Penile Length Shortening After Radical Prostatectomy: Men's Responses
Main Category: Prostate / Prostate CancerAlso Included In: Erectile Dysfunction / Premature Ejaculation; Men's health
Article Date: 06 Dec 2009 - 0:00 PST
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UroToday.com - Erectile dysfunction is the most commonly recognized side effect of radical prostatectomy (RP) for prostate cancer (CaP). However, post-surgery penile length shortening (PLS) is known to occur in up to three-fourths of men. The impact of PLS has not previously been assessed.
The mechanism causing PLS is not known, but may be related to anatomic changes or fibrosis and scaring in the retropubic space. Studies suggest that men are more concerned with penile length than women, and that men desiring penile lengthening actually have normal penile length. The goal of this study that appears in the European Journal of Oncology Nursing was to determine patients' perceptions and responses to PLS after RP.
Six participants were recruited by open invitation from a CaP support group. The main criterion for inclusion was perception of PLS at least one year after undergoing RP. Five of the six men were married. Most were of Caucasian descent and had completed secondary education. None of the men reported to be able to achieve adequate erections for penetrative sex. Participants underwent one-on-one semi-structured interviews and a second interview with the principal investigator to confirm findings. Interview analysis followed a substantive theory, within the grounded theory method. In this process, data collection, coding and analysis occur simultaneously and coding and analysis continue after the interview.
The central theme to emerge from the study was "resignation", a conveyed awareness of their inability to return to a pre-cancerous lifestyle. Men adapted to the changes of having CaP. All participants focused on the bigger picture and this allowed them to coexist with a diagnosis of CaP. To focus on the bigger picture, they took into consideration past experiences, current state of affairs and hypothesized how potential outcomes would impact upon them. Family relations were prioritized, especially spousal communication. In addition, three sub-themes were identified; unaltered masculinity, the unimportance of PLS and erectile dysfunction as a speed bump. None of the men perceived changes in their own evaluation of masculinity after noticing PLS after RP. While men saw themselves as being unable to perform a "masculine" role in procuring coitus, this did not mean that they saw themselves as unmanly. The men also felt that PLS was unimportant, in part due to the fact that they all experienced erectile dysfunction. It is unclear how PLS might impact potent men in this regard. Finally, all men identified return of erectile function as the event that would improve satisfaction with penile function.
Yu Ko WF, Degner LF, Hack TF, Schroeder G
Eur J Oncol Nurs. 2009 Oct 5. Epub ahead of print.
doi:10.1016/j.ejon.2009.09.001
Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS
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MLA
13 Feb. 2012. <http://www.medicalnewstoday.com/releases/173054.php>
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http://www.medicalnewstoday.com/releases/173054.php.
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Visitor Opinions In Chronological Order (2)
The Final Irony - penis size after radical prostatectomy
posted by F. P. Taylor on 24 Dec 2009 at 2:36 amIn 2002, at the age of 51, I elected to undergo a radical prostatectomy. At that time - a scant six years ago - nerve sparing technique was fairly well evolved, albeit without the further refinements of robotic technology. I sought out a highly skilled surgeon with an reputation for excellent technique in sparing nerve and erectile function.
After nearly a year had passed , I started to have functional erections with the help of a prescrption PDE5 inhibitor. My post surgical erections were noticably smaller my normal eretions but I assumed the smaller size was the early phase of a gradual progression toward an approximate restoration of normal erections , i.e., a correlation between firmness and size. Unfortunately - and surprisingly - this was not to be the case. In fact, I was unprepared, and ill advised, for the smaller length and girth of my post-op erections.
(It goes without saying that I am grateful to have relatively good health and function - but that is not the point of this discussion.) The point is that I was not advised - or preferably coached - as to the mere possibility of such a dramatic reduction in size.
The article above is more of an academic than medical distinction, since the patients have little or no function in the first case.
I would like to see the authors of the research take their case studies to the next logical level and include interviews with men who do have functional erections but dysfunctional size. And include some discussion of the cause, and treatment, if any.
Penile Length Shortening After RP
posted by Anon on 24 Apr 2010 at 7:33 pmI had a radical prostatectomy in 2004. I definitely have experienced penile length shortening in both the unerect and erect states. My reaction is similar to those described in the article. My image and confidence in my manhood was developed before this condition occurred.
Nevertheless, it does result in some psychological impact on my self image sexually, even though I feel I have been able to deal with it fairly well. Had this occurred in my younger years, I feel it would have been considerably more difficult to accept. Neither the vacuum pump nor oral or injectable medications have provided any help.
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