Erection Concerns After Prostate Biopsy

When his doctor mentioned the prostate biopsy, Stan’s heart sank. What did this mean? Did he have cancer? And if so, how would his life change?

Quietly, he listened his doctor explain. Stan had high levels of prostate-specific antigen (PSA) and the doctor had found an unusual lump on his prostate during his digital rectal examination. These two factors made a biopsy necessary. Stan might have cancer and catching it early was important.


Some men do develop ED for a time after a prostate biopsy. But not all do. Learn more here... (Click to tweet)


The biopsy could be done at the office and would probably take about fifteen minutes. A needle would be used to remove about ten tissue samples from his prostate. Then, an expert would analyze the tissues in a lab, looking for cancer cells. Having the biopsy didn’t mean he had cancer. It just meant they needed to take a closer look.

Stan’s expression was stoic, but inside, his body was in turmoil. He was anxious about his prognosis, of course. Also, the idea of having a needle in his private parts made him nervous. He knew the biopsy was necessary. He knew it could save his life. But he had other questions, too.

For example, what would happen to his erections? Would the biopsy procedure affect his sex life?

Lots of men share Stan’s concerns. The anxiety of a biopsy is enough to cope with, but wondering about your erections afterward is also difficult.

Some men do develop erectile dysfunction (ED) for a time after a prostate biopsy. But not all do. Let’s look at this topic more closely.


What happens during a prostate biopsy?

As Stan’s doctor explained, a biopsy involves removing tissue with a special needle. To do a thorough analysis, the doctor removes several samples from different areas of the prostate. Then, a specialist examines the samples under a microscope to check for cancer.

Typically, a prostate biopsy is done in one of three ways:

  • Through the rectum. With a transrectal biopsy, the needle travels through the rectum (the last part of the large intestine, which ends in the anus). This is the most common approach.
  • Through the urethra. With the help of a tiny camera, the doctor removes tissue through the tube the carries semen and urine out of the body.
  • Through the perineum. Doctors who use the transperineal method make a small cut in the perineum (the area between the scrotum and anus). The needle is passed through the cut to collect tissue.

Will I have problems with erections afterward?

You might. The prostate is surrounded by sensitive nerves important for erections. These nerves are hard to miss when placing the needle.

Sometimes, it depends on the type of biopsy you have. A 2015 study in BJU International found that men who have a transrectal biopsy can have trouble with erections up 12 weeks after the procedure, especially if they are over age 60.

Another 2015 study, published in the International Journal of Impotence Research, reported that men had a 5% increased risk for ED after a transperineal biopsy, but that the ED usually got better within three to six months.

Often, psychological issues contribute to ED as well. It’s possible that anxiety over the biopsy or depression after a cancer diagnosis, can lead to erectile difficulties.

If you have concerns about your erectile function after a prostate biopsy, be sure to mention them to your doctor. He or she can go over the types of procedures that are best for your situation and discuss the odds of ED afterward. Your doctor can also talk with you about treatments for ED, such as medications and vacuum devices. You may also be referred to a counselor who can help you (and your partner) cope with anxieties associated with ED or a pending cancer diagnosis.

We have lots of information on prostate cancer here on SexHealthMatters. Just click this link to read more. You’ll also find comprehensive information on ED and its treatment here.


American Cancer Society

“How is prostate cancer diagnosed?”

(Last revised: March 12, 2015)

International Journal of Impotence Research

Pepe, P. and M. Pennisi

“Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRI-targeted prostate biopsy (32 cores)”

(Full-text. August 20, 2015)

BJU International

Murray, Katie S., et al.

“A prospective study of erectile function after transrectal ultrasonography-guided prostate biopsy”

(Abstract. March 23, 2015);jsessionid=9A2ECAB5E2109C9FBFD5D45760D7FE93.f03t03

Johns Hopkins Medicine

“Prostate Biopsy”,p07710/

Mayo Clinic

“Types of prostate biopsy procedures”

(April 26, 2013)

Medscape Medical News

Mulcahy, Nick

“ED Induced by Prostate Biopsy Likely 'Underestimated'”

(October 1, 2015)