My dear wife is a librarian. She had been listening to me complain that I had someone else's penis after surgery. It looked nothing like mine. So, she found these interesting articles. Looks like all we have to do is be patient (that word again) and exercise it.
Preserved postoperative penile size correlates well with
maintained erectile function after bilateral nerve-sparing radical
retropubic prostatectomy.
Briganti A, Fabbri F, Salonia A, Gallina A, Chun FK, Dehò F, Zanni
G, Suardi N, Karakiewicz PI, Rigatti P, Montorsi F.
Department of Urology, Vita-Salute University, Milan, Italy.
OBJECTIVES: Controversial data on penile length after radical
retropubic prostatectomy are available. We hypothesised that
postoperative penile size correlates to erectile function following
bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP).
METHODS: Thirty-three consecutive patients with a preoperative
erectile function domain of the International Index of Erectile
Function (IIEF-EF) score indicating full potency (> or = 26) were
prospectively enrolled. All patients underwent BNSRRP performed by one
high-volume surgeon. All patients were preoperatively evaluated by
IIEF-EF, analysis of comorbidities, physical examination, and penile
power colour Doppler ultrasound using intracavernosal injection of
prostaglandin E(1) (PGE(1)) 20 microg plus audiovisual and manual
genital stimulation. Penile length and circumference were measured in
flaccidity and at maximum erection. Six months postoperative, patients
were assessed with the same protocol plus general assessment questions
investigating penile structure and function. Statistical analysis was
performed with an independent sample t test.
RESULTS: Mean patient age was 56.5 yr. We found no difference between
the preoperative and the 6-mo postoperative mean IIEF-EF domain score
(27.2 vs, 26.7, respectively; p = 0.35). No difference was found in
penile colour Doppler evaluation between the preoperative and
postoperative periods (all p values > or = 0.3). We found no
differences in penile length and circumference between the
preoperative and postoperative evaluation either in the flaccid or in
the erect state. Mean flaccid penile length (cm; preop vs. postop):
13.2 vs. 13 (p = 0.6). Mean flaccid penile circumference (cm; preop
vs. postop): 11.1 vs. 11 (p = 0.7). Mean erect penile length (cm;
preop vs. postop): 16.8 vs. 16.5 (p = 0.08). Mean erect penile
circumference (cm; preop vs. postop): 15.6 vs. 15.3 (p = 0.2).
CONCLUSIONS: This is the first report on penile changes in flaccidity
and at maximum erection after BNSRRP in patients treated by one
high-volume surgeon. The postoperative preservation of erectile
function positively correlated with the maintenance of penile length
following surgery. We found no change in penile size after surgery.
European Association of Urology
PMID: 17418936 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~
J Urol. 2007 Aug;178(2):602-7. Epub 2007 Jun 13.
Comment in:
Nat Clin Pract Urol. 2008 Jan;5(1):20-1.
New insights into the pathogenesis of penile shortening after
radical prostatectomy and the role of postoperative sexual function.
Gontero P, Galzerano M, Bartoletti R, Magnani C, Tizzani A, Frea
B, Mondaini N.
Urologia 1, Università degli Studi di Torino, Torino, Italy.
[email protected]
PURPOSE: We assessed penile changes after radical prostatectomy by
performing serial penile measurements. The potential effect of nerve
sparing surgery and the recovery of erectile function on the degree of
penile shortening were also evaluated.
MATERIALS AND METHODS: A total of 126 consecutive patients were
enrolled. Penile measurements were taken immediately before surgery,
at catheter removal, and at 3, 6 and 12 months postoperatively. Sexual
function was assessed at baseline and at 3, 6 and 12 months using the
erectile function domain of the International Index of Erectile
Function.
RESULTS: The maximum degree of shortening was noted at the time of
catheter removal (mean 0.84 cm, CI 0.62-1.06, p <0.0001 for stretched
penis). All penile parameters showed a lesser but significant decrease
at all subsequent intervals. Univariate analysis revealed that
baseline penile length was the only variable significantly associated
with stretched penile length at catheter removal. Age, nerve sparing
surgery and the recovery of erectile function were strong predictors
of penile size 1 year after surgery. Multivariate analysis showed that
nerve sparing surgery (<0.0001) and the recovery of erectile function
(p = 0.053) were independent predictors of the final changes in penile
size.
CONCLUSIONS: Penile shortening after radical prostatectomy peaks at
the time of catheter removal and it continues to a lesser but still
significant degree for at least 1 year. Nerve sparing surgery and
recovery of erectile function appeared to have an independent
protective effect on penile length loss at 1 year. These figures
should be taken in consideration when counseling patients for radical
prostatectomy.
PMID: 17570431 [PubMed - indexed for MEDLINE]
=-=-=-=-=-=-=
Prostate Cancer Education and Support -- visit the Us TOO website:
http://www.ustoo.org
=-=-=-=-=-=-=
Prostate Cancer News You Can Use -- recent articles:
Taxotere plus Emcyt Confirmed Superior to Taxotere Alone for Hormone
Refractory Prostate Cancer
New colorectal cancer risk factor found
http://www.ustoo.org/Prostate_Cancer_News.asp
=-=-=-=-=-=-=
Visit the Prostate Events Calendar at
http://www.prostatepointers.org/calendar/index.phtml
Visit the PCAI list of ED specialists at
http://www.prostatepointers.org/pcai/ed.html