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I’m 4 years post robotic RP. I have been very concerned about penile volume and length decrease. I have not regained anything close to pre-op. Studies show many men regain. I would ask anyone with information to reply. Has anyone heard of surgery to correct this condition?
Thank you for your message here and for posting your story on YANA.
There are mixed opinions on this topic, but some information about Penile Shrinkage after surgery can be found here. Some doctors acknowledge that the temporary loss of spontaneous erections (a.k.a., "morning wood") during the recovery period after surgery results in the erectile tissues becoming atrophied from lack of regular stretching. Others feel that removing a portion of the urethral tract (the prostate) results in some shortening of the overall length. In reality, it may be a combination of both of these. In any case, it's important for doctors to properly inform patients in advance about possible side-effects. Patients should also be prepared to ask sensitive questions like this, since this particular side-effect can have a dramatic impact on our post-operative self-image and emotional well-being.
I had a prostatectomy in Feb. 2018, with supposedly partial nerve sparing. I think I was around an average length before surgery. Post surgery, I was kind of shocked at being barely able to protrude enough to urinate. The doctor never mentioned this issue, not that
Gradually, the flacid length increased but it was less than original...at least 1/2 inch.
I can't say I've had anything like an erection since before the surgery, so somewhat doubt the claim of nerve sparing. I won't take ED meds as I'm already on pills for blood pressure and having enough problems with side-effects from these, and don't want to add to the pill cocktail. I don't care enough to explore any other options. My wife is in total agreement with my decision.
I frankly don't think I'll ever get back erectile functionality and view it as something I have to live with and a trade-off.
Thank you for your reply. I certainly respect your comment about not wanting to take ED meds or add to your medication regimen. I don't take ED meds either but I do take Trimix just before intercourse. I talked to my urologist and asked if there was an alternative to ED meds since they're so expensive. He told me about Trimix - an injection in the penile shaft. The needle is so small you can barely feel the shot and it is far less expensive, doesn't interfere with other medications (although verifying with your physician is best) and certainly does the trick. Just thought I'd mention it....
Jim, and the multitude of others out there who have been effected by this little mentioned or acknowledged side effect; This subject of penile size loss after prostate cancer treatment comes up over and over again. It appears to be a vastly under reported issue because - well, who really wants to admit it and we all know there is nothing to be done about it anyway. The medical industry has been taking advantage of this " skeleton in the closet" issue by basically ignoring it as a fact, thereby not having to deal with it by looking for a possible preventive measure for it. Though we are all led to believe it is s minor issue that we are foolish and vain to even be concerned about, we all know inside what the effect is on us personally, the part of us that we keep to ourselves. We all learn to accept it and live with it but it would be helpful to know that some sort of research could be done to at least look into some form of prevention rather than just having it written off as collateral damage. With all the concerns, along with all the other things we loose because of this cancer treatment, this "minor" but long lasting, personal issue sure isn't needed. Encouragement to all my cancer "brothers" out there! Jon.
Jon R., I agree with you. I think the ol' surgeon motto, "A chance to cut is a chance to cure", certainly takes precedent over full disclosure of all side effects as a result of surgery. We're big boys and we can take it given the alternative if surgery is the best option; however, full disclosure would surely help manage expectations post-op. New technology like proton therapy may be having an impact on practice revenue although I'm not suggesting all surgeons think or act on the basis of money. I think it begs the question, are surgeons using the cancer diagnosis as leverage to recommend surgery - regardless of side effects; are they arrogant enough to think they are the best option; or are they threatened by new technology? Hopefully men who are diagnosed in the future will be educated by their surgeon better than I was. It's a very precarious situation - cancer scares the hell out of you; you look to the expert urologist for advice with great confidence they have your best interest at heart; you lean heavily on their advice; emotions drive the decision; and "a chance to cut is a chance to cure".
To men reading this who are just going through the process of diagnosis: If you are diagnosed with prostate cancer, first just breathe. Second, read this website thoroughly because when you're diagnosed you "don't know what you don't know". Learn from those of us that have gone before you. Surgery may be the best answer for your situation. Just go in with your eyes open and your expectations managed.
Jim J. - there is some good advice in your response for those needing some input. Hopefully those reading these posts use their own judgment and take into consideration the statements of those having been through it. My feelings after going through it, in spite of the "in your face" results, is that I would do the same course over again knowing what I do now. My opinion - if one is going to treat this disease, don't cut corners to save side effects - go for the kill and don't give this disease a chance to get away from you by taking chances with less aggressive action. I see surgery as very aggressive but it also gives you the best picture of what you are dealing with. Jon R.
First, I have to laugh... the topic got changed to Pencils volume... :P I'll change it back.
Second, I wholeheartedly agree with what's been said. Doctors allude to a lot of things but, don't, in my opinion, go into great detail with every possible and/or probable scenario that will or just may occur.
It took me several years to realize... am I shrinking? Not that I'm special. I'm just slow sometimes. I refused drugs. I just accept what has happened. I'm not married and don't have a 'partner'. But, I've definitely gotten smaller over the years. Lately, I've wondered... would a pump 'help'? Do I just need more "exercise"? :-) I don't know.
I think doctors are proponents for the services they offer. Back in the day, I checked out 3 options... surgery, seeds and proton therapy. I was 44 so, the decision was easy. Too young for anything but surgery unless I really wanted to risk re-occurrence.
Each doctor promised nerve sparing techniques and less side affects than another. They all touted the benefits of their solution over the others. Personally, back then, I would've gone for proton therapy... if it was a viable option for me, even more so today.
The one thing I've come to realize is... a man has to have a comfort level with the doctor performing whatever procedure they perform and the outcome he ultimately expects to receive.
The struggle for each man seems to be 1) ejaculation, 2) erection, 3) re-occurrence of the cancer, & 4) sex life afterwards. In effect... men are going to think with their dick and base their decision on the outcome they think will happen. What's new?
For example... I would read up on the options/procedures... take all I could stomach and then set the information down and process. When I could stand some more then I would research some more, take what I could stomach, set the information down and process. It's overwhelming. If the doctor sat you down and went over every minute detail he would risk freaking the patient out and losing them to another doctor, in my humble opinion.
Can you imagine the doctor saying... and, after all is said and done... your penis will be smaller... maybe 50% or more. How many men would get up and say... I want to find somebody who won't say that to me. Tickle my ear and make me feel good... that's what a man is ultimately looking for. And, the doctor's want the business...
Paul, I also refused meds. post-surgery despite the doctor inquiring at every PSA test-time...if I'd "like to resume my sex life." Was I supposed to feel odd not joining the "party?" I have my reasons. Sorry to disappoint you in being unable to let you bill me for further services.
I know I'm tired of dealing with urologists after years of testing and finally prostate removal.
As far as penile length, that seems to increase with time and exercise (wink) in may case flacid length. It was kind of shocking after surgery to barely protrude, with just the tip showing...being as incontinent as a baby after catheter was removed added to the OMG feeling.