Objective
To investigate if there is a correlation between penile size
measured preoperatively and erect penis after penile implant
surgery (PI). A common cause of patient dissatisfaction after
PI is caused by patients complaining 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 was done to investigate this theory.
Patients and Methods
Standardised measurements of stretched penile length and
girth were performed in theatre before PI implantation then
re-measured at the end of the procedure with the penis in the
erect position. We recorded type of PI, cylinder lengths and
malleable rod diameters. All patients had data recorded on
body mass index (BMI), hypertension (HTN), glycated
haemoglobin (HbA1c), and Peyronie’s disease (PD).
Results
In all, 133 patients were assessed; 88 (66.2%) had a malleable
penile prosthesis (MPP) and 45 (33.8%) an inflatable penile
prosthesis (IPP). The median age and BMI were 56 years and
30 kg/m2, respectively. In all, 40 (30.1%) patients had HTN,
37 (27.8%) had PD, and 89 (66.9%) were diabetic. The mean
(SD) pre-implant stretched length was 12.8 (1.8) cm. The
mean (SD) flaccid girth was 10.3 (1.2) cm. Postoperatively,
the mean (SD) erect length and girth were 13.1 (1.7) cm and
11.3 (1.3) cm, respectively. Overall, there was a significant
(P < 0.05) increase in both the mean (SD) length at
+0.36 (0.63) cm, and girth at +1.04 (1.02) cm. Patients who
had an IPP, had a greater increase in both length (mean [SD]
0.62 [0.72] cm) and girth (mean [SD] 1.7 [1.0] cm)
compared to those who had a MPP (mean [SD]
0.22 [0.53] cm and 0.7 [0.87] cm, respectively) (P < 0.05).
We investigated correlations between pre- and postoperative
outcomes related to BMI, HTN, diabetes, and PD. None of
these variables affected outcome.
Conclusions
PI surgery does not significantly decrease penile size
compared to the preoperative assessment. The outcome was
not affected by co-morbidities. The preoperative length and
girth correlated well with the immediate postoperative erect
penis, although girth was not necessarily comparable in this
series of patients measured under anaesthesia. Recording
penile dimensions in the clinic and agreeing these with
patients’ preoperatively may be a way of improving
satisfaction levels with this surgery. |
