Penile length after inflatable penile prosthesis implant: a single-center, high-volume experience

Penile shortening after inflatable penile prosthesis (IPP) implant represents one of the most common concerns in patients. In this study, our aim is to compare both flaccid and stretched penile length before, immediately after, and up to 1 year after surgery. We prospectively collected measurements in 142 patients undergoing IPP implant. Standardized measurements of flaccid and stretched penile length were performed before IPP. Penile length measurements in erect and flaccid positions were then performed at the end of the IPP and at 6 weeks, 12 weeks, and 1 year of follow-up visits. Data concerning age, body mass index (BMI), smoking status, and comorbidities were collected. Penile length was compared using Wilcoxon-paired test, after assessing lack of normal distribution through Shapiro-Wilk test. Linear regression was used to correlate comorbidities and time from erectile dysfunction diagnosis to IPP with postoperative length. Mean (standard deviation [s.d.]) of preoperative flaccid and stretched lengths was 10.3 (1.9) cm and 13.3 (1.9) cm, respectively. A statistically significant difference was shown between preoperative and postoperative stretched penile length (+0.21 cm, P < 0.001), while no difference was observed for flaccid length (+0.20 cm, 95% confidence interval [CI]: -0.01 to 0.08, P = 0.1). Erect length remained stable up to 1 year after surgery, with 21% of patients showing an increase of ≥1 cm. At linear regression, a higher BMI was associated with shorter postoperative flaccid length (P = 0.03). Erect penile length after IPP implant is shown to remain stable up to 1 year of follow-up visits. Higher BMI may negatively impact flaccid length, but no other factors were associated with changes.