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Prospective analysis of penile length changes after radical prostatectomy
Author(s) -
Berookhim Boback M.,
Nelson Christian J.,
Kunzel Brian,
Mulhall John P.,
Narus Joseph B.
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12443
Subject(s) - erectile dysfunction , medicine , urology , prospective cohort study , prostatectomy , erectile function , univariate analysis , multivariate analysis , prostate cancer , cancer
Objectives To assess the impact of radical prostatectomy ( RP ) on penile dimensions. To assess the impact of phosphodiesterase‐5 inhibitor ( PDE 5i) use on penile length changes.Patients and Methods Men undergoing RP were enrolled in this prospective study before surgery. Demographic, clinical and PDE 5i frequency‐of‐use data were collected. Erectile function was measured using the erectile function domain ( EFD ) of the International Index of Erectile Function. A single evaluator measured stretched flaccid penile length ( SFPL ) before RP , and at 2 and 6 months after RP . Repeated measures analysis was used to test differences in SFPL between timepoints. Pearson correlation was used for univariate analyses and multiple regression was used for multivariable analysis.Results A total of 118 patients were evaluated at baseline, with 76 and 63 patients evaluated at 2 and 6 months, respectively. At 2 months, there was a 2.4‐mm mean decrease in SFPL , while at 6 months there was no significant difference. At 6 months, those subjects who took a daily PDE 5i had no SFPL loss ( n = 36, 1±6.7 mm gain, P = 0.37 compared with baseline), while those subjects who did not consistently take a PDE 5i had SFPL loss ( n = 27, 4.4±6.6 mm loss, P < 0.002 compared with baseline). In multivariable analysis, PDE 5i use at 6 months and 6‐month EFD score without on‐demand PDE 5i were significant predictors of 6‐month SFPL loss, suggesting that an increase in these variables leads to SFPL preservation.Conclusions In this rigorously conducted prospective study of SFPL changes after RP , there was evidence of SFPL loss at 2 months, but not at 6 months after RP . PDE 5i use moderated SFPL loss, with patients who regularly used PDE 5i having no loss in SFPL .