Preserving penis length after radical prostatectomy

Following radical prostatectomy, a significant number of patients notice a progressive shortening of the penis, a fact confirmed in recent studies. To better understand why, Italian researchers measured the length of the flaccid and stretched penis in 126 patients at five time points: just before surgery, when the catheter was removed 7 to 10 days later, and at 3, 6, and 12 months postoperatively. They reported that shortening peaked at the time the catheter was removed and continued, though to a lesser extent, for at least a year. (The average reduction in length after one year was just over a half inch when flaccid and nearly an inch when stretched.) Interestingly, men who had nerve-sparing surgery, as well as those who recovered some erectile function during the year of follow-up, lost less length than other study participants.

The researchers theorize that the death of nerve cells and reduced blood flow (and thus a loss of oxygen) to the penis during surgery and recovery may contribute to shortening. Although penile rehabilitation remains controversial, they suggest that it might help temper shortening, a conclusion supported by a study from a team of researchers in Minnesota. They found that starting the use of a vacuum erection device one month after surgery improves sexual function and helps to preserve penile length.

Sources: Gontero P, Galzerano M, Bartoletti R, et al. New Insights Into the Pathogenesis of Penile Shortening After Radical Prostatectomy and the Role of Postoperative Sexual Function. Journal of Urology 2007;178:602–7. PMID: 17570431.

Kohler TS, Pedro R, Hendlin K, et al. A Pilot Study on the Early Use of the Vacuum Erection Device After Radical Retropubic Prostatectomy. BJU International 2007; 100:858–62. PMID: 17822466.

Originally published Oct. 1, 2007; Last reviewed April 11, 2011