Prospective analysis of penile length changes after radical prostatectomy

Area of Science:

• Urology
• Andrology
• Sexual Medicine

Background:

• Radical prostatectomy (RP) is a common treatment for prostate cancer.
• Penile dimensions and erectile function can be affected post-RP.
• Phosphodiesterase-5 inhibitors (PDE5i) are used to treat erectile dysfunction.

Purpose of the Study:

• To evaluate the impact of radical prostatectomy (RP) on penile dimensions.
• To determine if phosphodiesterase-5 inhibitor (PDE5i) use influences penile length changes after RP.

Main Methods:

• A prospective study enrolled men undergoing RP.
• Stretched flaccid penile length (SFPL) was measured pre-surgery and at 2 and 6 months post-surgery.
• Data on demographics, clinical factors, and PDE5i use were collected; erectile function was assessed using the IIEF-EF domain.

Main Results:

• A mean SFPL decrease of 2.4 mm was observed at 2 months post-RP, with no significant difference at 6 months.
• Patients consistently using PDE5i daily showed no SFPL loss at 6 months (1±6.7 mm gain, P=0.37).
• Patients not consistently using PDE5i experienced SFPL loss (4.4±6.6 mm, P<0.002); PDE5i use and 6-month EFD scores predicted SFPL preservation.

Conclusions:

• SFPL reduction occurs at 2 months after RP but is not significant at 6 months.
• Regular PDE5i use significantly mitigates SFPL loss after RP.
• PDE5i use and erectile function are key factors in preserving penile length post-prostatectomy.