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Penis smaller after prostatectomy

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Posted 12/3/2014 1:39 PM (GMT 0)
I have been getting erections since 2-weeks after my surgery 1-8-2014. They were weak about 60%(without Viagra) I called my surgeon about a pump and he said I didn't need one. I have actively stimulated my self for fear of damage from lack of blood and have sex with my wife every Saturday night with sildenafil. I get seldanfil citrate much cheaper so at 4-month out I started to take for nocturnal erections and again a full dose on Saturdays. Before my surgery I was 8" or more and now Im 6 1/2 inchs or close to 7" on a good day. I don't know if this is because I gained around 10pds. I don't see how I could have suffered damage due to lack of blood unless because I wasn't getting extreme erections for a while and wasn't using a pump some scar tissue happened. If this is not my imagination can I expect things to continue to get better as a far as size with time. One person on this sight mentioned that he used a pump twice a day and wasn't having erections at 9 months but now at 3-yrs he is 99% what he was preop. Any thoughts or positive outcomes would be awesome THANKS GUYS!
PS started using pump last week to try and regain size
Posted 12/3/2014 2:03 PM (GMT 0)
John,

With the sildenafil I take it your erections are adequate for sex (adequately hard ignoring the size issue)? How about your nocturnals? With your low-dose sildenafil do you ever wake up with a tent pole? Because for penile rehab the most important thing is to get a decent erection a few times a week (nocturnals count) to keep the tissues oxygenated and exercised. If your erections with the PDE5i pills are normal-ish then your problem is probably mostly those ten pounds. Studies of shrinkage after RP found that men who were potent after RP did lose a bit of size at, as I recall, three months after surgery, but regained it by six.
Posted 12/3/2014 2:50 PM (GMT 0)
Thanks Peter, yes I have woken up with erections not rigid erections and not every night. I Just wish I had started using a pump earlier although the blood is not oxiginated. Can you answer this question, do you have to have extreme erections to prevent any damage to any areas of your penis or does a let's say erection of 80% get blood to all of the areas of the penis so there no scar tissue that could effect your erection long term. Long question I know thanks
Posted 12/3/2014 2:51 PM (GMT 0)
I'm at 11 months post-op. I've been using Cialis daily since the catheter came out. Very little response until the 6-7 month mark. I'm doing better now, and things are hit and miss with 10mg of Cialis, and 20mg works pretty well. I'm definitely still smaller than before surgery. My wife has been honest about the change in size, but being the saint she is, she says my size is perfect.

I have also gained some weight since before the surgery, but it is almost gone. I think I gained about 15 pounds after the surgery, but I've recently dropped a notch on the belt, which felt good. A couple more would be even better.
Posted 12/3/2014 2:52 PM (GMT 0)
There's also the part about the Urethra being snipped during surgery and that when attached - tugs on the penis a bit and gives the impression it's shorter.
Posted 12/3/2014 3:15 PM (GMT 0)
Peter, answering a question I missed but yes my erections have been adequate for penetration consistently for about 8 weeks in a row and hit or miss before that.
Posted 12/3/2014 5:52 PM (GMT 0)
John,

For oxygenation purposes a wobbly chubby is sufficient, or so I've been told. So you should be OK there. My uro says that a pump will help keep things from shrinking through disuse which can be something of a separate issue. Penile traction is a mostly-accepted treatment for men with excessively short organs so stretching can produce a modest change in size over time. Sounds like you are doing fine. Keep up the good work and throw way the ruler.
Posted 12/3/2014 6:12 PM (GMT 0)
John,

What does your Uro say? I recently had a conversation with the urologist who developed one of the most widely used questionnaires for quality of life after prostate cancer treatment (EPIC). I asked him why two of the most common symptoms I hear about in my groups - penile shrinkage and climacturia - are not addressed on his survey. He said that it wasn't reported much at the time of development, and he doesn't hear about it much from patients even now. This creates a Catch-22: it's not addressed by many urologists because they don't ask about it, and patients don't bring it up (a lot of men are shy to discuss such things), but until it's routinely reported, it won't be addressed. We need to put his on their radar.

- Allen
Posted 12/3/2014 10:48 PM (GMT 0)
Size matters -- yeah the size of our egos.

Climacturia was an issue whilst I was using the pump, but not anymore -- as I've said before, the "pump" and I aren't friends.

Hardons are back! Isnt that sufficient for now. I agree with Peter, throw away the ruler and be thankful that it wasn't used to measure six-feet under.
Posted 12/3/2014 11:28 PM (GMT 0)
Mine is a little smaller too. When I asked my urologist he said the penis is the same size, just a little pulled into the pelvic region.

My reply was that if you have 2 fifty foot telephone poles, and bury one 10 foot deep and another one 20 foot deep, everyone will say that one pole is 10 foot shorter. So who is right, from my point of view, it is shorter.
Posted 12/3/2014 11:50 PM (GMT 0)
I lost much more. At least 1 inch gone and also significant loss of "girth". However, the size decrease was not due to the surgery, it was due to the Peyronie's that developed after (some would argue "due to") the surgery.

I try to keep things in perspective: 20 months ago I had cancer; Today I have no cancer, but lost penis size, lost the ability to ejaculate, still need Viagra as my erectile function slowly returns, and have a few small fading scars. I'd call that a very good deal, all things considered. And my wife says that the smaller size doesn't matter to her (but it does bother me quite a bit).

(For more info on Peyronie's, check the link in my signature.)

-Gedman
Posted 12/4/2014 12:04 AM (GMT 0)
Pilot:

Guys tend to lose flaccid length for a while after RP but reductions in stretched and/or erect size are less common and less extreme. Here's why:

If you check out this YouTube video and pay close attention to the structure of the penile root (roughly 1:00-2:10) you will see that your telephone pole is anchored in bedrock (the corpus cavernosus attaches to the pelvis). In an erect penis the two corpus cavernosa have very definite ideas about how long they are going to be and a bit of tuggling on the side of the corpus spongeosus from your shortened urethra doesn't do much. It is true that the shortened urethra can pull part of the flaccid member up into the body cavity but it's no match for your hydraulics if you can keep them in good running order.
Posted 12/4/2014 2:14 AM (GMT 0)
I agree 100% with PeterDisAbelard. Very consistent with my understanding of the subject based on reading and discussion with my surgeon.
Posted 12/4/2014 2:18 AM (GMT 0)
No its just a peek a boo penis, you know like the groundhog. er, eh, no I never checked...
Posted 12/4/2014 3:25 AM (GMT 0)
Allen, No I haven't spoken to uro bout this specific issue, maybe I'm thinking to much, thNks for everyone's responses.
Posted 12/4/2014 3:36 AM (GMT 0)
Psa your right bout being grateful thanks again everyone
Posted 12/4/2014 5:42 AM (GMT 0)
john on pennis smaller, its what the doctors all seem to B.S. about, on going to the cancer center every 3 mos for my treatment, most men Ive talked to, say YES around 1 to 2 inchs, my self was around 2 inchs, now when I was off my hom shots, it went back to normal minus 2 inchs and when your on hom it shinks even more, now when your psa levels start to rise, they try to get your T levels as low as possible, So people who try everthing to have sex have to be increasing their T levels which feeds your psa and cancer, that's what their talking about last time,,,,,
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