PURPOSE: We conducted this study to evaluate whether glans-preserving surgery (GPS) would be more helpful for patients to regain satisfactory sexual competency than conventional partial amputation after operation.
PATIENTS AND METHODS: From 2004 to 2012 at four centers, 135 cases treated with GPS and 36 with partial amputation were selected for evaluation from 273 consecutive penile cancer cases. Subjective evaluation for patients' sexual performance was investigated using the International Index of Erectile Function (IIEF)-15. Objective evaluation was carried out by the Audio Visual Sexual Stimulation (AVSS) test with RigiScan-Plus. The degree of satisfaction for penile appearance and patients' confidence and partners' acceptability for intercourse were evaluated by 5-point scales.
RESULTS: Patients treated with GPS showed better performances in four IIEF-15 domains (erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction) as well as one RigiScan parameter (tip rigidity) (all p < 0.01) and significantly higher ratios of appearance satisfaction (64.4% vs 13.9%) and intercourse confidence (55.6% vs 5.6%) compared with those undergoing partial amputation. Their sexual partners in glans-preserving group also exhibited significantly higher ratios of appearance satisfaction (51.1% vs 5.6%) and intercourse acceptability (37.8% vs 16.7%) than in partial amputation group.
CONCLUSIONS: GPS effectively preserves the functional anatomy and cosmetic appearance of the glans penis. Glans preservation contributes to minimize postoperative erectile dysfunction and negative psychological impediments, and promotes a return to satisfactory sexual performance. Patients with glans preservation have more advantages in obtaining sexual acceptance from their partners than those experiencing amputation.
Written by:
Yang J, Chen J, Wu XF, Song NJ, Xu XY, Li Q, Qiao D, Zhang JY, Wang W, Su H, Wang ZJ, Su JT, Song NH. Are you the author?
Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of General Surgery, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Institute of Dermatology Surgery, China Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China; Department of Dermatology, Shanghai Skin Diseases Hospital, Shanghai, China; Department of Dermatology, Jiangsu Province Official Hospital, Nanjing, China; Department of Urology, Jiangsu Province Official Hospital, Nanjing, China.
Reference: J Urol. 2014 Apr 21. pii: S0022-5347(14)03415-6.
doi: 10.1016/j.juro.2014.04.083
PubMed Abstract
PMID: 24769027
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