Radical Prostectomy and Penis Growth? - Advanced Prostate...

Advanced Prostate Cancer
8,738 members9,825 posts

Radical Prostectomy and Penis Growth?

EricE
EricE
50 Replies

I just had an RP on April 12th, 2018. Say, did anyone's penis grow several inches as a result of the surgery? I could swear mine is shorter and I feel ripped off!!! :)

50 Replies
oldestnewest
Tall_Allen

Grow?? Penile shortening and loss of girth are well-known and common side effects of surgery. Your urologist should have told you. Try using a pump every day - you may be able to regrow some lost tissue.

2 likes
Reply
kenner
kenner
in reply to Tall_Allen

TRUST ME. It ain't ever getting back to what you had. RP 18 years ago, keeps getting shorter every year.We're past the stud muffin stage. Gone... never coming back.

Reply
ctarleton
ctarleton
in reply to kenner

I've been on Lupron for almost 4 1/2 years and added Xtandi for 16 months. I'm almost 70 and my wife is a little older than 70. A while back my wife and I were affectionately chatting about something, and she dropped "my stud muffin" as an old term of endearment into the conversation. I smiled at her and said, "Just call me 'muffin', now, Dear." There was a slight pause, and we both started laughing our heads off.

1 like
Reply
AlanMeyer

I once read that a small section of the urethra that passes through the prostate is removed with the prostate itself. The two cut ends of the urethra are then sewn together. The patient goes home with a catheter in place so that the urine won't leak out through the stitching before it has a chance to heal. The effect of the shortening of the urethra is to pull back the penis a bit.

If you ask your doctor about this, please let us know if he confirms it.

It's one of those things that I bet most men are not told about their surgery.

Alan

4 likes
Reply
Tall_Allen

That's not how it works. The bladder, being heavier, is drawn downward by gravity. The loss in size comes from penile atrophy because the tissue is not innervated and getting regular blood supply. That's why immediate penile rehab is so important.

3 likes
Reply
WSOPeddie

My HIFU surgeon prescribed daily cialis to promote the health of my penis. I'm guessing that most urologists could care less. Somebody tell me I am wrong in my cynicism.

Reply
Tall_Allen

There's something called the "McNamara Fallacy" - the only things that get attention are the things that are measured. Perceived penile shortening, climacturia, and Peyronie's are not part of the standard questionnaires urologists use, so most urologists ignore them and think they don't exist.

Some of the blame lies with patients. Patients don't often talk about these things with their urologists, so it is not entirely their fault that they don't think it's important. In my live support groups, it comes up all the time.

2 likes
Reply
Nalakrats

I was once 6 foot one inch in Height. At 74 even with 50 years in the gym I am now 5 Feet 11 1/2 in Height. As to my Penis, I use it to Pee--as to its size---I am lucky to see it! I remember when women would tell me not to go too deep--and today---well with having had RP surgery and age I am happy to say, "I came, I lived, I died, I got resurrected, I got Pca, and I am still here". Do I care about my penal size---NO---I was told I would not be the same Man I use to be, in many ways--we did not talk about reduced penis size--it was obvious my sex life as I once knew it would be gone. Glad I can piss though---take what you can when you get a bad news DX.

Nalakrats

21 likes
Reply
gusgold
gusgold
in reply to Nalakrats

Nal,

You must be in tight with The Lord...when you died and got resurrected...God gave you a nose to replace the penis you lost to PCa....so, your sex life is not gone...you just have to use a different organ. See pic of Nal below.

Gus

img.izismile.com/img/img3/2...

9 likes
Reply
tdouds
tdouds
in reply to gusgold

Gus, you’re a hoot! Gave me good chortle today! Thanks!

1 like
Reply
Lulu700
Lulu700
in reply to gusgold

Dam , put a condom on that guy. Don’t want him reproducing.

Reply
J_Monacello
J_Monacello
in reply to gusgold

Looks like Judd Hirsch.

Reply
whatsinaname

Excellent reply, Nalakrats, very well said indeed.

"As to my penis, I use it to pee....as to its size---I am lucky to see it" --- Absolutely brilliant and dead honest. Kudos !!

2 likes
Reply
lincolnj8
lincolnj8
in reply to Nalakrats

Well said..I'm glad to be active and alive..

3 likes
Reply
toml77
toml77
in reply to Nalakrats

............and have flow control!

2 likes
Reply
Lulu700
Lulu700
in reply to Nalakrats

Peeing is more important than either penis size or sex.. I’m in agreement .Be grateful for what you’ve got. Ego must go.

3 likes
Reply
WSOPeddie
WSOPeddie
in reply to Nalakrats

I've had a few weeks when I couldn't pee and had to wear a catheter. I'll take peeing over sex.

2 likes
Reply
Dayatatime

Before I was diagnosed, if you would have asked me give up your sex life as you know it or watch your children grow up? My reply without a thought would have been to be there for my children. Not going to lie, I miss my manhood however I love my family. Being there for them is the most important thing in my personal life.

I look at it as scars made out of sacrifice and I'm still here to be a dad. I'm still here to give them advice, give them support, give them security, stare at them with pride and hopefully someday be a granddad.

Don't give cancer the glory, treasure the good.

Ron

12 likes
Reply
Lulu700
Lulu700
in reply to Dayatatime

Sound like a dam good father to me. You’ve got your priorities straight.

6 likes
Reply
kenner
kenner
in reply to Lulu700

Good for You. Just don't eat anything made with shortening. LOL Love your comment.

1 like
Reply
Lulu700
Lulu700
in reply to kenner

Good it get any shorter?

Reply
RJ-MN

My urologist told me that, during a RRP (2006), they would not scrape the prostate away from the urethra. Rather, they would snip the urethra before and after the prostate and remove it; they would then rejoin the urethra. I naively asked him if subsequent erections would tear the shortened urethra. He laughed and said the urethra was eminently stretchable and that there would be no problem.

He didn’t mention that they would also remove the ejaculatory sphincter at the base of the bladder or that they would also remove the top of the bladder neck - necessitating forming a new bladder neck to attach the urethra to. All of this is initially shortening to be sure.

But then, if one’s “Nerve-sparing” surgery did NOT spare the nerves, and one’s last erection was the morning before surgery, then there is no longer that flooding and stretching of penile tissue that happens so many times during the day and night. Everything atrophies. 8 years on Lupron compounds the issue.

But I’m with Nalacrats. The urethra still works (if a little too well!), and I’ve lived 12 years more of sweet life - 9 of them stage 4 metastatic - and have seen my children grow into their careers, loved my grandchildren, traveled widely, and loved and played with my wife in happy ways.

Surgeons should be more upfront about many things, but what a blessing when life goes on!

11 likes
Reply
Lulu700
Lulu700
in reply to RJ-MN

Rj-mn , I want to be like you when I grow up. I admire your attitude and those 12! good years with your wife and family. You be handled this well ._Thank you for the inspiration.

2 likes
Reply
SsgCulldelight

AEEEII, that's funny as hell, less blood flow to the groin means less PP, pull on it more often that should help, and remember if u don't use it, you lose it. Ha besides you probably had more than your fair share of coochy anyway lmao. Cheers.

2 likes
Reply
BrianF505

This worked for me:

1 like
Reply
EricE
EricE
in reply to BrianF505

Yeeouch.

2 likes
Reply
Lulu700
Lulu700
in reply to BrianF505

Iron penis. A tuff way to make a living .Wonder what these guys do for fun??? Russian roulette. ?

2 likes
Reply
abmicro

The ErecAid esteem is absolutely the best pump to help resolve the lack of blood flow side effect. It is pricey but Insurance should cover it.

1 like
Reply
pjoshea13

My experience is that the shortening of the urethra causes a pulling inward of the penis, but this resolves in time.

Some men have reported a loss of up to an inch - mostly very angry men who said that they didn't have an inch to spare. But the loss is an illusion.

It was a relief for me when the pulling sensation stopped.

-Patrick

2 likes
Reply
FCoffey

The shortening can't be helped, but you may be able to avoid permanent ED.

We know now that losing nocturnal erections deprives the penis of oxygen and nourishment. Nocturnal erections, mostly during dream sleep, are the body's way of keeping the organ healthy. Without them, the tissues atrophy, scar tissue develops. The scar tissue makes the corpora cavernosa start to leak, and firm, lasting erections become impossible.

Nocturnal erections are reduced or lost entirely due to poor sleep, excess alcohol, excess weight, smoking, diabetes, heart conditions, RP, castration, radiation, many chemo drugs. Left untreated the damage is largely irreversible.

Taking low doses of sildenafil (Viagra) will restore nocturnal erections in most men. Instead of the 50 or 100 mg doses used by men with ED, the dose is 20 mg before bedtime.

Sildenafil 20 mg is used to treat pulmonary hypertension. Your urologist, MO, or PCP can prescribe it "off label" perfectly legally. This low dose version is off patent so it is far less expensive than Viagra: $22.50 for 30 tablets compared to $50 a tablet for the patented product.

Frequent use of a pump does the same thing, but only when you are awake. You can use both pump and low-dose sildenafil.

Good luck!

3 likes
Reply
EricE
EricE
in reply to FCoffey

Good idea. I was prescribed Sildenafil when I started on Lupron so I have some left!

Reply
WSOPeddie
WSOPeddie
in reply to FCoffey

I've read that same advice.

Reply
Pokeragain

If I lost several inches I'd be a she. As they say in Brooklyn, "FAHGETTABOUTIT." Take care of your health and don't worry about your package.

1 like
Reply
gourd_dancer

Keep the blood flowing. Take 12.5 mg of Viagra a day. It'll help repair the vascular network.

GD

3 likes
Reply
EricE

So for those who suggested low dose Viagra, when should I start doing that? I have some on hand. I'm two weeks out from surgery so I'm not sure if I should start tugging and pulling and Viagraing while I'm healing. Anybody know when I should start?

I knew this was likely to happen, but I didn't hear a peep about it from my surgeon.

I wasn't well endowed to begin with. I'm just happy it's still there and I have a long life to look forward to.

Thanks Everybody!

Reply
FCoffey
FCoffey
in reply to EricE

Here's an article on the topic. It has links to several medical journal articles.

harvardprostateknowledge.or...

Options after radical prostatectomy

Preliminary studies indicate that penile rehabilitation for men who undergo radical prostatectomy is most effective when it begins soon after surgery and involves a combination of therapies.

A study published in 2005 in the Journal of Sexual Medicine, for example, reported the results of 132 men who were followed for 18 months after radical prostatectomy. A total of 58 men enrolled in a penile rehabilitation program within six months of surgery and took sildenafil (Viagra) or penile injections (see Figure 1) to achieve erections three times a week. When investigators followed up 18 months later, 52% of the men in the penile rehabilitation group said they could have spontaneous erections firm enough for intercourse, compared with 19% of the men who did not seek intervention. A larger proportion of men who underwent penile rehabilitation also said they responded to sildenafil when they needed to take it: 64% of the rehabilitation group responded versus 24% of the untreated group.

...

Although both studies were small, they provide evidence that early intervention to restore erectile function may be important. Exactly when treatment should begin, though, is still an open question. One small study has looked at various intervention points. As reported in the Journal of Urology in 2003, investigators enrolled 73 men who underwent radical prostatectomy and randomly assigned them to receive injections at various times (within a month, 2–3 months, 4–6 months, or 7–12 months) after surgery. A total of 36 men received injections within the first three months, while 37 received injections between months 4 and 12. When the men were examined 5, 10, and 20 minutes after receiving the injection, the investigators found that 70% of the men who received an injection within the first three months after surgery could achieve erections firm enough for intercourse, compared with 40% of men receiving an injection after three months.

The results of this study are sometimes used to support the opinion that penile rehabilitation is most effective for men following radical prostatectomy if it begins within three months of surgery. However, it’s important to point out that the study involved only a single injection given within particular time frames after surgery; it’s not clear that the men would continue to respond so dramatically later on.

2 likes
Reply
Tall_Allen
Tall_Allen
in reply to EricE

Ideally, you want to start it before surgery. The earlier the better. Loss of length and girth is associated with the loss of erectile function. The longer you let it go without blood flow, the worse it gets. A VED can be used after the catheter comes out, with surgeon's permission:

goldjournal.net/article/S00...

1 like
Reply
FCoffey

The medical articles I read when researching this suggested starting immediately, but I wasn't facing surgery.

20 mg (or 12.5) isn't going to give you a huge erection. Nocturnal erections in general aren't that powerful, they just get some blood in there during REM sleep to provide oxygen and nourishment.

The pump is another matter. In an ideal world I'd say ask your surgeon, but since he has already lied by omission I wouldn't trust him. He probably doesn't know about this - or care.

3 likes
Reply
j-o-h-n

Me?..... I've only got 2 inches....... from the floor.

Good Luck and Good Health.

j-o-h-n Thursday 04/26/2018 6:17 PM EDT

3 likes
Reply
FCoffey
FCoffey
in reply to j-o-h-n

I have 2 inches ON the floor - when I'm sitting on the floor. ;-)

3 likes
Reply
Lulu700
Lulu700
in reply to FCoffey

Hahahahaha!!

2 likes
Reply
j-o-h-n

Now that's funny!!

Good Luck and Good Health.

j-o-h-n Thursday 04/26/2018 7:58 PM EDT

2 likes
Reply
Lulu700

That’s done.Major move. Quick recovery . Pray for success . Rest up big guy..There will be much time to play the bagpipes later...

1 like
Reply
EricE
EricE
in reply to Lulu700

Thanks very much. I just talked to my boss and got the month of May off. We'll see where I am June 1. Until then I'll try not to sweat it. I'll call my doctor about the Sildenafil. Sounds like a good idea.

Reply
gusgold

What happens if low dose viagra is not taken...I was told viagra only works after nerve sparing surgery. I just read a study that nerve sparing surgery greatly increases the chance of a BCR after an RP

1 like
Reply
EricE
EricE
in reply to gusgold

Oh, so it might not do anything to me since I could not have the nerve-sparing? I'll look into it.

Reply
Tall_Allen
Tall_Allen
in reply to EricE

About 13% of men who do not have nerve-sparing are able to regain some erectile function. Trimix should work even without nerve-sparing, as long as you don't have vascular leak.

Reply
Kiwidave

Hey Eric...feeling your pain and frustration. My cock grew about three inches, backwards!! Dont feel bad mate,you are not alone......I don't think about it all now other than to joke about it. As long as i can piss im happy. Relax and take it easy until you can blow those pipes again. Take care and heal fast...

1 like
Reply
EricE
EricE
in reply to Kiwidave

Thanks Dave!

Reply
GranPaSmurf

A while back, I had a catheter put in. The pretty, young, girl, of a nurse was narrating the delicate task every step while I just laid there with my eyes closed. My emotions were embarrassment and.. well... humiliation. I was thinking, "it wasn't always the size of a 6 year old boy's. You should have seen me 'back in the day.'"

I didn't say any of that.

I just lay there with my eyes closed.

1 like
Reply

You may also like...