Approximately one year ago, I started to notice medical journal articles linking PD and treatment for prostate cancer, primarily Radical Prostatectomies. Both men with PD and related adverse reaction, i.e. decrease in penile dimensions. Even more disturbing was the finding that men who sought treatment for prostate cancer were unaware of these treatment side effects. This was due either to their physician’s lack of knowledge or the patient's own failure to pay appropriate attention to the pre-treatment discussion. Finally, I have also discussed men’s mistaken impression that minimally invasive or robotic-assisted laparoscopic prostatectomies are far superior in terms of post operative sexual functioning as compared to the open prostatectomy, an older procedure.
Currently, there have been many articles confirming these findings. They are now generally accepted as fact.
Let us review each of the issues above and cite just some of the research findings.
1.Patients are unaware of post- surgical outcomes
Modern Medicine August 01, 2009. Almost none of the patients understand that there will be documented orgasm changes. They think they are going to get back to the way they were prior to surgery, but this is just not true. Many will have sexual dysfunction, including Peyronies Disease. Physicians need to develop a structured pretreatment protocol.
2.There are adequate findings to document that newer surgical techniques are superior to more established procedures
New York Times, October 14, 2009. Dr. Hu, director of Urologic Surgery at a Boston Hospital. “People intuitively think that the minimally invasive approach has few complications, even in the absence of data.” Men who had minimally invasive surgery were at greater risk of incontinence and erectile dysfunction as compared to open surgery.
3. A radical prostatectomy leads to an increase in the incidence of PD
Most recent and important finding for men whose primary interest is PD. Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, June 17, 2010. The study reviewed a prospectively built sexual medicine database, years 2002-2008, for men who underwent surgical removal of the prostate. This study included 1,011 patients and the PD incidence was 15.9% vs 3.2- 8.9% in the general male population. Mean time to develop PD was approximately 13.9 months with younger age at the time of surgery a significant predictor for PD development. An editorial in UroToday, July 22, 2010, comments upon the previous cited research study. “Peyronies Disease occurs more frequently following a radical prostatectomy than it does among men in the general population…” Patients who were in the study had only surgery and no other salvage therapy. Nerve sparing surgery was not an independent predictor of Peyronies development.
4. Decreased penile dimension and PD following a radical prostatectomy.
Current Urology Report, 2009 November. The majority of men undergoing a radical prostatectomy for prostate cancer have a measured loss of penile length, which can also occur with PD and maybe exacerbated by surgery. This article omitted the issue of decreased circumference, also a common adverse event
This website is about PD. However, since my feedback indicates that prostate issues are of great importance to my audience and there is a relationship to Peyronies Diseaase, I am going to continue with prostate news. The feed lower down on this page will contain prostate news and be almost updated daily. Be patient, it takes about 15 seconds for it to begin scrolling.