What I actually wrote was, "Subjective perceptions, which are probably a more important measure than stretched penile length." I did not write that that is "all that matters." The reason I believe it is more important is because I am interested in reducing suffering. You can tell me all you want that my stretched penile length is only 1 cm shorter, but if I wet myself and the toilet seat every time I have to sit down to pee because my penis barely pops out, your assurance will not mean much.
In terms of self-perceptions, this study
among 1288 men undergoing RP found that twice as many men perceived size loss vs age-matched controls.
The study you cite was the one I was referring to when I said "plagued with problems because of loss to follow up." Take a closer look. The study began with 118 men at baseline, lost 36% of the sample by 2 months, and lost almost half the original sample by 6 months. Are the men who were left the ones who did better and were happy to come in and get measured?
This is something that few men seem to complain to their urologists about
, but I hear it universally in support groups.
The best solutions seem to be ED meds, pumps and stretchers. I think that all urosurgeons ought to include this in obtaining informed consent. I would be very interested to read a report of Dr Tewari's "penile oxygenation" technique to see if that can prevent shrinkage.