Department of Urology and Andrology, Elaj Medical Centers, Jeddah, Saudi Arabia.
King's College, London, UK.
BJU Int. 2019 May;123(5):885-890. doi: 10.1111/bju.14604. Epub 2018 Nov 25.
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.
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 (Hb ), and Peyronie's disease (PD).
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/m , 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.
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.
探讨术前阴茎大小与阴茎植入术后勃起阴茎之间是否存在相关性。阴茎植入术后患者不满意的常见原因是患者抱怨手术缩短了阴茎。有人提出，术前伸展的阴茎长度在假体处于勃起状态时几乎与术后相同。然而，没有全面的数据支持这一理论。本前瞻性研究旨在调查这一理论。
在阴茎植入术之前，在手术室对伸展阴茎的长度和周长进行标准化测量，然后在手术结束时用勃起状态下的阴茎再次测量。我们记录了阴茎假体的类型、圆柱体长度和可弯曲棒直径。所有患者均记录了体重指数（BMI）、高血压（HTN）、糖化血红蛋白（Hb）和阴茎硬结症（PD）的数据。
共评估了 133 例患者；88 例（66.2%）为可弯曲阴茎假体（MPP），45 例（33.8%）为可充气阴茎假体（IPP）。中位年龄和 BMI 分别为 56 岁和 30kg/m²。共有 40 例（30.1%）患者有高血压，37 例（27.8%）有 PD，89 例（66.9%）为糖尿病患者。术前伸展长度的平均值（SD）为 12.8cm（1.8cm）。术前松弛周长的平均值（SD）为 10.3cm（1.2cm）。术后，勃起长度和周长的平均值（SD）分别为 13.1cm（1.7cm）和 11.3cm（1.3cm）。总体而言，长度（P<0.05）和周长（P<0.05）均有显著增加（平均[SD]分别为+0.36cm[0.63cm]和+1.04cm[1.02cm]）。与 MPP 相比，IPP 患者的长度（平均[SD]为 0.62cm[0.72cm]）和周长（平均[SD]为 1.7cm[1.0cm]）的增加更明显（P<0.05）。
与术前评估相比，阴茎植入术不会显著缩小阴茎尺寸。该结果不受合并症的影响。术前长度和周长与术后即刻勃起阴茎密切相关，尽管在本系列接受麻醉测量的患者中，周长不一定具有可比性。在诊所记录阴茎尺寸并与患者术前达成一致，可能是提高该手术满意度的一种方法。
