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radical prostatectomy and 'penile shrinkage'

William Parkinson
Posts: 60
Joined: Oct 2009

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!

Posts: 241
Joined: May 2007

1 inch----------------never used a vacuum device.


Posts: 4
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.

Posts: 3
Joined: Dec 2014

Had the same issue until I bought a poste vac penis pump...comes with restriction bands to keep the blood trapped inside the penis...it'll give an erection hard enough to penetrate for 30mins or until u climax. lube inside & outside of tube about a 1/2 in above the edge of The tube..Place band on the lubed area. Place tube over penis...pump...release...pump release..over & over until it's erect...slide band on erect penis...then release air pressure inside tube..ur ready to go....it works...and it's better than nothing....at least until u completely heal....doc says use every to every other day to speed up normal erections...before u start with pump...have oral sex to help prime the penis with a good amount of blood inside....then use pump...don't forget to have the band already set on the tube...to trap the blood.  Oral 1st  Will add a 1/2 to 1 extra inch of length and girth. 

One more thing...believe it or not...KEGELS really help...urinary and erection recovery.  Downloaded a tabata timer to help keep track of time and sets.  Now I'm up to holding 30sec for 40 sets.  I do them in the car on my way to work every morning.

1st set of 20 I hold the 2nd set of 20 I do quick pulses. I started out with 10 sec holds and worked up to 30 sec at a 50% squeeze force. 50‰ squeeze is a constant,from 10sec up until  whatever.


shubbysr's picture
Posts: 87
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)

Posts: 3
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!

gkoper's picture
Posts: 174
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.


Posts: 1
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?

Posts: 1
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.

Posts: 1
Joined: May 2013

If your having pain with Trimix, switch to Bimix. World of difference. On my pump, the documentation states a maximum of 30 minutes with restriction on penis. If your band is too big diameter, it's letting bood flow out of penis, giving you a reduced time. I hope it's that easy, probably not.   You can vacuum again up to 30 minutes then you have to let blood flow in penis.  30 min of  band restriction total. Read your documentation. It may differ. 

Posts: 3
Joined: Dec 2014

Oral 1st to prime the penis....then use the pump...u'll get more blood in...more length...more girth....i'm a witness.


Posts: 1
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.

ralph.townsend1's picture
Posts: 359
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!

Posts: 897
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. 





Posts: 1
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.

hopeful and opt...
Posts: 2096
Joined: Apr 2009

that indicated that taking large amounts of vitamin e increases incidence of prostate cancer


Afterward, another study was done at the Cleaveland Clinic which confirmed the results.

Rakendra's picture
Posts: 198
Joined: Apr 2013

This is a little off topic.  I had castration, and I will add that the shrinkage in my case was very large, like 50%.  It kind of looks like a worm left out on a hot tennis court, all shriveled and tiny.  My friend says, "So what.  You cannot use it for anything anway other than to pee thru, and you can do that sitting down."  However, I am sure I will not be going to the gym ever again and showing off my ex-manhood.


   I have a lot of experience with both Ciallis and Viagara and used plenty of both.  I preferred Cialis because of the longer time window.  However both had unpleasant sides effects like head ache and nausea.  Here in Asia there is an over the counter product called Robust.  It is chinese herbs, and I found it to be just as effective as Ciallis, but had no side effects.  I do not know if it is available in USA, but if you come to Davao, I have a good supply that I can no longer use, so you are welcome to it. 

I am 81, but am married to a gorgeous 26YO Pinay, and now I am totally unable to perform, but I get to see that perfect body every day.  I guess this must be pay-back for my long time previous life style.  I love the acceptance and optimism I see on these posts.  You guys are wonderful. love, Rakendra

Posts: 3
Joined: Dec 2014

Sir...the poste vac penis pump will do wonders for u...it will pull the blood in for u...I have both the man and battery op...I personally like the battery op best...bought it off EBay...waaay cheaper than from other company sites. Look above at the post I left...it'll give a bit more info on how to use it

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