After radical prostatectomy, many men experience a temporary shortening of the penis. But they could regain most of that length, if not all, within a year, according to new research in BJU International.
Past studies have shown that stretched penile length (SPL) typically is reduced after surgery, but results have been mixed. Some scientists believe that the penis gradually continues to shorten after prostatectomy. Others say the original length is recovered within six months to five years.
Because so many men associate penile length with masculinity and virility, shortening of the penis can affect self-esteem.
The current study involved 102 men with an average age of 64 years. All of the men had localized prostate cancer and underwent robot-assisted radical prostatectomy at the same hospital.
Researchers measured each man’s SPL before surgery and ten days after surgery. SPL was again measured at one- and three-month follow-ups and every three months thereafter for the next two years.
Magnetic resonance imaging (MRI) was used to assess anatomical changes before and after surgery. The men also completed questionnaires to evaluate erectile function and erection hardness.
The men’s penises were at their shortest ten days after surgery, with an average length loss of 1.99 centimeters. However, length gradually recovered. The men’s twelve-month SPLs were not significantly different from their preoperative SPLs.
Why did the men regain penile length? The researchers suggested that part of the urethra and the bulb of the penis could be temporarily retracted into the pelvis during surgery. Over time, these tissues move back down to their original position.
The authors noted some limitations to their study. They worked with a small group of men and assessed only penile length, not circumference or rigidity. Also, some men took phosphodiesterase type 5 (PDE5) inhibitors. Past studies have suggested that these medications can prevent shortening after prostatectomy. Thus, the effect of PDE5 inhibitors “requires further investigation.”
Additional research should also focus on the effects of sex hormones and changes in penile blood flow for longer durations, they added.
Still, the results could be useful for patients considering radical prostatectomy.
“These results can help inform patients about changes in penile appearance after [radical prostatectomy],” they wrote.
Kadono, Yoshifumi, et al.
“Changes in penile length after radical prostatectomy: investigation of the underlying anatomical mechanism”
(Full-text. First published: February 8, 2017)
Seaman, Andrew M.
“Does penis length recover after prostate removal?”
(February 23, 2017)
“Prostate cancer surgery can affect penis length”
(February 10, 2017)