Self-perceived penile shortening after radical prostatectomy

Area of Science:

• Urology
• Oncology
• Sexual Medicine

Background:

• Postoperative penile length changes after radical prostatectomy (RP) have conflicting study results.
• Understanding the impact of RP on penile length, quality of life, and self-esteem is crucial for patient care.

Purpose of the Study:

• To analyze self-perceived penile shortening, quality of life, and self-esteem following radical prostatectomy.
• To compare these outcomes in patients who underwent RP versus an age-matched control group.

Main Methods:

• Cross-sectional study of 1411 men undergoing RP (2002-2006) at Karolinska University Hospital.
• Utilized a study-specific questionnaire assessing perceived penile length changes (current vs. age 30), quality of life, and self-esteem.
• Compared 1288 RP patients (91% response rate) with 442 age-matched population-based controls.

Main Results:

• 55% of RP patients reported self-perceived penile shortening, compared to 26% in controls (RR 2.1).
• Adjusted analysis showed a 1.7-fold increased risk of penile shortening in RP patients.
• Penile shortening was associated with lower quality of life (RR 1.2) and self-esteem (RR 1.2).
• Extensive nerve-sparing technique correlated with less perceived penile shortening.

Conclusions:

• Radical prostatectomy is associated with a significantly higher risk of self-perceived penile shortening.
• Erectile function appears to be a key factor influencing penile length perception post-RP.
• Penile shortening negatively impacts patient quality of life and self-esteem.