Penile prosthesis implantation preserves penile length
Habous, M1; Giona, S2; Muir, G2; Binsaleh, S3; Abdelwahab, O4; Nassar, M1; Abdelrahman, Z1; Elserafy, A1; Mulhall, J5; Ralph, D6
1: Elaj Medical Centers, Saudi Arabia; 2: King’s College Hospital,London,UK; 3: King Saud University,Riyadh,Saudi Arabia; 4: Benha University,Egypt; 5: Memorial Sloan Kettering cancer center, NY USA; 6: St Peters Andrology Center,UCLH,London,uk
Introduction: A common cause of patient dissatisfaction after penile implanting (PI) is caused by patients complaing that surgery has shortened the penis.
It has been suggested that stretched penile length preoperatively is almost the same after surgery when the prosthesis is in erect status. However, no comprehensive data supports this theory. This prospective study aimed to investigate penile size measured preoperatively and erect postoperatively.
Methods: Consecutive penile prosthesis operations were assessed over one year period. Standardised measurements of stretched penile length and girth were performed in theatre preoperatively then re-measured at the end of the procedure with the penis in the erect position. We recorded type of penile implant, cylinder lengths and malleable rod diameters. All patients had data on body mass index (BMI), hypertension, glycated haemoglobin (HbA1c) and Peyronie’s disease(PD).
Results: 133 patients were assessed. 88 (66.2%) had malleable prosthesis( MPP), 45 (33.8%) inflatable prostheses (IPP). Median age and BMI were 56 and 30 respectively. 40(30.1%) patients had hypertension and 37(27.8%) suffered from PD. 89 men (66.9%) were diabetic.
The mean pre-implant stretched length was 12.8cm(+1.8). Mean flaccid girth was 10.3cm(+1.2). Postoperatively mean erect length and girth were 13.1cm(+1.7) and 11.3cm(+1.3) respectively. Overall, there was a significant (p<<0.05) increase in both length +0.36 cm(+0.63) and girth +1.04 cm(+1.02). Patients who had IPP, had a more significant increase in both length (0.62cm +0.72) and girth (1.7cm +1.0) compared to MPP (0.22cm +0.53) and (0.7cm +0.87) (p<<0.05). We investigated correlations between pre and post-op outcomes related to BMI, HTN, Diabetes and PD. None of these variables affected outcome.
Conclusions: Penile implant surgery does not significantly decrease penile size compared to pre-operative assessment, but preserves it for the majority of patients.
The outcome was not affected by co-morbidities. The preoperative length and girth correlated well with the immediate postoperative erect penis. Recording penile dimensions in the clinic and agreeing these with patients pre-operatively may be a way of improving satisfaction levels with this surgery.
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