According to new research, prostate cancer (PCa) patients receiving radical prostatectomy may have a slight decrease of penile length immediately after surgery, although this returns within six months. Researchers discovered that usage of a phosphodiesterase-5 inhibitor (PDE5i) mitigated SFPL loss, with patients who routinely took PDE5is seeing no SFPL loss.
A single evaluator assessed stretched flaccid penile length (SFPL) before RP and again two and six months after RP in a research including 118 males at baseline. At two and six months, 76 and 63 men were assessed, respectively.
Researchers led by John P. Mulhall, MD, of Memorial Sloan-Kettering Cancer Center in New York reported online ahead of print in BJU International that at two months after surgery, patients’ SFPL decreased by a mean of 2.4 mm, but at six months, there was no significant difference in SFPL compared to baseline.
At six months, males who took a daily PDE5i had no SFPL loss, but those who did not regularly take a PDE5i had a substantial mean SFPL reduction of 4.4 mm compared with baseline.
The authors said, “The present study is among the first to demonstrate preservation of SFPL in individuals using daily PDE5i vs those patients not using daily PDE5i.”
Multiple hypotheses have been presented as to why penile length varies in the post-RP population, according to Dr. Mulhall’s team. The authors indicated that one idea is that “cavernous nerve damage causes sympathetic overdrive, resulting in smooth muscle contraction and a hypertonic retracted penis in the early phase.”