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Pharmacologically induced erect penile length and stretched penile lengh are both good predictors of post-inflatable prosthesis penile length

International Journal of Impotence Research volume 26, pages 128–131 (2014)Cite this article

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Abstract

Inflatable penile prosthesis (IPP) remains the gold standard for the surgical treatment of refractory erectile dysfunction; however, current literature to aid surgeons on how best to counsel patients on their postoperative inflated penile length is lacking. The aim of this study was to identify preoperative parameters that could better predict postoperative penile length following insertion of an IPP. Twenty men were enrolled in a prospective study examining penile lengths before and after IPP surgery. Patients with Peyronie’s disease were excluded from this analysis. Baseline preoperative characteristics, including body mass index, history of hypertension, diabetes, Sexual Health Inventory for Men scores and/or prior radical prostatectomy were recorded. All patients underwent implantation with a three-piece inflatable Coloplast penile prosthesis. We compared stretched penile length to pharmacologically induced erect lengths. Postoperatively, we measured inflated penile lengths at 6 weeks and assessed patients’ perception of penile size at 12 weeks. The median (±interquartile range) stretched penile length and pharmacologically induced erect penile length was 15 (±3) and 14.25 (±2) cm, respectively (P=0.5). Median post-prosthesis penile length (13.5±2.13 cm) was smaller than preoperative pharmacologically induced length (P=0.02) and preoperative stretched penile length (P=0.01). The majority of patients (70%) had a decrease in penile length (median loss 0.5±1.5 cm); however, this loss was perceptible by 43% of men. Stretched penile length and pharmacologically induced erect penile length were equally good predictors of postoperative inflated length (Spearman’s correlation 0.8 and 0.9, respectively). Pharmacologically induced erect penile length and stretched penile lengths are equal predictors of post-prosthesis penile length. The majority of men will experience some decrease in penile length following prosthesis implantation; however <50% report a subjective loss of penile length.

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References

  1. Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB . Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol 2000; 163: 460–463.

    Article  CAS  Google Scholar 

  2. Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002.

    Article  CAS  Google Scholar 

  3. Furlow WL, Goldwasser B, Gundian JC . Implantation of model AMS 700 penile prosthesis: long-term results. J Urol 1988; 139: 741–742.

    Article  CAS  Google Scholar 

  4. Mulhall JP, Ahmed A, Branch J, Parker M . Serial assessment of efficacy and satisfaction profiles following penile prosthesis surgery. J Urol 2003; 169: 1429–1433.

    Article  Google Scholar 

  5. Akin-Olugbade O, Parker M, Guhring P, Mulhall J . Determinants of patient satisfaction following penile prosthesis surgery. J Sex Med 2006; 3: 743–748.

    Article  Google Scholar 

  6. Montague DK . Penile prosthesis implantation: size matters. Eur Urol 2007; 51: 887–888.

    Article  Google Scholar 

  7. Mondaini N, Ponchietti R, Gontero P, Muir GH, Natali A, Caldarera E et al. Penile length is normal in most men seeking penile lengthening procedures. Int J Impot Res 2002; 14: 283–286.

    Article  CAS  Google Scholar 

  8. Shaeer O . Supersizing the penis following penile prosthesis implantation. J Sex Med 2010; 7: 2608–2616.

    Article  Google Scholar 

  9. Miranda-Sousa A, Keating M, Moreira S, Baker M, Carrion R . Concomitant ventral phalloplasty during penile implant surgery: a novel procedure that optimizes patient satisfaction and their perception of phallic length after penile implant surgery. J Sex Med 2007; 4: 1494–1499.

    Article  Google Scholar 

  10. Deveci S, Martin D, Parker M, Mulhall JP . Penile length alterations following penile prosthesis surgery. Eur Urol 2007; 51: 1128–1131.

    Article  Google Scholar 

  11. Wang R, Howard GE, Hoang A, Yuan JH, Lin HC, Dai YT . Prospective and long-term evaluation of erect penile length obtained with inflatable penile prosthesis to that induced by intracavernosal injection. Asian J Androl 2009; 11: 411–415.

    Article  Google Scholar 

  12. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  13. Wolf JS Jr., Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 2008; 179: 1379–1390.

    Article  Google Scholar 

  14. Eid JF . No-touch technique. J Sex Med 2011; 8: 5–8.

    Article  Google Scholar 

  15. Eid JF, Wilson SK, Cleves M, Salem EA . Coated implants and ‘no touch’ surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology 2012; 79: 1310–1316.

    Article  Google Scholar 

  16. Wessells H, Lue TF, McAninch JW . Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol 1996; 156: 995–997.

    Article  CAS  Google Scholar 

  17. Mulhall JP, Jahoda A, Aviv N, Valenzuela R, Parker M . The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ. BJU Int 2004; 93: 97–99.

    Article  CAS  Google Scholar 

  18. Benevides MD, Carson CC . Intraurethral application of alprostadil in patients with failed inflatable penile prosthesis. J Urol 2000; 163: 785–787.

    Article  CAS  Google Scholar 

  19. Borges F, Hakim L, Kline C . Surgical technique to maintain penile length after insertion of an inflatable penile prosthesis via infrapubic approach. J Sex Med 2006; 3: 550–553.

    Article  Google Scholar 

  20. Henry G, Houghton L, Culkin D, Otheguy J, Shabsigh R, Ohl DA . Comparison of a new length measurement technique for inflatable penile prosthesis implantation to standard techniques: outcomes and patient satisfaction. J Sex Med 2011; 8: 2640–2646.

    Article  Google Scholar 

  21. Montague DK, Angermeier KW . Increasing size with penile implants. Curr Urol Rep 2008; 9: 483–486.

    Article  Google Scholar 

  22. Daitch JA, Angermeier KW, Lakin MM, Ingleright BJ, Montague DK . Long-term mechanical reliability of AMS 700 series inflatable penile prostheses: comparison of CX/CXM and Ultrex cylinders. J Urol 1997; 158: 1400–1402.

    Article  CAS  Google Scholar 

  23. Wilson SK, Cleves MA, Delk JR 2nd . Ultrex cylinders: problems with uncontrolled lengthening (the S-shaped deformity). J Urol 1996; 155: 135–137.

    Article  CAS  Google Scholar 

  24. Savoie M, Kim SS, Soloway MS . A prospective study measuring penile length in men treated with radical prostatectomy for prostate cancer. J Urol 2003; 169: 1462–1464.

    Article  Google Scholar 

  25. Munding MD, Wessells HB, Dalkin BL . Pilot study of changes in stretched penile length 3 months after radical retropubic prostatectomy. Urology 2001; 58: 567–569.

    Article  CAS  Google Scholar 

  26. Gontero P, Galzerano M, Bartoletti R, Magnani C, Tizzani A, Frea B et al. New insights into the pathogenesis of penile shortening after radical prostatectomy and the role of postoperative sexual function. J Urol 2007; 178: 602–607.

    Article  Google Scholar 

  27. Briganti A, Fabbri F, Salonia A, Gallina A, Chun FK, Dehò F et al. Preserved postoperative penile size correlates well with maintained erectile function after bilateral nerve-sparing radical retropubic prostatectomy. Eur Urol 2007; 52: 702–707.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA

    E C Osterberg & R Ramasamy

  2. Weill Cornell Medical College, New York, NY, USA

    A Maganty

  3. Depeartment of Urology, North Shore Long Island Jewish Lenox Hill Hospital, New York, NY, USA

    J F Eid

Authors
  1. E C Osterberg
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  2. A Maganty
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  3. R Ramasamy
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  4. J F Eid
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Correspondence to E C Osterberg.

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Competing interests

JFE receives compensation as a consultant for Coloplast Inc. All other authors declare no conflict of interest.

Appendix 1

Appendix 1

Questionnaire completed by patients at 12 weeks post operatively.

  1. 1

    When your penis is flaccid (soft), do you feel like it is bigger, smaller, or the same as compared with that before your operation (circle one)?

  2. 2

    When your penis is erect (hard) after inflation of your prosthesis, do you feel like it is bigger, smaller, or the same as compared with that before your operation (circle one)?

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Osterberg, E., Maganty, A., Ramasamy, R. et al. Pharmacologically induced erect penile length and stretched penile lengh are both good predictors of post-inflatable prosthesis penile length. Int J Impot Res 26, 128–131 (2014). https://doi.org/10.1038/ijir.2013.50

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