Penile Length Shortening After Radical Prostatectomy: Men's Responses
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.
Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS
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