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Before treatment, take photos!

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Posted 5/13/2008 9:19 PM (GMT -8)
Before treatment, photograph your penis. (Or if you don't have one, your significant other's!) This is something I haven't seen on any pre-operation checklists: take photographs and measurements of the penis. Include a ruler in the photographs. Flaccid, fully erect and foreskin, should there be such a thing, forward and back. Some guys lose length after surgery, and it is useful to know how much. I have gone the other way and would also like to know how much. I have been using a VED for exercise, and yesterday for sex after yet another injection failure. I think my penis pumped up is rather bigger than it used to be, both in length and girth, although decidedly floppier.  I do have some "before" photographs -- but no ruler anywhere in them -- wish I had thought of it at the time. [Edit: changed the title which was too "in-your-face"] Post Edited (Piano) : 5/14/2008 10:44:39 PM (GMT-6)   Age 63. Other than cancer, in good health; BMI 20 Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores 7 March 2008, RRP, non nerve sparing Two nights in hospital; catheter and staples out after 7 days Continent, no pads needed from the get-go Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm 6-week PSA: 0 No erections (of course!) Experimenting with VED and Bimix     Post edited to bring this topic back within the already stretched   boundaries we have been given in order to discuss our side effects from prostate cancer. <!-- Edit --> Post Edited By Moderator (bluebird) : 5/20/2008 3:43:15 AM (GMT-6)
Posted 5/13/2008 11:17 PM (GMT -8)
I actually have a set of before and after pics. The "before" pic is a fond memory of a bygone era...

Anyhow, I didn't use a ruler, but the change is obvious.
Posted 5/14/2008 5:06 AM (GMT -8)

Well , I should have ,but didn't photograph myself.  I have before surgery measurements at least.  I do have a series of after surgery pics of the results, plus results using the pump and ring, Bimix and Trimix injections over a period of time.  A truly scientific study, with no posibility of publishing.... tongue

James C.

Posted 5/14/2008 5:57 AM (GMT -8)

  yeah A Gentle Reminder about Forum Rules....

# 12. If it shouldn’t be viewed by minors, then it shouldn’t be posted to the forums or chat rooms.  

This is a public, family-friendly forum. 

In addition, if something would not be considered “work safe” (to a boss or co-worker),

then it shouldn’t be posted.

Prostate Cancer has many issues and concerns on our healing/recovery stepping-stone.  HealingWell's (Mr. Waite) has given our forum a broader range to post these issues and concerns. 

Wording is important....

Please re-read your posting and re-vamp them to meet the rule above...

*bluebird ~ Moderator  

Posted 5/14/2008 6:39 AM (GMT -8)
I trust you'll be posting the before and after pics! Ho,ho,ho On a serious note I do see where Piano is coming from. While I was fully informed of possible ED issues following surgery, at no stage did any health professional tell me that I may lose a bit of flaccid length due to the shortening of the urethra post op. This came as a bit of a shock and was only understood after reading fellow PCa patients posts. While I had a bit of fun with his post (we do need humour after all) I see it as raising a genuine issue (albeit with a humourous note) particularly for those with ongoing ED issues. 1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs Aged 59 when diagnosed Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer! Core 1 <5%, core 2----50%, core 3----60%, core 4----50% Biopsy Pathologist's comment: Gleason 4+3=7 (80% grade 4) Stage T2c Neither extracapsular nor perineural invasion is identified CT scan and Bone scan show no evidence of metastases Da Vinci RP Aug 10th 2007 Post-op pathology: Positive for perineural invasion and 1 small focal extension Negative at surgical margins, negative node and negative vesicle involvement Some 4+4=8 identified ........upgraded to Gleason 8 PSA Oct 07 <0.1 undetectable PSA Jan 08 <0.1 undetectable PSA April 08 <0.1 undetectable Post edited to include previous post that was accidently deleted by bluebird... Post Edited By Moderator (bluebird) : 5/20/2008 3:25:10 AM (GMT-6)
Posted 5/14/2008 2:49 PM (GMT -8)
Bluebird, I'm sorry -- I didn't mean to offend you or the forum members. I was raising this topic as a serious suggestion -- it is something I didn't do, and now wish I had. I tried to explain my reasons in a humorous way and I am glad that others saw the funny side of it too. Even though I have serious ED, I am happy to see jokes about it. As I said in another thread, a strict interpretation of Rule 12, means that we shouldn't discuss ED issues here -- period. Yet clearly we do, and generally without, it seems, falling foul of Rule 12. But clearly, I overstepped the mark (probably not by much since the post is still there!). I would be interested to see how you would edit it to comply with your interpretation of Rule 12 -- both as an education for me and others. I will accept without argument any changes you make. Or if the post is beyond salvation, feel free to delete it entirely. Again, my apologies. (Reply Posting from Moderator placed here.......May 20, 2008)   Forum Members...   Yes ~ we are allowed to bump up against the #12 Forum Rule due to the nature of our disease.     Piano... Thank you for re-naming your thread.   Mr. Waite has locked the thread.   It will not be deleted.   All information is good when it concerns the side effects from our disease.   In my previous post above dated 5-14-08 requesting members to re-visit their posts and bring them back to this side of the boundary…   After 1 week some areas of postings will now be edited by the moderator and some will be deleted.      There is nothing wrong with discussing sex as it relates to prostate cancer, but when it gets beyond clinical discussion that is where we overstep the boundary with #12 Forum Rule.   I am bringing us back within the already stretched boundary that we are given due to the extent of our side effects with prostate cancer.     Comments from members who posted within this thread: “Raising a genuine issue” “I view ED as a medical issue” “it's a sensitive issue, but one we have to have humor about , we have no choice.” “I think this discussion is very healthy and informative.”   All of your statements are true and if you look within the forum you will find many threads on ED and humor is not discouraged…   If any of you have concerns about what I’ve edited… Please feel free to contact bluebird or Mr. Peter Waite, Founder/Editor HealingWell.com - Community, Information, Resources www.healingwell.com Post Edited By Moderator (bluebird) : 5/20/2008 3:50:59 AM (GMT-6)
Posted 5/14/2008 3:03 PM (GMT -8)

I think the problem is that each person probably has a somewhat different view of what is appropriate or inappropriate for a minor to read.

I view ED as a medical issue and see absolutely no reason it should not be discussed....and also see no reason why rule 12 implies that ED should not be discussed.

But that is just me....lol.

Posted 5/14/2008 3:43 PM (GMT -8)
My surgeon only mentioned it in the last appointment I had with him before the surgery. I guess they only want to mention this after they have your business.

I agree, it's a sensitive issue, but one we have to have humor about, we have no choice.
Posted 5/14/2008 3:45 PM (GMT -8)
I'd have to read more carefully... I see nothing offensive posted here.
Posted 5/14/2008 7:54 PM (GMT -8)
Ladies & Gentlemen:

This is a wonderful forum with information that often cannot be found anywhere else (i.e., the practical experiences of all of us who have been treated in some form for prostate cancer).  I was a little surprised when I read this post, but my intention here is not to be critical.  While I did not have surgery, I was well aware before my treatment, based on extensive research on the internet, that surgical removal of the prostate can cause a shortening of the penis.  It should certainly be the responsibility of the surgeon to tell his patients this fact so that they won't be shocked after surgery.  Isn't the most important thing here overcoming ED after surgery [or other forms of treatment]?  In a loving relationship size should not matter, but the person does. Men who have to deal with prostate cancer are subject to many sacrifices in their life and losing part of one's treasure in life is just one of them.  All of the photos in the world are not going to return to you what has been taken away.  Just be happy that hopefully your cancer has been eradicated for the sacrifices you have had to make.  God Bless!

Dave

Posted 5/14/2008 8:50 PM (GMT -8)
On reflection, I think the title of the thread was too "in-your-face" so I have changed it to something more innocuous. Hope that helps :-)
Posted 5/14/2008 9:02 PM (GMT -8)

Well, at my age, everything is shrinking so I guess I didn't notice...

Jim

Posted 5/15/2008 2:44 AM (GMT -8)
Very good thread. Wish I had taken a photo /measurements before.Like 'Piano' mine also seem to have gone the other way, looks bigger than before the surgery. Is it because there is actually not a good flow and drainage of blood to and from the penis ? Are there others out there whose look bigger than before surgery. Looking to see whether this has any relevance as to ED,return of erection etc.
Posted 5/15/2008 4:32 AM (GMT -8)
H Piano ,
without getting into much details, my only educated guess or theory of why you might be experiencing the reverse effect on Size, is that you had a NON NERVE sparing operation which probably LET things lose OFF THE ROPES and contributed to SIZE, where most others had a shrinking effect of Nerves and Urethra after being stitched back and NO USAGE for a while ..

GB :-)
Posted 5/15/2008 10:35 AM (GMT -8)
Hi GB

Mine was a nerve sparing surgery, and the size is bigger after surgery than before !! Initially I thought that's good news,the urethra was not shortened that much during the surgery,and the penis looks fine if not better. I am now wondering whether its anything to do with lack of good blood flow in and out of the penis. Dread to think the whole thing is held together by some nerves :-) but i could be wrong
Posted 5/15/2008 10:57 AM (GMT -8)

positivelife said...
Hi GB

Mine was a nerve sparing surgery, and the size is bigger after surgery than before !! Initially I thought that's good news,the urethra was not shortened that much during the surgery,and the penis looks fine if not better. I am now wondering whether its anything to do with lack of good blood flow in and out of the penis. Dread to think the whole thing is held together by some nerves :-) but i could be wrong

That is Good news and very good to know that it can be reversed, i just made a logical assessment of what can cause such a thing to reverse Most of us comlaint about shortening , the truth is i did not notice much change in mine from before to after..still dealing with the ED effects but it is also getting better ..
keep up the good work it does take time to heal and you are VERY VERY early in the process...
Good Luck !!

GB
Posted 5/15/2008 1:00 PM (GMT -8)

And now a word from the other side! I think this discusion is very healthy and informative. But, having had everything removed, I don't know what I could add. I do think back to the night before surgery and thinking how everything was about to change. And it did! But, and I hate to say this, I have not missed anything. Sounds crazy. But faced with the issues that some of us face, it dropped out of my "10 Most Important Things In Life" list real quick. I know that for you that "can" this is a very important issue and I offer my support when ever I can. I did try the pump and was thinking about injections, but having had surgery, radiation, hormones, and now chemo, it felt like trying swim up a waterfall. Maybe later, so keep up the discussions and I will try to catch up.

Keep it clean, guys.

Walt

Posted 5/15/2008 8:09 PM (GMT -8)
I wonder if the size issue isn't related to how much of the urethra had to be removed. I had an unusually large prostate so I figure I had a greater loss of length of the urethra -- and therfore the penis after reattachment since both "ends" had to be pulled up (penis) and down (bladder) to span the distance. Just a theory. The good news is that because of the "compaction", there has been an increase in girth! There's always a silver lining . . . Maybe the rejuvenation of the nerves is important, however, since as I've regained function, both with and without chemical assitance, it seems like the length is gradually returning to pre-op normal (but not quite there yet). I think I've read here that others have experienced the same thing. I'd be interested to hear from the Old Timers who are, like me, a year or more post surgery.
Posted 5/15/2008 8:52 PM (GMT -8)

puget said...
I wonder if the size issue isn't related to how much of the urethra had to be removed. I had an unusually large prostate so I figure I had a greater loss of length of the urethra -- and therfore the penis after reattachment since both "ends" had to be pulled up (penis) and down (bladder) to span the distance. Just a theory. The good news is that because of the "compaction", there has been an increase in girth! There's always a silver lining . . . Maybe the rejuvenation of the nerves is important, however, since as I've regained function, both with and without chemical assitance, it seems like the length is gradually returning to pre-op normal (but not quite there yet). I think I've read here that others have experienced the same thing. I'd be interested to hear from the Old Timers who are, like me, a year or more post surgery.

Hi Pudget,
I am happy to hear that you regained function of Mr Happy a year into the process YOU are doing WELL.
I Had my open RP just about the same time you had yours (june 13th 2007)and now 11 months into the recovery process.
ED is somewhat still a problem but progressing well , However very slow , can achieve erection with oral meds and stimulation , and even harder erection with Pump.
I might even try the injection therapy at the one year mark when i visit my Uro again just to speed things up a bit.

hope to cross the finish line soon where like you i can be back t pre op condition without any help ...i thin the fact you had a Robotic oppose to an open RP has to do with faster recovery being it is the less invasive route.
as far as size concern, i still can not attest to the fact that i have changed much, maybe at the first few months i felt i might as i did not see it erect yet , but using the VED i think it is the same normal size as i was pre op...

Hope that information helps
Good Luck !!! and keep us posted !!

GB :-) :-) :-)
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