Analysis of Voiding Impairment Following Transperineal Prostate Biopsy: Do Alpha-Blockers Reduce the Risk?

Abstract

Backgrounds: To identify predictors of voiding impairment following transperineal prostate biopsy (TPPB) and evaluate the effect of alpha-blocker pretreatment: METHODS: A prospective observational study was conducted between June 2022 and May 2024, enrolling 279 patients undergoing TPPB. Patients were stratified into four groups according to the duration of alpha-blocker pretreatment. Baseline characteristics and voiding parameters were collected, including the international prostate symptom score (IPSS), quality of life, maximal flow rate (Q_max), and post-void residual urine. Follow-up assessments were performed at 7 and 30 days post-biopsy. The rate of voiding impairment and post-biopsy voiding parameters were compared across groups. Logistic regression analyses were conducted to identify independent predictors of post-biopsy voiding impairment.

Results: Baseline characteristics were comparable among all groups. At 7 days post-biopsy, patients with alpha-blocker pretreatment duration of < 12 months exhibited a lower voiding impairment rate, lower IPSS scores, and higher Q_max compared with patients without alpha-blocker pretreatment (p < 0.05). In contrast, patients with alpha-blocker pretreatment duration of > 12 months showed no differences in voiding impairment rate or voiding parameters compared to those without alpha-blocker pretreatment (p > 0.05). Logistic regression analyses demonstrated that diabetes mellitus (DM) was independently associated with post-biopsy voiding impairment, whereas alpha-blocker pretreatment for < 12 months exerted a protective effect (p < 0.01).

Conclusion: TPPB is associated with voiding impairment. DM may serve as a predictor of post-biopsy voiding impairment, while alpha-blocker pretreatment for < 12 months may play a protective role.