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radical prostatectomy and 'penile shrinkage'
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Oct 21, 2009 - 6:44 pm
Hi everyone. I am wondering how bad the shrinkage is with radical prostatectomy. When they take out the prostate, they also take the urethra. Prostates are typically an inch or more in length (and thus so is the urethra they take out). They do lower the bladder down when they attach the bladder neck to the urethral 'stump', in order to lessen this problem, but many men still suffer from a loss of size right out of the box, so to speak. Also later on, in the aftermath of the surgery, the nerves are not functioning, thus muscle atrophy can occur, as well as hypoxia (low oxygen levels), due in part to lack of tumesence (engorement). Hypoxia, in turn, can lead to fibrosis. All of this can lead to shrinkage. The best way to ward this off (to the degreee it can) is the early use of some type of vacumn device. So, I am wondering how bad this effect can be. Has anyone had this problem and did you use the device or not and did it get better later on? Thx for the help in advance! |
Joined: May 2007
Bill,
1 inch----------------never used a vacuum device.
Lion1
Joined: Sep 2005
I had surgery Aug of 05, with shrinkage of more than an inch right after surgery.
I must say, I tried all the various pills that the doctor would prescribe for help with erections but the side effects were not good for me. So, I had to quite taking them. I have also used injections and at times have problems with it. I have used the vacuum device which seems to help but still cannot maintain a erection long enough to have any fun.
I still talk to the doctor about the problem, which I have taken several tests to see if I have other problems but none have been found.
Hoping to get some more help someday.
Joined: Jun 2009
Hey Bill,
While many of your comments are true, there are some differences.
the nerves are not functioning, Yes there is the chance of nerve interuption or damage but, over time this function returns.
muscle atrophy can occur, okay but, muscle tissue can regain strength
hypoxia (low oxygen levels), due in part to lack of tumesence (engorement) many of the ED meds (i.e. Cialis) help increase blood flow to this area, thus minimizing noted side effects.
All of this can lead to shrinkage. Gives a different meaning to "Bigger is better"
I am almost 6 months post DaVinci and I have had many of the same thoughts as you. Don't give up!
jim (shubbysr)
Joined: Jan 2010
I am 57 yrs old and almost 3 yrs post surgery and about 1.5 yrs post radiation. The shrinkage for me is considerable, approx 2+ inches. It did not happen right away and really only some “shape changing” happened after the surgery. The end curves down when erect due to uneven pulling of the salvaged nerves (according to doc).
The real shrinkage came after radiation (PSA went back up after 1 yr). Not sure if it was the radiation or delayed results from surgery.
I use the pump several times a week for 10 minutes alternating applying pressure and releasing to keep it from getting worse (recommendation from doc) but I do not use it for intimacy.
I still maintain a fairly satisfying intimate relationship with my wife thanks to Cialis (minimal side effects) but things are certainly different. This is a physical condition that makes be glad I have life long partner. I’d hate to be single and trying to impress the ladies with this going on! But the bottom line is that allthis is manageable and I wouldn’t (and didn’t) let knowing any of it sway making the right decision for treatment.
Good Luck!
Joined: Apr 2009
Since last May 21, I've had the Davinci & 37 radiation treatments. Although I've never used the "ruler" I guestimate I've lost at least an inch. I took a few viagra after surgery but didn't like the side effects...got a hi end vac pump and use it occasionally to promote flow. Hard to get used to the dry ejaculations....erections 30% less.
Good bladder control though & able to do all the other stuff I did before PCa.
Keeping the faith & moving forward.
Regards...
Joined: Apr 2012
Hello DRC.I am experiencing something similar. Were you ever able to get fully erect after prostatectomy? Would the end curve down even then? My front half does not seem to get erect on its own but it eventually fills out and the penis becomes straight and looks normal, at least with Cialis. Also the front 2/3 feels smaller and firmer when flaccid, is it the same for you?
Joined: Dec 2012
I had a Da Vinci prostatectomy last July. Bladder control is fully restored. My guess is my penis is about 1" shorter when erect. It seems about the same length as it was prior to surgery when flaccid.
I had erectile dysfunction prior to surgery. As my doctor predicted, it is worse now than before. I do not believe I have nocturnal erections. Viagra doesn't work for me. I have a pump which works good, although the erections don't last long enough for intercourse. I also inject tri-mix on occasion which works pretty well. It is an expensive option though at a little over $100 per prescription.
The odd thing is that my penis seems more sensitive then before. I hope this indicates that the nerve connections are recovering well. When I ejaculate, it is squirts of urine, since there is no semen factory left. When fully erect, my penis curves up as it always did. Being somewhat shorter, it appears fatter....probably an optical illusion.
Like someone else here said, I am glad that I am in a long term relationship (48 years) since I doubt I could impress anyone with my sexual powers these days.
The really great news is that we caught the cancer early on and it was fully contained within the prostate. My last PSA was .02 which means the cancer is undetectable. My six month check up is in about a week. I am not expecting anything but good news again.
Joined: Mar 2013
What you really need is a good blood flow suppy into your corpus cavernosum. That will reduce any chance of shrinking. If you don't use it, you lose it. That is very true in the penis. You should get injections ASAP. These injections should not be formulated for penetration, but for a mild 40% erection to start. Every other day apply a dose. Over time, you build your base up again and you can then increase the dose to penetration. I work with these patients each day, it takes time but it works.
Joined: Feb 2012
To my party, it happen and it is a part of life. I think I lost my mind, we all lose your mind at this game.
Good luck, I think the best!
Joined: Jan 2010
I sometimes wonder if I might get a 2nd "bellybutton" down under.
1- 2 inches are gone, but so are errections. Most discouraging after affect of PCa.
When I was still using the urologist that did my Devinci surgery- the surgeon who I never saw again- his PA told me any shrinkage was in my mind. I hung around that urologist's office 2 or 3 visits too long.
Joined: May 2013
I had a radical prostatectomy in September 2003. The reduction in penis size was noticable following the surgery. I thought like several men that the size would come back eventially. Well after almost ten years after my surgery nothing has changed. The erect size was reduced by approximately 40% to 45% both in length and girth after surgery and has not reversed at all since. The nerve sparing part of the surgery worked great. I am able to have erections, although much smaller and orgasms. I have tried several suiggestions from my urologist, such as taking Vitimine E and Vitimine C. I even tried the topical Verapamil treatment. I have used the pump and Viagra and all of the other type medicines. Nothing has increased size from the post-operative size. When not erect the penis looks like it is uncircumsized and looks more like "innie" versus an "outtie". The every day problem is urinating. Sometimes I have a hard time finding the tiny penis and pulling it far enough so I don't urinate on my pants.
Joined: Apr 2009
that indicated that taking large amounts of vitamin e increases incidence of prostate cancer
http://nccam.nih.gov/research/results/spotlight/101111.htm
Afterward, another study was done at the Cleaveland Clinic which confirmed the results.