Penis length decrease after RP

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Pete N.
New Member


Date Joined Jan 2011
Total Posts : 6
   Posted 1/13/2011 9:40 AM (GMT -6)   

I never really cared about the length of my penis. I am sure there are some more important things in life.

 

However, after my RP (end of november 2009):

 

1- my penis was minuscule (and the urethra hard...) for a long time after the surgery

2- It got "better" slowly

3- I am 90% sure it lost some length (eg. I can see that in the pump as I remember the measurement I made years ago...)

 

I would say 3/4 of an inch are gone (may be a bit more ?)

 

When I saw my urologist, I mentioned this to him. His answer was that this cannot really happen. The reasons he invoked were "geometrical" (something like: there is this membrane that separates this and that region, so this limits what can happen”) plus “we pull down the bladder”.

 

Now, I know that I should have measured it right before the surgery for the comparison to be acceptable but .... I trust doctors but I also trust my own eyes.

 

So my question is: am I alone to have experienced this? Is this common ?


JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3744
   Posted 1/13/2011 10:07 AM (GMT -6)   
I didn't have surgery, but both my urologist and two different rad-oncs said it occurs due to the shortening of the urethea during the surgery.   I have also heard that you may be able to stretch it back over time!   Keep your hands in your pockets!!

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/13/2011 10:08 AM (GMT -6)   
Most doctors deny the possibility, but many, many guys who have had surgery report that it has happened to them. It happened to me, at least in the flaccid state. Erect is the same as before.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
ED-total-Bimix 30cc

Bring-it-on
New Member


Date Joined Jan 2011
Total Posts : 8
   Posted 1/13/2011 10:39 AM (GMT -6)   
I am certain that I lost about 3/4 inch.  I swear I lost length and girth.  Oh well....things could be worse!!!
Age 65
Feb 2, 2010 12 core biopsy
Feb 5, 2010 Dr. called to inform me there were cancer cells
15% of 2 cores positive
Gleason 3 + 3
Partin Table T1C
PSA 2.7
April 22, 2010 DaVinci Robotic Surgery nerves spared
April 29, catheter removed, 6 to 7 pads per day
August 4 to 5 pads per day
October 3 pads per day
Currently 1-2 pads per day

Bring-it-on

natural44
Regular Member


Date Joined Dec 2010
Total Posts : 172
   Posted 1/13/2011 10:56 AM (GMT -6)   
I had RRP 3 months ago had same experience as you post surgery and still to this day I am same size in the pump and after pump with constriction ring...but if i just "manually" bring it up ...at about 60-70% hardness is all i can get still yet but the size is 1 - 1.5 inches shorter about the same diameter i think... I am hopefull that as the firmness of the erection gets better the size will improve. My uro also denies that shortening happens but it does! You will recover all the loss the from my understanding
age 44 when diagnosed 45 now
RRP 9-28-10
gleason 3+3=6
pathology report all clear
11-1-10 PSA 0.02
3 month PSA 0.00
bladder control 3 weeks post cath. removal!
Osbon pump works great!
some noctural erections stated 12-01-10
5mg Cialis daily 1-3-11 able to get short semi erections(60-75%) with effort daily

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/13/2011 11:53 AM (GMT -6)   
My surgeons explanation still makes the best sense to me. Before surgery, the bladder is held in place at 2 points, after, only 1. When the bladder neck is re-attached to the urethra, the bladder is pulled to make the connection. In the flacid state, the penis does pull in a bit, it varys, due to the weight of the bladder and how much liquid is in it at times, also, the angle has changed too, where the 2 connect.

My flacid size has been slightly less than before, but when errect, and I am a lucky one with zero ED issues from the start, it is the same size as before.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 1/13/2011 12:02 PM (GMT -6)   
I don't care what the Uro reports. They need to do some measurements and then the would know what we have already discovered! It is shorter!!

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 1/13/2011 12:28 PM (GMT -6)   
I had DaVinci surgery 18 months ago and absolutely mine is shorter than before. I'm missing a good 3/4 of an inch when flaccid.
I can't say how much I lost when erect because, well, I lost that too.

It looks normal when the VED is on but the instant the vacuum is released, it goes back into hiding.

My Uro said he did not shorten the penis but did remove some of the support structure. Doesn't matter. The end result is the same. I no longer need to worry about the depth of the urinal water.
Jeff

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/13/2011 12:32 PM (GMT -6)   
Cajun Jeff:

Actually, since my urostomy surgery, my flacid state is actually back to about what it was before my open surgery from 2 years ago. Makes sense, my bladder is now non-functioning, there is zero weight from fluid in it, so there is no in-put. In most cases, the urethra is not cut as in shortening, the bladder neck juncture is re-worked to fit the existing urethra, not the other way around.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Pete N.
New Member


Date Joined Jan 2011
Total Posts : 6
   Posted 1/13/2011 12:36 PM (GMT -6)   
Well...
 
This is not a scientific poll but ... I am definitely not alone in this situation.
 
Wonder why this is not mentioned in most web sites that give info on RP. I understand that RP is here to save lives, not to take care of penis length but still, this is not a negligible side effect.
 
Ok ok it is mostly psychological... in the head....
 
oh well...
 
 

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 1/13/2011 12:48 PM (GMT -6)   
Pete, reduction immediately after surgery, catheter, etc is an expected short-term side effect. Here's a link to a study's abstract which showed that after robotic prostatectomy (bilateral, nerve-sparing) the SPL (stretched penile length) returned (for this study group; 94 patients; all from one surgeon) after about 9 months time. Psychological preception may also play a role, although not discussed here.

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2233951

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3738
   Posted 1/13/2011 1:47 PM (GMT -6)   
3/4 inch, no doubt..Flaccid is MORE flaccid than before...At least my surgeon was honest and warned this "could" happen..he claimed he was not sure why....

So tell us Pete, what were you doing with the pump BEFORE surgery??

"3- I am 90% sure it lost some length (eg. I can see that in the pump as I remember the measurement I made years ago...)" tongue rolleyes

TinFoilHat
Regular Member


Date Joined Sep 2010
Total Posts : 51
   Posted 1/13/2011 1:51 PM (GMT -6)   
Guys being guys ... we worry about these things.

I didn't measure before or after my open RP, but darned if I can see a difference. Maybe my wife would disagree. blush

Jeff

STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 1/13/2011 1:56 PM (GMT -6)   
Shorter. My wife agrees.
I warned my brother about this before his surgery. I found that for most uses standing a tad closer to the toilet takes care of any issues.

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 1/13/2011 3:53 PM (GMT -6)   
In the Uro clinic where I also went for ED treatment, there was a poster by the elevator that had some comments for men after prostatectomy. One of the line item questions was "...why is my penis shorter after surgery?..."

I think Uros know well about it. One good explanation given to me was that the trauma from surgery (nerve sparing or not), interrupts the nocturnal wood and some muscle atrophy happens in the penis.

Mine is certainly much smaller. Maybe I can get that back, maybe not.

Mike
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving. ED oral meds didn't do much initially. TRIMIX was working very well. Initial dose of 0.1 mL too much. Had priapism at 0.075 mL that ended up in a humiliating ER visit. Doses recently after 50% dilution by Uro about 0.025 mL or less. Don't use Trimix anymore...I'm too sensitive to it, even at very low doses and the Alprostadil is pretty consistent in causing erection pain...had a few episodes of 3+ hour wood with pain.
-Levitra now starting to work at low doses of 5 mG to 10 mG. Sometimes the side effects like stuffy nose aren't fun...sometimes OK.
-Was supposed to see ED doc last week, but due to his schedule, will now be late August. Will discuss bimix with him.
 

sfigato
Regular Member


Date Joined Dec 2010
Total Posts : 144
   Posted 1/13/2011 7:00 PM (GMT -6)   
Definitely shorter post op
I think I lost 1+ inches and then girth too
It's like someone reached inside and pulled up my internal suspenders
Now 5 weeks post and it's coming back a little
Hard to imagine it will be the same as it was a least when flaccid

When standing I think it's closer to orig size, but never measured and still working on this part anyway
Age at diagnosis 48
Gleason 3+3
Pre-Surgery PSA 5.1, 5.7
Cores Positive: 10 of 12 up to 40%
Treatment: open Surgery Dec 2010

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/13/2011 9:18 PM (GMT -6)   
My uro warned me to expect about 1/2 inch loss. Think of the prostate as a push-up bra. Take it off and there ain't no push.

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 1/13/2011 9:37 PM (GMT -6)   
Our urologist also was very clear about this - said most urologists did not admit this was the case but shortening was a common outcome from surgery.
 
However, as Paul's wife I cannot see any change at all.
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 1/14/2011 7:56 AM (GMT -6)   
I had a 56 gram prostate - big but not super sized. Based on the density of water and my girth I calculate 3.4 cubic inches or about 1.5 inches in length loss.

We need to hear from some of the guys with really big prostates. A certain moderator was carrying a 106 cc bohemoth in his groin before his surgery. Significant loss, Sir? Oops, I see you might or might not have answered already.

Jeff

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7201
   Posted 1/14/2011 9:15 AM (GMT -6)   
Let me put it this way:
 
Willy has turned into Willy Jr.
 
That's really not even on my radar of concerns.
 
Mel

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 1/14/2011 9:19 AM (GMT -6)   
Mel,
I trust your math. Did the loss correlate with the prostate size? You can figure 16.4 cc per cubic inch.
Not that it really matters. :)
Jeff

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/14/2011 9:51 AM (GMT -6)   
Jeff, mine was 110 gms. My waist size is 40. I do not retain water (although I do retain fat, for some strange reason) Do what you will with that, I'll tell you the exact loss measurement after you do. It's never been exactly revealed here, as far as I know. blush smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
ED-total-Bimix 30cc
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