Document Detail

Reduced penile size and treatment regret in men with recurrent prostate cancer after surgery, radiotherapy plus androgen deprivation, or radiotherapy alone.
MedLine Citation:
PMID:  23273077     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report the relative incidence of the perceived reduction in penile size across prostate cancer treatment modalities and to describe its effect on quality of life and treatment regret.
MATERIALS AND METHODS: The incidence of patient complaints about reduced penile size was calculated for 948 men in the Comprehensive, Observational, Multicenter, Prostate Adenocarcinoma (COMPARE) registry who experienced biochemical failure (per registry definition) and were assessed a median of 5.53 years after prostatectomy or radiotherapy (RT) consisting of either external beam RT or brachytherapy, with or without androgen deprivation therapy (ADT). Multivariate logistic regression analysis was used to determine the factors associated with treatment regret and interference with emotional relationships.
RESULTS: Of 948 men, 25 (2.63%) complained of a reduced penile size. The incidence of reduced penile size stratified by treatment was 3.73% for surgery (19 of 510), 2.67% for RT plus ADT (6 of 225), and 0% for RT without ADT (0 of 213). The surgery (P=.004) and RT plus ADT (P=.016) groups had significantly more shortened penis complaints than the RT alone group. The rate of a shortened penis after surgery and after RT plus ADT was similar (P=.47). On multivariate analysis adjusting for age, treatment type, and baseline comorbidity, a perceived reduction in penile size was associated with interference with close emotional relationships (odds ratio 2.36, 95% confidence interval 1.02-8.26; P=.04) and increased treatment regret (odds ratio 3.37, 95% confidence interval 1.37-8.26; P=.0079).
CONCLUSION: Complaints about a reduced penile size were more common with RT plus ADT or surgery than RT alone and were associated with greater interference with close emotional relationships and increased treatment regret. Physicians should discuss the possibility of this rarely mentioned side effect with their patients to help them make more informed treatment choices.
Arti Parekh; Ming-Hui Chen; Karen E Hoffman; Toni K Choueiri; Jim C Hu; Charles L Bennett; Michael W Kattan; Oliver Sartor; Karen Stein; Powell L Graham; Anthony V D'Amico; Paul L Nguyen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Urology     Volume:  81     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-03-22     Revised Date:  2014-03-21    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Adenocarcinoma / radiotherapy,  therapy*
Aged, 80 and over
Antineoplastic Agents, Hormonal / therapeutic use
Brachytherapy / adverse effects,  psychology
Chemoradiotherapy / adverse effects,  psychology
Confidence Intervals
Interpersonal Relations
Logistic Models
Middle Aged
Multivariate Analysis
Odds Ratio
Organ Size
Patient Satisfaction*
Penis / pathology*
Prostatectomy / adverse effects,  psychology
Prostatic Neoplasms / radiotherapy,  therapy*
Quality of Life / psychology*
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal
Comment In:
Urology. 2013 Jan;81(1):134; author reply 134-5   [PMID:  23273078 ]
Aktuelle Urol. 2014 Jan;45(1):13-4   [PMID:  24500952 ]

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