In a newly published study, one in five men who had prostate cancer surgery had a 15% or more decrease in penis length. Though the majority of men had very slight decreases, researchers say men undergoing prostate cancer surgery should be warned of this potential outcome.
"For whatever reason, many men focus on the size of their penis," urologist Mark S. Soloway, MD, tells WebMD. "It is a big deal to some people, so I think it should definitely be mentioned to men who are facing this surgery."
But while size does seem to matter, Soloway says most men with prostate cancer are much more concerned about two other common side effects of prostate cancer surgery -- urinary incontinence and impotence.
"I see about 10 new men a week with prostate cancer, and the main thing they are concerned about is curing their cancer," Soloway says. "The next thing is that they don't want to lose urinary control, and erections are further down the list."
Prostate cancer is the most common malignancy among men and also one of the most treatable if caught early. More than 80% of prostate cancers are diagnosed in the early stages, and almost all of these men are cured of their cancer.
In the newly reported study, Soloway and colleagues at the University of Miami measured flaccid and stretched penis length among 63 men before and after prostate removal. Three months after surgery, 68% of the men saw decreases in stretched penis length. Before surgery the average length was 5.1 inches; following surgery it was 4.9 inches. About 20% had substantial decreases in penis length of 15% or more. The findings are published in the April issue of TheJournal of Urology.
Soloway says the decrease in penis length might be caused by the operation itself or it may due to disuse, similar to the way the muscles weaken when a broken arm or leg is put in a cast for several months. Only 33% of the men in the study could achieve an erection three months after surgery. If disuse is the cause, the researcher says, treatments designed to produce artificial erections, such as vacuum pump devices, might prevent the loss in penis length.
Urologist J. Brantley Thrasher, of the University of Kansas Medical Center, says more studies are needed to determine whether decreased penis size is permanent or temporary after prostate cancer surgery. He also wants to know if men who undergo nerve-sparing prostate cancer surgery -- designed to help prevent loss of bladder control and impotence -- experience the same loss of penis length as men who have traditional prostate cancer surgery. More and more men are having the nerve-sparing procedure.
Thrasher, spokesman for the American Urological Association, says he does not hear complaints about penis size from men after prostate cancer surgery very often, but he has heard them.
"The funny thing is that I hear this complaint about any [groin] operation, even if it has nothing to do with the penis," he says. "But I don't hear much about penile shortening in my surgical patients who have regained sexual function, and you would expect that these men would be more likely to notice."