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!!!
Radical Prostectomy and Penis Growth? - Advanced Prostate...
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.
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.
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.
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.
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.
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.
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!
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.
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.
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.
Here's an article on the topic. It has links to several medical journal articles.
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.
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:
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.
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...
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.