Use of local hyperthermia as prophylaxis of fibrosis and modification in penile length following radical retropubic prostatectomy

Objective: The aim of the study was to evaluate the effectiveness of local hyperthermia in reducing possible penile shortening following radical retropubic prostatectomy. Patients and methods: The study population comprised 40 patients, aged 52 - 74 years, submitted to radical retropubic prostatectomy. Patients were divided into two groups of 20. In Group A, patients were submitted to local hyperthermia 3 weeks after surgery, three times a week, with treatment lasting 30 min. Patients received a total of 10 applications, which reached a local temperature of 39 - 40 degrees C. A second cycle was repeated after 1 month. In Group B, patients were submitted only to post-operative follow-up once a month. Penile length was measured in all patients both before and 3 months after surgery in the 'stretching phase' from the pubo-penile junction to the tip of the glans. Results: In Group A patients ( hyperthermia treatment), no variation in penile length was observed in 16 cases (80%), while the reduction ranged from 0.5 - 1.5 cm in four cases (20%). In Group B, 12 patients (60%) showed a reduction in penile length ranging from 0.5 - 2.5 cm, while penile length remained unchanged in eight patients (40%). Conclusions: Results of this study demonstrate a mild but statistically relevant reduction in penile shortening following low-grade, externally delivered penile hyperthermia, thus confirming the efficacy of this approach in preventing penile shortening caused by post-ischaemic fibrosis.