(345) Is Peri-Operative Penile Length Change Following Penile Prosthesis Surgery a Debunkable Myth or Hard Reality: A Review of Prospective Evidence
Notice bibliographique
Résumé
Abstract Introduction Penile prosthesis implantation remains a definitive treatment for erectile dysfunction (ED) unresponsive to medical therapies, with consistently high long-term satisfaction rates. However, concerns about penile length loss following surgery continue to be a major source of patient anxiety. Perceived or actual shortening can affect sexual confidence and satisfaction. As penile length is a key determinant of postoperative outcomes, understanding its changes and modifiable factors is vital for counselling and care. Objective This systematic review consolidates current prospective evidence on peri-operative penile length changes following primary inflatable penile prosthesis (IPP) surgery and explores the role of implant type, measurement methods, and rehabilitation protocols. Methods A systematic review was conducted in accordance with PRISMA guidelines. Seven databases (PubMed, Medline, ClinicalKey, Embase, OVID, Google Scholar, and NHS Wales e-Library) were searched for studies published between January 2000 and June 2024. Eligible studies were prospective, reported pre- and post-operative penile length changes following primary IPP implantation for ED, and were published in English. Due to heterogeneity in measurement techniques, implant types, and rehabilitation protocols, meta-analysis was not feasible. A narrative synthesis was performed. Methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool (MMAT) and Newcastle-Ottawa Scale (NOS), respectively. Results Eleven studies (10 prospective, 1 retrospective) involving 547 patients were included. Penile length was typically measured using stretched penile length (SPL) from the pubic symphysis to the meatus, though variations existed in technique and anatomical landmarks. Four studies demonstrated a measurable increase in penile length postoperatively, particularly with the use of length-expanding implants like the AMS LGX and structured cycling regimens. Four studies reported no significant change in length at follow-up, and two studies observed modest decreases at 3 and 12 months. Notably, several studies found that subjective reports of length loss did not align with objective measurements, suggesting a strong psychological component. Postoperative rehabilitation protocols varied widely, ranging from early daily cycling and vacuum device use to more delayed or passive strategies. No standardized protocol emerged as clearly superior, though earlier initiation and consistent cycling were generally associated with more favorable outcomes. Conclusions Contrary to widespread belief, most patients undergoing primary IPP implantation do not experience true penile length loss. The majority of studies report preserved or increased length, with subjective dissatisfaction often unlinked to objective change. Variability in measurement techniques, implant selection, and postoperative management limits definitive conclusions. Standardized approaches to length measurement and rehabilitation, along with focused pre-operative counselling, are essential to improve patient satisfaction and accurately address concerns about penile length. Disclosure No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,048 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,006 | 0,006 |
| Bibliométrie | 0,007 | 0,009 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».