Objective
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.
Results
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.
Conclusion
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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Changes in incidence, survival and mortality of prostate cancer in Europe and the United States in the PSA era: additional diagnoses and avoided deaths.Ann Oncol. 2012; 23: 1325-1334
- Guideline for the management of clinically localized prostate cancer: 2007 update. AUA Prostate Cancer Clinical Guideline Update Panel.J Urol. 2007; 177: 2106-2131
- Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial.Lancet Oncol. 2011; 12: 891-899
- Pilot study of changes in stretched penile length 3 months after radical retropubic prostatectomy.Urology. 2001; 58: 567-569
- A prospective study measuring penile length in men treated with radical prostatectomy for prostate cancer.J Urol. 2003; 169: 1462-1464
- Penile length changes after radical prostatectomy.BJU Int. 2005; 96: 472-474
- New insights into the pathogenesis of penile shortening after radical prostatectomy and the role of postoperative sexual function.J Urol. 2007; 178: 602-607
- Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy.Int Braz J Urol. 2011; 7: 336-344
- Recovery of erectile function after nerve sparing radical prostatectomy and penile rehabilitation with nightly intraurethral alprostadil versus sildenafil citrate.J Urol. 2010; 183: 2451-2456
- Long-term potency after early use of a vacuum erection device following radical prostatectomy.BJU Int. 2010; 106: 1719-1722
- Penile rehabilitation after radical prostatectomy.J Urol. 2012; 187: 15-17
- Penile shortening after radical prostatectomy and Peyronie's surgery.Curr Urol Rep. 2009; 10: 468-474
- Changes in penile length after robot-assisted laparoscopic radical prostatectomy.J Endourol. 2011; 25: 65-69
- Preserved postoperative penile size correlates well with maintained erectile function after bilateral nerve-sparing radical retropubic prostatectomy.Eur Urol. 2007; 52: 702-707
- Anatomic radical prostatectomy: evolution of the surgical technique.J Urol. 1998; 160: 2418-2424
- Penile length in the flaccid and erect states: guidelines for penile augmentation.J Urol. 1996; 156: 995-997
- Penile anthropometry in Brazilian children and adolescents.J Pediatr (Rio J). 2007; 83: 441-446
- The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction.Urology. 1997; 49: 822-830
- Tradução e adaptação cultural do índice internacional de função erétil para a língua portuguesa.Rev Bras Med. 1998; 55: 35-40
- Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function.Urology. 1999; 54: 346-351
- Comparing measurements in normal and erectile dysfunction subjects.J Sex Med. 2009; 6: 2305-2310
- Penile measurements in normal adult Jordanians and in patients with erectile dysfunction.Int J Impot Res. 2005; 17: 191-195
- Prediction of erectile function following treatment for prostate cancer.JAMA. 2011; 306: 1205-1214
- Health-related quality of life of patients who underwent multiple surgeries for penile diseases.J Sex Med. 2004; 1: 80
- Men's perspectives on selecting their prostate cancer treatment.J Natl Med Assoc. 2011; 103: 468-478
Article info
Publication history
Published online: October 24, 2012
Accepted:
July 7,
2012
Received:
April 13,
2012
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial CommentUrologyVol. 80Issue 6
- PreviewThis 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.
- Full-Text
- Preview
