Briganti Alberto, Fabbri Fabio, Salonia Andrea, Gallina Andrea, Chun Felix K-H, Dehò Federico, Zanni Giuseppe, Suardi Nazareno, Karakiewicz Pierre I, Rigatti Patrizio, Montorsi Francesco
Department of Urology, Vita-Salute University, Milan, Italy.
Eur Urol. 2007 Sep;52(3):702-7. doi: 10.1016/j.eururo.2007.03.050. Epub 2007 Mar 26.
Controversial data on penile length after radical retropubic prostatectomy are available. We hypothesised that postoperative penile size correlates to erectile function following bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP).
Thirty-three consecutive patients with a preoperative erectile function domain of the International Index of Erectile Function (IIEF-EF) score indicating full potency (> or = 26) were prospectively enrolled. All patients underwent BNSRRP performed by one high-volume surgeon. All patients were preoperatively evaluated by IIEF-EF, analysis of comorbidities, physical examination, and penile power colour Doppler ultrasound using intracavernosal injection of prostaglandin E(1) (PGE(1)) 20 microg plus audiovisual and manual genital stimulation. Penile length and circumference were measured in flaccidity and at maximum erection. Six months postoperative, patients were assessed with the same protocol plus general assessment questions investigating penile structure and function. Statistical analysis was performed with an independent sample t test.
Mean patient age was 56.5 yr. We found no difference between the preoperative and the 6-mo postoperative mean IIEF-EF domain score (27.2 vs, 26.7, respectively; p = 0.35). No difference was found in penile colour Doppler evaluation between the preoperative and postoperative periods (all p values > or = 0.3). We found no differences in penile length and circumference between the preoperative and postoperative evaluation either in the flaccid or in the erect state. Mean flaccid penile length (cm; preop vs. postop): 13.2 vs. 13 (p = 0.6). Mean flaccid penile circumference (cm; preop vs. postop): 11.1 vs. 11 (p = 0.7). Mean erect penile length (cm; preop vs. postop): 16.8 vs. 16.5 (p = 0.08). Mean erect penile circumference (cm; preop vs. postop): 15.6 vs. 15.3 (p = 0.2).
This is the first report on penile changes in flaccidity and at maximum erection after BNSRRP in patients treated by one high-volume surgeon. The postoperative preservation of erectile function positively correlated with the maintenance of penile length following surgery. We found no change in penile size after surgery.
关于耻骨后根治性前列腺切除术后阴茎长度的数据存在争议。我们假设在双侧保留神经的耻骨后根治性前列腺切除术（BNSRRP）后，术后阴茎大小与勃起功能相关。
前瞻性纳入33例术前国际勃起功能指数（IIEF-EF）评分的勃起功能领域显示完全勃起功能（≥26分）的连续患者。所有患者均由一位经验丰富的外科医生进行BNSRRP手术。所有患者术前均接受IIEF-EF评估、合并症分析、体格检查以及阴茎海绵体内注射20微克前列腺素E1（PGE1）加视听和手动生殖器刺激后的阴茎功率彩色多普勒超声检查。测量阴茎在疲软状态和最大勃起状态下的长度和周长。术后6个月，采用相同方案对患者进行评估，并增加关于阴茎结构和功能的一般评估问题。采用独立样本t检验进行统计分析。
患者平均年龄为56.5岁。我们发现术前和术后6个月的平均IIEF-EF领域评分之间无差异（分别为27.2和26.7；p = 0.35）。术前和术后阴茎彩色多普勒评估无差异（所有p值≥0.3）。我们发现术前和术后评估中，阴茎在疲软或勃起状态下的长度和周长均无差异。平均疲软阴茎长度（厘米；术前与术后）：13.2对13（p = 0.6）。平均疲软阴茎周长（厘米；术前与术后）：11.1对11（p = 0.7）。平均勃起阴茎长度（厘米；术前与术后）：16.8对16.5（p = 0.08）。平均勃起阴茎周长（厘米；术前与术后）：15.6对15.3（p = 0.2）。
这是关于由一位经验丰富的外科医生进行BNSRRP手术的患者术后阴茎在疲软和最大勃起状态下变化的首份报告。术后勃起功能的保留与术后阴茎长度的维持呈正相关。我们发现手术后阴茎大小无变化。
