Penile Length and Its Preservation in Men After Radical Prostatectomy

Abstract

Penile changes (most prominently shortening) after radical prostatectomy (RP) can negatively influence body image and quality of life. Here, we review the relevance of penile length to sexual satisfaction, the etiology of penile shortening after RP, and interventions that may preserve penile length. Most studies measure flaccid stretched penile length from the penopubic skin junction to the glans tip; however, the technique reportedly underestimates erect length by 23%. There is evidence that oral pharmacotherapy and mechanical devices may provide some benefit for length preservation, but the evidence basis remains marginal. Surgical augmentation in the setting of penile shortening may be efficacious but carries risks including potential for failure and/or worsening deformity. Penile length loss (perceived or objective) can have a major impact on quality of life after radical prostatectomy. Additional research is required to understand optimal means to help men preserve penile length after RP.