Abstract Introduction PSA levels are widely used for the diagnosis and monitoring of prostate cancer. However, their relationship with postoperative functional outcomes, such as erectile dysfunction (ED), remains underexplored. Objective To investigate whether there is an association between pre-biopsy PSA levels and the occurrence of erectile dysfunction (ED) following radical prostatectomy. Methods Patients who underwent radical prostatectomy without previous ED—either open or laparoscopic—between March 2018 and March 2023 were selected. Preoperative PSA levels and the incidence of postoperative ED were evaluated. Results Patients with ED (n: 59) had significantly lower pre-biopsy PSA levels (p = 0.048; 95% CI: 0.01–0.43) compared to patients without sexual dysfunction (n: 43). There was also a significant association between lower pre-biopsy PSA levels and better therapeutic response to ED treatment (p = 0.034), suggesting that lower PSA values were related to improved treatment outcomes. Conclusion Lower pre-biopsy PSA levels were associated with a higher prevalence of postoperative erectile dysfunction but also with a better response to treatment. These findings suggest a potential role for PSA as a functional prognostic marker. Financing No conflict.
Rodriguez et al. (Sun,) studied this question.