Nerve-Sparing Surgery Reduces Risk of Penile Shortening

Return of erectile function may also reduce risk in prostate cancer patients

TUESDAY, Aug. 14 (HealthDay News) -- Men undergoing radical prostatectomy may be less likely to have post-operative shrinkage of penile length if they undergo nerve-sparing surgery and quickly recover erectile function, according to a report in the August issue of the Journal of Urology.

Paolo Gontero, M.D., of the University of Turin in Italy, and colleagues enrolled 126 prostate cancer patients with a mean age of 65 undergoing surgery between September 2004 and March 2005. The researchers took penile measurements before surgery, after catheter removal and at three-, six- and 12-month intervals. Erectile function was also measured post-operatively at each interval.

The men had significant penile shortening (mean, 0.84 cm) at catheter removal and to a lesser degree for a year after radical prostatectomy, although the cause wasn't determined. In addition, some protection against the shortening process was associated with early recovery of erectile functions and with nerve-sparing surgery.

"Interestingly enough, one of the most notable observations of our study was that nerve-sparing surgery, irrespective of the functional outcome, was an independent predictor of reduced penile loss only when we considered the changes in length occurring during the whole follow-up period but not during the early days," the authors write. "While a clear explanation for early modifications in penile size is presently lacking, the protective effect exerted by nerve-sparing surgery on long-term penile changes may be viewed as a beneficial role of cavernous nerves in preventing fibrotic changes."

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