrectal (TR) biopsy, it remains unclear which approach carries a lower risk of erectile dysfunction. This study aims to be the first meta-analysis to evaluate erectile dysfunction following TR versus TP prostate biopsy at 1, 3 and 6 months intervals, thereby providing clinicians with evidence-based guidance for patient counseling and shared decision-making. MATERIALS AND

methodsThis review was prospectively registered on PROSPERO (CRD42024541557) and followed PRISMA guidelines, with searches conducted in PubMed, Scopus, and the Cochrane Library databases up to July 2024. A total of 22 studies reporting erectile function outcomes (IIEF scores) at baseline and 1, 3 and 6 months post-biopsy were identified. After applying inclusion and exclusion criteria, 12 studies were included in the final meta-analysis. TR and TP biopsy methods were compared using a random-effects model to assess standardized mean differences (SMD) in erectile function at each follow-up point. The risk of bias for each study was evaluated to ensure result reliability.

resultsAt 1 month follow-up, a significant decline in erectile function was observed overall (SMD: - 0.3785, p = 0.038). The TP approach showed a slightly more significant decline than the TR approach; however, this difference was not statistically significant (p = 0.074). At 3 months follow-up, no significant differences were observed between methods overall (SMD: - 0.1663, p = 0.132), although TP biopsy alone showed a modest yet considerable decline (SMD: - 0.1868, p = 0.03). At 6 months, erectile function had generally returned to baseline, with no significant differences observed between biopsy techniques (p = 0.41).

conclusionBoth TR and TP prostate biopsies are associated with a transient decline in erectile function. These effects typically resolve by 6 months in most patients, with no significant long-term impact observed. While the initial functional impact may be slightly greater with the TP technique, this difference attenuates over time. These findings are crucial for managing patient expectations post-biopsy.

Indexed as

Erectile DysfunctionPostoperative ComplicationsProstateProstatic NeoplasmsBiopsyHumansMalePerineumRectumErectile dysfunctionIIEF-5Meta-analysisProstate biopsySexual functionTransperineal approach

Identifiers

PMID41051480

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.