Penis size after prostate surgery

After robotic prostate surgery I noticed that my penis was only 4 1/2 inches in length. The circumference might also be less but not positive.

I know that years ago I was 6 inches and most likely with more girth. I am not sure if some of the loss has been related to my age (70). If might have happened gradually over time.

However, I have read a number of articles that relate the shorter penis size to the surgery.

Has anyone else ended up with a smaller penis? Dose anyone know why that situation occurs? More important does anyone know how to improve on size?

I will post just a brief personal knowledge about this subject.

There are others here who will chime in I'm sure who are relative experts.

As I have read with the removel of the Prostate, a section of the urethea is also removed.

And so, depending on the size of the prostate, and because the urethea is pulled to and reattached to the bladder you are going to be shortened that much.

I've observed on the forum here that there are several actions you can take and get that length back.

I personally experienced just what you are saying. Hopefully some of our knowledgeable guys can fill you in.

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Gleason 3+4=7
DX - 9/12 DaVinci February2013 (robotic) Age68 CONE HOSP G'boroNC
EST Proportion%5% Both Lobes EXT ext.s NO InvolApex NO Margins FREE SEM Vesicles FREE
TNM code : pT2c, pNX
Comments: extensive PNI by tumor
Trimix for ED No natural Erections, yet Don't think nerves spared Pyronies from trimix

BUSH said...




As I have read with the removel of the Prostate, a section of the urethea is also removed.

And so, depending on the size of the prostate, and because the urethea is pulled to and reattached to the bladder you are going to be shortened that much.
.

I've been told by two different surgeons that there are different techniques employed to avoid this. My guy went as far as to explain exactly what he did and how he did it to avoidd the potential of shortening but I wasn't really paying attention cause I had already verified I had no issues.

I lost about an inch...This is not one of the selling points used to promote surgery...

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Age now 71 . Diagnosed G-9 6/2010
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA <0.1 10/'11, <0.1 2/12, <0.1, 4/12 <0.1, 9/12, 0.8 3/13, 0.5 6/13, 1.1, back on HT
Eligard + Casodex PSA 0.04 10/2013 PSA 0.32 on 1/14

Thanks for the second, Gedman. What brand of uncomfortable-looking stretching thing do you use to treat your Peyronie's? I may be in the market for one.

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60
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
2)neg,
3)positive 1 of 14 GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
4)neg.
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Leaky but better, Trimix, VED
Forum Moderator - Not a Medical Professional

I agree that the size loss probably has little to do with the removal of a section of the urethra. The bladder moves down -- the penis does not get pulled up.

Mulhall and others, observing that the size loss occurs very quickly after surgery, believe that atrophy of penile tissue occurs very quickly after surgery, owing to loss of oxygenation. Studies on this have been plagued with problems because of loss to follow up, and men not complaining about it. Subjective perceptions, which are probably a more important measure than stretched penile length, are not routinely measured - a hole in our knowledge.

- Allen

What I actually wrote was, "Subjective perceptions, which are probably a more important measure than stretched penile length." I did not write that that is "all that matters." The reason I believe it is more important is because I am interested in reducing suffering. You can tell me all you want that my stretched penile length is only 1 cm shorter, but if I wet myself and the toilet seat every time I have to sit down to pee because my penis barely pops out, your assurance will not mean much.

In terms of self-perceptions, this study among 1288 men undergoing RP found that twice as many men perceived size loss vs age-matched controls.

The study you cite was the one I was referring to when I said "plagued with problems because of loss to follow up." Take a closer look. The study began with 118 men at baseline, lost 36% of the sample by 2 months, and lost almost half the original sample by 6 months. Are the men who were left the ones who did better and were happy to come in and get measured?

This is something that few men seem to complain to their urologists about, but I hear it universally in support groups.

The best solutions seem to be ED meds, pumps and stretchers. I think that all urosurgeons ought to include this in obtaining informed consent. I would be very interested to read a report of Dr Tewari's "penile oxygenation" technique to see if that can prevent shrinkage.

- Allen

that subjective interpretations are more important that facts is your unique way of looking at it.

If I walk into a movie theater and don't see an aisle seat available i don't feel safe. Then my wife tells me to get a grip of reality and enjoy the movie.

I also think that men who go to support groups are probably not representative of the majority of men and how they perceive this issue.

Are you interested in reducing suffering universally or specifically as it relates to men who opt to seek treatment for PCa and may have to endure some side effects? I ask because in my family we have a long line of published and known social and environmental activists and I always thought the cross they carry to reduce suffering must be very difficult to carry on a daily basis.

ps - I sit down to pee out of comfort at home. Maybe i'm lazy.

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40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

Very strangely, if anything, I think I have slightly increased the flaccid hang, and at least the same erect after injections. At 1st I was convinced it was the opposite, and I was definitely pulled up inside. And 1st pump use was depressing, I seemed to be about 1/2 normal. But, then I had my 1st low dose injection, and all has been back to at least normal, plus seem to be slightly less of a "grower" than normal. Not sure what could account for that. It has made me wonder if they damaged something else while working in there, like the ligaments they cut for lengthening surgery. Because not only do I hang more loose(a little), but when injecting there is not even a hint of "hat rack" effect, like I had in earlier days. But I'm not sure if that wasn't already gone. So just guessing wild as to why most of that shrinkage went away so soon, leaving me at least normal if not a bit more so.

Plus, I am < 3 months out, for all I know most of the trouble comes later?

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PSA 10.9 ~112013
Bx on 112013 at age 64 yrs 11 months, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, but some seminal ves. involvement, still G9, thinks he MAYBE got it all by cutting wide, but 1 tiny foci was right at the edge of margin ) Pros. 106.7 gms!
Foley out 030314
JP drain out on 0310
PSA <.1 on 4/7

I was told that it was the urethra cutting that shortened the length. I lost about a half inch or more. Magically it came back somewhere around 6 or 7 months postop. I too developed Peyronies as a side effect, which can also challenge size. I daily use VED and traction for therapy, to help combat atrophy and the curve. Regards Inkhorn

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Age 62-dx pc 11/09- Gleason score 6-1 core positive with 4 others suspicious- RP on 1/10-Path report indicated the tumor was present in 6 slides both right and left- stage t-2-After 1 year 98% continent-after 4 years still have ED- PSA remains <.01-other side effects,epididymitis, peyronies disease