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Post Op newbie questions - sex, size and appearance

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Posted 6/25/2010 3:24 AM (GMT 0)

Greetings fellow Prostate Cancer warriors, I salute you in your/our fight against this disease.  This is my first posting.

My robotic surgery for prostate removal was May 24 2010.  I was diagnosed in March with a 4.8 PSA and a 6.5 Gleason score.  I am 53 years of age and in very good physical condition as I am a fitness instructor by profession.

My issue I am hoping to get information on is a delicate one.  As I recover it seems to me that there is a small valley or indentation on my lower abdomen where the base of my penis attaches, and the size of my penis overall seems to have reduced.  Any input from anyone on this?

As far as sex I have to say I rec'd no instructions/restrictions from my doctor and have not had any desire or thoughts in that direction anyway.  The postings I have read on this forum have been extremely informative and I look forward to more interaction.

Post Edited (jahfreak) : 7/4/2010 10:49:12 PM (GMT-6)

Posted 6/25/2010 3:37 AM (GMT 0)
First, welcome jahfreak.

Now, your issue.

Ah yes, the mystery of the disappearing penis. Yet another in the saga of things they don't tell you about before they snip. At least they didn't tell me. Pity, I'd have liked to have said goodbye.

Here's the way I understand it. The bladder is up in there, pretty much fixed into place by whatever glue God uses. The prostate is below that, and then the penis. When the prostate comes out the surgeon has to attach the penis to something, at least if you're going to pee that is, and so naturally it gets attached to the bottom of the bladder. Now, the bladder won't come down, but the penis will retreat up, so guess what gets moved to make the attachment fit? Right.

I for one am glad my bladder isn't above my stomach.

jahfreak, your penis is the same size it always was, it's just filling in between the engine and the caboose so to speak.

Sheldon AKA Sleepless
Posted 6/25/2010 3:46 AM (GMT 0)
Welcome to the forum. Sorry you have to be here but you're very welcome.

Can't help with the indentation but the surgery does shorten the urethra, this can lead to a shorter willie when flacid. As for rehab' my uro' gave me a month long scrip' for 5mg Cialis and suggested I "exercise" it often. I (being a good patient) have taken her advice and after a few months length seems to be back to normal, hard to tell as full firmness is not yet available but getting much better. I'm now using 100mg Viagra (cut in half most of the time) from the forum's favorite internet source and it seems to work much better than the 5 or 20mg Cialis for me.

Best of luck in your recovery and remember the only bad question is the one you don't ask.
Posted 6/25/2010 3:47 AM (GMT 0)
I think Sheldcon is correct. However, I should say that one surgeon assured me that the bladder would descend to make up the length. I'm not sure she was telling me the whole truth. I am definitely nearly an inch shorter. However, other guys here said they have no decrease in length. Maybe some of us have movable bladders, and others do not.

DJ
Posted 6/25/2010 3:50 AM (GMT 0)
I supect I won't know about the real length until I see a real woodie. Having lost the nerves in the operation, that seems a bit unlikely. The "resting" state is no smaller than it was before DaVinci.
Posted 6/25/2010 4:54 AM (GMT 0)
Thanks for the input (especially sleepless). My doc is not just overflowing with post op info so this is a great resource-outlet. Four weeks ago today I had the robotic surgery, I feel great other than some pain in the rectal and scrotum area. First post op PSA test is July 6.
Posted 6/25/2010 11:38 AM (GMT 0)
Hi Jah.. Do a Google search, you will find the several studies showing that about 1/2 (+-) had some shrinkage. Since it matters most when the thing is working, I image those who get theirs to work again are pleased with that result.. and would be willing to "give an inch". This month around my 4 weeks I had the same rectal/scrotum issue.. it has since subsided... I think I worked the Kegel too hard, plus the recovery itself.
Posted 6/25/2010 12:12 PM (GMT 0)
Jahfreak,

You may want to take a look at Dr. Mulhalls talk.  He covers a lot of the stuff your doc didn't.  Its at:

www.mskcc.org/mskcc/html/94910.cfm

Posted 6/25/2010 12:33 PM (GMT 0)
Jah, i too have the mystery dent right where you say. I asked the doc about this at my last visit as i had never noticed it before the surgery. He was pretty non commital and gave me the you probably just never noticed it before answer but i`m sure it comes from the urethra reattachment. My surgery was in Feb and at this point i dont really see any loss in length and i`m having no problems. Good luck Tim
Posted 6/25/2010 12:34 PM (GMT 0)
Jah, for my husband "junior" is definitely shorter. I also notice a slightly different shape in that his penis seems more blunt (rounded) than it was pre-op.

We too didn't expect this happen (didn't find this board til after his surgery). And you're right in that the average uro/surgeon doesn't go into great detail about the quality of life issues. We were given statistics about the % of men in my husband's age group (58 at the time) who regain continence and ability to achieve erection. Some men experience no problems in these areas, some do so for a short period of time, and some struggle with one or both for years. And it doesn't seem to matter whether or not the surgery spared one, both or neither of the external nerve bundles.
Posted 6/25/2010 2:12 PM (GMT 0)
My experience is that I lost about an inch flaccid, but regain the full pre-surgery length when erect. The erection brings out the parts that are 'hiding', it seems. As has been mentioned early and often stimulation, practice and even using a pump will help somewhat. Another thing is we sometimes gain a little weight aftert surgery and a larger belly can make it appear that we are shorter. If you have a gut, try holding it inward and see if the missing section 'magically reappears" smilewinkgrin
Posted 6/25/2010 3:49 PM (GMT 0)
jahfreak:  I have exactly the same indentation, and am shorter - not only that, but my natural "hang" moved from the right to the left.  Doesn't even appear to be the same little guy I've traveled with for 57 years, but I'm getting used to it!
Posted 6/25/2010 3:54 PM (GMT 0)
Welcome to the forum

Nothing like a skrinking willy to get you searching the web!

I think the readjustment of our bladders and penises to compensate for the prostate having been removed between these two bits of our body is a combination of the bladder dropping down a bit and the penis getting pulled in a bit. For some guys the bladder will drop morfe and the penis not disappeaer so much for others the penis is the bit that will move.

So the penis has not actually shrunk but moved.

And the difference may be much more obvious in the flaccid than the erect penis.

I'm nearly a year on from surgery and I guess I am still missing about an inch in the flaccis and half an inch in the erect version of little Alf.

I always had shallow dip in the skin at the base of my shaft about the size and shape for a small almond to fit in it. (What is name name for the male equivalent of the Mound of Venus? Mars's Hump perhaps? ) And yes it was more pronounced after surgery, but I may also just have noticed it more due to the hair removal down there. And of course putting the two things you mention together I can see that if the penis gets pulled in then the skin attached to the penis gets pulled in too, hence the dip.

I suggest doing all the appropriate penis exercise etc to get it where it likes to be.

Alfred
Posted 6/25/2010 7:27 PM (GMT 0)
Alf and Sheldon....you guys are killing me... the two of you should do stand-up prostate Improv! Hero
Posted 6/25/2010 7:59 PM (GMT 0)
Hi Hero --- nice to see your name in print. I know I owe you an email from what, last December? I'm marinating our friendship.

Alf and I are actually booked at the Royal Palladium Theatre, London, in October for three nights. We're billing ourselves as Wee Willie And His Testicle Two. Alf and I will be the Testicle Two. We're currently searching for a Wee Willie front man. I don't suppose you'd get out of your beloved swamp long enough to be front man for us? You'd love the costume!

Sheldon AKA Sleepless
Posted 7/4/2010 11:30 PM (GMT 0)

Welcome to the club jahfreak

Sounds to me like your Doctor is not doing his job.  Sorry to hear that.  Your physical and sexual health is his job.   I would call and speak to him one more time to seek the satisfaction your deserve and get answers to the questions you have for us now.

I might suggest you write things down in preparation for that discussion and take a witness if possible to the face to face consult.  Failing success on that, find another Doctor.

Penal shrinkage is common for all the same reasons others have commented before me.  Although it is a liittle early in your healing process to impliment a full blown penal restoration plan, it is not to early to have one.  I see a couple of choices for you.  Try to dig such a plan out of your present Doctor along with drug samples, for free, to test a little later.  Barring success on that front, find another Dr.  or make you own plan.  I personally lost an 1".

On the subject of your overall recovery I wish to caution you to be patient and go easy.  That might me counter intuitive to your nature but please go easy.  You have had Major Surgery and the healing process takes far longer then we realize at the beginning of the journey.  Those tissues are wet and take longer to heal.

The moderator of this BB has assembled a nice list of resources for your reading. 

Here is the link   https://www.healingwell.com/community/default.aspx?f=35&m=52996

You will find  many answers to your questions by mucking around with those links.  They are a marvelous resource.

On the pain in your butt.  Keep things very clean along with a little extra skin care after bathing.  It feels good, makes you smell better and promotes you getting familiar with how your body looks and feels now after surgery.  A decent sized mirror would be helpful.  Normal activities within reason are encouraged as we heal.  Walking, swimming and mild exercise.  Lifting is not encouraged till later but I want to stress all these activities are normally part of a Doctors orders to their patient.  The fact that you have not had such normal conversations leaves me concerned.  Caution is the word of day on these issues and proceding under medical advice is always recommended and encouraged.

As you can see from the humorous tone of some of these guys, if we don't laugh we sometimes cry at the devestating effects Prosate Cancer has on our minds and bodies and our families. 

We hope to encourage you to do the best you can for yourself  and for all who are around close you.  We want you to succeed and be well.  Please read the particulars of my closing signature block.  We do that for a good reason.

Prostate cancer used to be a fatal diagnosis but during my lifetime has become less so.  We want you to know you can still have a full productive life.

Are you the same NO.  Are you OK, YES. 

I hope this helps a little and please keep us up to date on your progress.

Best Wishes Jim

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