Male Sexual Dysfunction| Volume 80, ISSUE 6, P1293-1297, December 2012

The Natural History of Penile Length After Radical Prostatectomy: A Long-term Prospective Study

Published:October 24, 2012DOI:


      To describe the penile length after radical prostatectomy (RP) in a long-term follow-up.

      Materials and Methods

      We evaluated prospectively the penile length of 105 patients with localized prostate cancer treated by open RP. Participants using therapy for penile rehabilitation were excluded from statistical analysis. Measurements of the stretched penis were taken preoperatively and at 3, 6, 12, 24, 36, 48, and 60 months postoperatively. The International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaire was used to evaluate erectile function. The penile anthropometric measure used was the stretched length of the flaccid penis, from the pubopenile skin angle to the end of the glans, after the prepubic fat was depressed under maximum manual traction.


      The mean stretched penile length 3 months after RP decreased an average of 1 cm from baseline (P <.001). This mean difference persisted until 24 months. At 36 months, the penile length differed 0.6 cm. At 48 months (−0.3 cm) and 60 months (+0.4 cm), the mean differences in penile length before and after RP were not significant (P = .080 and P = .065, respectively). Erectile function was a predictor for early return of penile length.


      Nearly 1 cm of penile shortening after RP may be expected up to 12 months. However, a trend toward recovery of penile length occurs after 24 months of follow-up and is completely re-established after 48 months. The preserved erectile function after RP is a predictor for penile length recovery.
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      Linked Article

      • Editorial Comment
        UrologyVol. 80Issue 6
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          This is an important article for urologists performing robotic or open radical prostatectomy (RP) and for any physician advising patients on their therapeutic options when diagnosed with prostate cancer. The most significant life-changing complications after RP include incontinence, erectile dysfunction (ED), and penile shortening, all of which can result in decreased quality of life and self-esteem. In this prospective study, penile length was measured at baseline, at postoperatively at months 3, 6, and 12, and then yearly up to 5 years.
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