Figure 1 highlighted the mean SPL at the different time points. The SPL was shortest at 10 days after RP; it gradually recovered thereafter, and by 12 months, it was not significantly different from preoperative SPL.
In figure 2 (available online), the distal end of membranous urethra was found to have moved proximally (mean proximal displacement: 3.9 mm) at 10 days after RP, and to have returned to the preoperative position at 12 months after RP.
Only the volume of the removed prostate was a predictor of SPL change at 10 days after operation on univariate analysis; on multivariate analysis, the association was not statistically significant. By 12 months, there were no specific predictors of shorter SPL, as they were nearly identical to pre-operative SPL. Covariates assessed included age, BMI, nerve-sparing, use of PDE5 inhibitors.
On discussion, the authors noted that there was no regular penile rehabilitation program for all patients. Some patients received PDE5 inhibitors, but none used VED. This may affect ED recovery.
This was a very unique study and well-done. I think it helps address an important patient concern, and using this, we can reassure most men pre-operatively, that similar to urine continence, by 12 months, SPL will likely be back to its baseline.
Presented by: Yoshifumi Kadono, MD
Co-Authors: Kazuaki Machioka, Kazufumi Nakashima, Masashi Iijima, Kazuyoshi Shigehara, Takahiro Nohara, Kazutaka Narimoto, Kouji Izumi, Yasuhide Kitagawa, Hiroyuki Konaka, Atsushi Mizokami
Written By: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA