OBJECTIVES: To assess the impact of RP on penile dimensions.
A secondary objective was to assess the impact of phosphodiesterase-5 inhibitor (PDE5i) use on penile length changes.
SUBJECTS AND METHODS: Men undergoing RP were enrolled prior to surgery. Demographic, clinical and PDE5i frequency of use data were collected. Erectile function (EF) was measured with the Erectile Function Domain (EFD) of the International Index of Erectile Function (IIEF). Prospectively, a single evaluator measured stretched flaccid penile length (SFPL) preoperatively, and at two, and six months post-RP. Repeated measures analysis was used to test differences in SFPL between time points. Pearson correlation was used for univariate analyses and multiple regression was used for multivariable analysis.
RESULTS: 118 patients were evaluated at baseline, with 76 and 63 patients at two and six months. At two months, there was a 2.4mm mean decrease in measured SFPL, while at six months no significant difference existed. However, at six months, those subjects who took a daily PDE5i had no measured SFPL loss (n= 36, 1±6.7 mm gain, p=0.37 compared to baseline), while those subjects who did not consistently take a PDE5i had measured SFPL loss (n=27, 4.4±6.6 mm loss, p< 0.002 compared to baseline). In multivariable analysis, PDE5i use at six months and six-month EFD score without on-demand PDE5i were significant predictors (in the negative direction) of six-month SFPL loss, suggesting an increase in these variables leads to SFPL preservation.
CONCLUSIONS: In this rigorously conducted prospective study of SFPL changes post-RP, there was evidence of SFPL loss at two months, but not at six months postoperatively. PDE5i use moderated SFPL loss, with patients using PDE5i regularly demonstrating no length loss.
Written by:
Berookhim BM, Nelson CJ, Kunzel B, Mulhall JP, Narus JB. Are you the author?
Male Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY.
Reference: BJU Int. 2013 Sep 5. Epub ahead of print.
doi: 10.1111/bju.12443
PubMed Abstract
PMID: 24053766
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