Changes in Penile Length After Robot-Assisted Laparoscopic Radical Prostatectomy

Engel, Jason D.; Sutherland, D. E.; Williams, Stephen B.; Wagner, Kristofer R.

doi:10.1089/end.2010.0382

Cited by 38 publications

(50 citation statements)

References 20 publications

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“…We were unable to find other studies about the impact of postoperative penile shortening on quality of life and self-esteem among prostate cancer survivors (other than a comment from Engel et al 12 that studies concerning this topic would be desirable). That self-perceived penile shortening seems to affect quality of life and self-esteem in prostate cancer survivors to a greater degree than in the control group might be attributable to the control group probably having had a longer period of time to cope with their self-perceived penile shortening than the operated group where onset can be thought to be more sudden.…”

Section: Radical Prostatectomy S Carlsson Et Almentioning

confidence: 92%

“…They stated that this non-operated group of men already had end-organ (penis) changes from their longstanding ED. Recently, Engel et al, 12 in a study of 127 patients after robot-assisted radical prostatectomy, found a median penile shortening of 0.64 cm 1 month postoperatively, but found that after 9 months penile length had returned to the preoperative measurement. They concluded that penile shortening could be a surrogate measure of erectile function after a radical prostatectomy.…”

Section: Radical Prostatectomy S Carlsson Et Almentioning

confidence: 99%

“…6--12 Drawing supportable conclusions from these studies is hampered, however, by somewhat conflicting results with one study stating that no penile shortening occurred postoperatively 10 and another recent study showing recovery of penile shortening 9 months after surgery. 12 All studies published to date used the measurement of penile length (flaccid, stretched or erected) as their outcome measure. This is the first study to put the patient's perspective and perception in the spotlight and this is also the first study to associate length loss with quality of life and self-esteem.…”

Section: Introductionmentioning

confidence: 99%

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Self-perceived penile shortening after radical prostatectomy

et al. 2012

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The postoperative effect on penile length after radical prostatectomy has been the subject of studies with conflicting results. We analyzed self-perceived penile shortening, quality of life and self-esteem after radical prostatectomy. In this cross-sectional study of a cohort of 1411 men who underwent a radical prostatectomy at Karolinska University Hospital between 2002 and 2006, we used a study-specific questionnaire. Patients and controls were asked about their perceived penile shortening by comparing present penile length now and at age 30 years. All subjects were also asked about their present quality of life and self-esteem. Patients were compared with 442 age-matched population-based controls. Among 1288 who underwent radical prostatectomy and answered the questionnaire (response rate 91%), 663 patients reported self-perceived penile shortening (55%), as compared with 85 (26%) of 350 men in the control group, corresponding to a relative risk (RR) of 2.1 (95% confidence interval (CI) 1.8--2.6) of self-perceived penile shortening compared with the age-matched control group. Age, grade of erectile dysfunction and angina were correlated with self-perceived penile shortening in both the operated and the control group. After adjustments for all of these mentioned potential confounders, we obtained a RR of 1.7 (95% CI 1.4--2.1) of self-perceived penile shortening compared with the controls. We also found that self-assessed penile shortening was associated with a RR of 1.2 (95% CI 1.1--1.3) for a low-to-moderate self-assessed quality of life and a RR of 1.2 (95% CI 1.1--1.4) for a low-to-moderate self estimation of selfesteem. Extensive nerve-sparing technique seems to be associated with less self-perceived penile shortening compared with radical prostatectomy with lower degree of nerve-sparing approach. These data indicate that radical prostatectomy is associated with self-perceived penile shortening and suggests that erectile function is a key factor in penile shortening.

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Section: Radical Prostatectomy S Carlsson Et Almentioning

confidence: 92%

Section: Radical Prostatectomy S Carlsson Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Self-perceived penile shortening after radical prostatectomy

et al. 2012

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“…Considering that SPL measurements have been reported to strongly correlate with those for erect PL (Wessells et al, 1996), SPL measurements of PL have been adopted in many studies (Munding et al, 2001;Savoie et al, 2003;Gontero et al, 2007;Haliloglu et al, 2007;Engel et al, 2011;Park et al, 2011;Vasconcelos et al, 2012;Berookhim et al, 2014;Kadono et al, 2017). Considering that SPL measurements have been reported to strongly correlate with those for erect PL (Wessells et al, 1996), SPL measurements of PL have been adopted in many studies (Munding et al, 2001;Savoie et al, 2003;Gontero et al, 2007;Haliloglu et al, 2007;Engel et al, 2011;Park et al, 2011;Vasconcelos et al, 2012;Berookhim et al, 2014;Kadono et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Changes in penile length after radical prostatectomy: effect of neoadjuvant androgen deprivation therapy

et al. 2018

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Although reports have shown evidence for penile length (PL) shortening after radical prostatectomy (RP), the association between neoadjuvant androgen deprivation therapy (NADT) and PL after RP has yet to be determined. This study evaluates chronological changes in PL after NADT and RP. Stretched PLs (SPLs) of 143 patients, 41 of whom had undergone NADT, were measured before, 10 days after, and 1, 3, 6, 9, 12, 18, and 24 months after RP. Chronological erectile function and testosterone levels were then evaluated. SPL was shortest 10 days after RP in both the NADT (-) and NADT (+) groups and gradually recovered in length thereafter. SPL in the NADT (-) group was significantly longer than that in the NADT (+) group before RP. However, no significant differences in SPLs were found between both groups 6 months after RP. Although all subjects in the NADT (+) group had testosterone levels of <50 ng/dL before RP, such levels increased after RP. Before RP, the NADT (-) group was found to have significantly better erectile function than the NADT (+) group. However, differences in erectile function between the NADT (-) and NADT (+) groups after RP were not significant. This report is the first to show that among patients with prostate cancer, those who underwent NADT had greater PL recovery after RP than those who did not. Data regarding PL recovery after NADT and RP obtained in this study could be useful for patients with prostate cancer who plan to undergo such procedures.

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“…2–4 In a study by Engel et al, 3 the stretched penile length was measured before and after bilateral nerve-sparing RP and showed a significant decrease in length from 11.77 to 11.13 cm at 1 month. In a similar study by Savoie et al, 4 in which penile length was measured before and after retropubic RP, significant decreases were seen for the flaccid and stretched measurements and circumference.…”

Section: Commentmentioning

confidence: 99%

Reduced Penile Size and Treatment Regret in Men With Recurrent Prostate Cancer After Surgery, Radiotherapy Plus Androgen Deprivation, or Radiotherapy Alone

Parekh

Chen

Hoffman

et al. 2013

Urology

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OBJECTIVE To report the relative incidence of the perceived reduction in penile size across prostate cancer treatment modalities and to describe its effect on quality of life and treatment regret. MATERIALS AND METHODS The incidence of patient complaints about reduced penile size was calculated for 948 men in the Comprehensive, Observational, Multicenter, Prostate Adenocarcinoma (COMPARE) registry who experienced biochemical failure (per registry definition) and were assessed a median of 5.53 years after prostatectomy or radiotherapy (RT) consisting of either external beam RT or brachytherapy, with or without androgen deprivation therapy (ADT). Multivariate logistic regression analysis was used to determine the factors associated with treatment regret and interference with emotional relationships. RESULTS Of 948 men, 25 (2.63%) complained of a reduced penile size. The incidence of reduced penile size stratified by treatment was 3.73% for surgery (19 of 510), 2.67% for RT plus ADT (6 of 225), and 0% for RT without ADT (0 of 213). The surgery (P = .004) and RT plus ADT (P = .016) groups had significantly more shortened penis complaints than the RT alone group. The rate of a shortened penis after surgery and after RT plus ADT was similar (P = .47). On multivariate analysis adjusting for age, treatment type, and baseline comorbidity, a perceived reduction in penile size was associated with interference with close emotional relationships (odds ratio 2.36, 95% confidence interval 1.02–8.26; P = .04) and increased treatment regret (odds ratio 3.37, 95% confidence interval 1.37–8.26; P = .0079). CONCLUSION Complaints about a reduced penile size were more common with RT plus ADT or surgery than RT alone and were associated with greater interference with close emotional relationships and increased treatment regret. Physicians should discuss the possibility of this rarely mentioned side effect with their patients to help them make more informed treatment choices.

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Changes in Penile Length After Robot-Assisted Laparoscopic Radical Prostatectomy

Abstract: This report describes changes in SPL over time after RALRP for prostate cancer. The expected decrease in length was observed shortly after surgery, but, by 9 months, penile length had returned to the preoperative measurement.

Cited by 38 publications

References 20 publications

Self-perceived penile shortening after radical prostatectomy

Self-perceived penile shortening after radical prostatectomy

Changes in penile length after radical prostatectomy: effect of neoadjuvant androgen deprivation therapy

Reduced Penile Size and Treatment Regret in Men With Recurrent Prostate Cancer After Surgery, Radiotherapy Plus Androgen Deprivation, or Radiotherapy Alone

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