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I had my surgery in late 2008. No pain from operation, no incontinence at all, lost about 1 inch from erection, need Viagara to have sex...and it's not as good as prior. Golf game improved significantly. I believe that radiation has improved since 2008 to almost on par with removal, but I was just interested in staying alive.
Yes, penile shortening is widely experienced but little discussed, probably because it is little understood. Research focuses on aftereffects of all prostate cancer treatments that are more severe.
I find it hard to believe that penile shortening is simply because of the removal of 3 cm of the urethra. Think about a normal erection. The urethra stretches as much as twice that.
After my robot assisted prostatectomy and the catheter was removed, I noticed some shortening for at most a week. Chalk that up to healing from two weeks of surgical trauma.
A different problem is deterioration of the spongy vessels that fill with blood to support erections. Those corpora deteriorate without at least nocturnal erections keeping the tissue nourished. Rather than shortening in the flaccid condition, I experience curved erections(Peyronie disease). I could not afford the PDE5 inhibitor (Cialis)that the surgeon prescribed for rehabilitation. My insurance would not pay a few hundred for that,but would shell out several thousand for a prosthetic implant.
I suspect that long term loss of length may be a form of Peyronie's disease. The issue needs more attention. Body image is important. Reconstruction or sophisticated prostheses have become routine with breast cancer surgery.
The men's side needs to make a little more noise.
Wellness and happiness to all, _Bill
I agree with Bill. Doctors are under a lot of pressure to perform quickly and so "extra" steps that are deemed un-necessary by the ins. and medical industry guidelines are casualties along with the patient's best wishes. It is easier and quicker to just cut and tie off blood vessels than to restore proper blood flow to the now dysfunctional external organ. It could be done. If they can put new arteries in a beating heart,(Which I had done) they could certainly patch in few lines to restore proper blood flow to and from the penis. This wouldn't restore erectile status but preserving the penis "intact" in the soft state would go a LONG way toward establishing a better self image after loosing so much of one's manhood to the cancer. I don't pretend to know its purpose but I do know the entire dorsal venous complex is eliminated in the process. A lot of emphasis is put on not loosing a lot of blood during operations these days and is a sort of "report card" for surgeons in grading performance ability. I think there are times when this takes priority over the good of the patient's outcome and this "deflating" side effect may well be an example of that. I am pretty certain that if the medical industry, with all its knowledge, cared to take this seriously they could alleviate the problem. Jon R.
Paul, I hope your shortening is short lived. Mine was. You may be continent already. I was at 1 pad/day at 2 weeks, gradually to occasional stress leaks at 6 months. On troublesome days I use the wider super female pads. They provide more room to wander. My uro told me to expect 50% recovery of erection I had before. After 2-1/2 years It's there, but 50% of 50% isn't useful. If your surgeon Rx's Cialis or Viagra for rehab, use it. That at least wards off curvature. Vacuum devices tend to be a hassle and uncomfortable, but they also work.
I can't say much about the return of erections as I was not able to have a nerve sparing procedure due to the extent of the disease - mine are gone forever. As for the penile shortening, Yes, this is a common side effect that very few are forewarned about. It is just one more shock we are forced to endure on our own. The medical industry is often in denial of this side effect for some reason, almost like they are ashamed to admit it happens. If it happens to you, you understand its impact and it is not such a minor deal after all else we have lost. My foreskin was harvested at birth but now it looks like I have one again since the little guy has backed up into his own skin. Maybe this won't be so permanent for those fortunate enough to have had a nerve sparing procedure. Two years post op here and no improvement. Good luck to all. J.R.