Climacturia and Penile Length Shortening: Adverse Outcomes following Robot-Assisted Radical Prostatectomy

Area of Science:

• Urology
• Oncology
• Sexual Health

Background:

• Radical prostatectomy (RP) for prostate cancer can lead to various side effects.
• Erectile dysfunction and urinary incontinence are well-documented post-RP complications.
• Climacturia and penile length shortening are less frequently studied outcomes.

Purpose of the Study:

• To investigate the incidence of climacturia and penile length shortening after robot-assisted radical prostatectomy (RARP).
• To identify risk factors and predictors of recovery for these specific side effects.
• To compare patient-reported importance of these outcomes against erectile dysfunction and incontinence.

Main Methods:

• A survey was administered to 800 patients 1 year after RARP.
• The survey assessed outcomes including continence, erectile dysfunction, climacturia, and penile length shortening.
• Descriptive statistics and logistic regression were used to analyze incidence, risk factors, and recovery predictors.

Main Results:

• Response rate was 42-46%; 37.5% reported climacturia and 58.5% reported penile length shortening.
• Risk factors for penile length shortening included higher BMI, prostate weight, lack of nerve-sparing, and higher pathologic stage.
• Preoperative erectile function (IIEF-5 score >21) predicted climacturia recovery; <5% prioritized these outcomes over ED/incontinence.

Conclusions:

• Climacturia and penile length shortening are significant, yet under-reported, side effects following RARP.
• Patient-reported quality of life impact is low compared to erectile dysfunction and urinary incontinence.
• Further research may be warranted to understand patient perspectives on these specific functional outcomes.