Subacute penile numbness after brachytherapy for prostate cancer

Penile numbness is a rare complication of permanent prostate brachytherapy, and optimal clinical management remains unclear. We present such a case and discuss pathophysiology and clinical management strategies. Methods and Materials: A 68-year-old male presented with a serum prostate-specific antigen level of 6.9 ng/mL, Gleason score of 7 (3+4), and clinical T1c adenocarcinoma of the prostate. After a permanent prostate brachytherapy implant with ¹²⁵I monotherapy to a dose of 145Gy, the patient developed complete penile numbness postoperatively on the third day. Results: The patient experienced complete restoration of penile sensation and function by postoperative day 9 with conservative management. Conclusions: Subacute penile shaft numbness after brachytherapy is rare and is caused by dorsal penile nerve compression. Over the course of a week, the restoration of penile sensation is likely to occur with conservative management.