Materials and Methods: A total of 86 patients who underwent prostate biopsy between January 2020 and September 2021 were included in the study as two study groups. Forty patients (Group-1) received 10 mL intrarectal lidocaine gel 2%, and 46 patients (Group-2) underwent periprostatic nerve block with 10 ml lidocaine HCL 1%. We recorded demographic data (age, height, weight), PSA values before the biopsy procedure, prostate volumes, visual analogue scores (VAS), and post-procedure complications. Erectile function and changes over time was investigated with IIEF-5 questionnaire at the time of biopsy and 1, 3 and 6 months after the biopsy. Significance was set at p<0.05.

Results: The mean age was 61.08±6.05 years, and mean BMI, biopsy duration were 27.35±3.7 kg/cm2, 11.84±2.32 minutes respectively. PSA values, prostate volumes, and mean IPSS were 8.19±3.82 ng/ml, 56.8±23.8 cc, and 10.5±4.28, respectively, without any significant differences between the groups. No difference was found between two groups when mean IIEF-5 scores over time were compared with changes in erectile function (p=0.907). In-group comparisons of changes over time also yielded insignificant results in both groups (Group-1: χ2(4)=2.22, p=0.529, Group-2: χ2(4)=6.61, p=0.086).

Conclusion: Periprostatic nerve block does not affect erectile function negatively six months after the biopsy. Its initial negative effect on erectile function in the first month is temporary. Therefore, we concluded that periprostatic nerve block can be safely used during transrectal ultrasound-guided prostate biopsy in terms of erectile function.