Early intervention with a vacuum erection device (VED) after radical retropubic prostatectomy (RRP) may reduce the likelihood of penile shortening, a researcher concluded.
Previous studies have shown that stretched penile length (SPL), which most closely correlates with erect penile length, was decreased in many men three months after surgery. In one study, 48% of men experienced a decrease of 1 cm or more in SPL.
The new study, by Bruce L. Dalkin, MD, of Southern Arizona Urologic Oncology in Tucson, to date has enrolled 42 men under-going nerve-sparing RRP who had erections adequate for sexual intercourse prior to surgery without the use of any medications or devices. Dr. Dalkin measured SPL preoperatively and three months after catheter removal. He considered a decrease in SPL of 1 cm or more significant.
Prior to surgery, men were provided with a VED and instructed in its daily use, which was to begin the day after catheter removal (10-14 days postoperatively). The men used the VED to provide 10 minutes of maximal engorgement of the penis per daily session.
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At the completion of the study, 39 men were available for analysis. Three had dropped out, one for not completing the surgery, one for early treatment with androgen ablation after surgery, and one for failure to return on schedule for follow-up measurement.
Thirty-six of the men were compliant with their VED use for at least 50% of the possible days, and 35 (97%) maintained their SPL. Of the three noncompliant men, two had a significant reduction in SPL. Use of the VED significantly reduced the rate of penile shortening from 48% in the earlier study to 3% in the present study, Dr. Dalkin said.
As a result of their findings, Dr. Dalkin concluded that “early intervention with a VED should be recommended to all potent men undergoing nerve-sparing RRP to preserve penile length.”
