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What causes penis to change size after prostate surgery?

Posted by lados @lados, Dec 16, 2023

@mention what cause your penis to become shorten length and size after a laser prostrate surgery

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pratapmehta | @pratapmehta | Apr 27, 2024
In reply to @tempest541 "My experience was obvious penis shortening after arriving home immediately after my LRP at age 53...." + (show)
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My experience was obvious penis shortening after arriving home immediately after my LRP at age 53. As if it was pulled into my body. Never regained size regardless of the treatments available. The two urologists that were involved with my decision to proceed with the LRP did not communicate this possibility. It’s my opinion that had I known I would have considered other options.

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See my comment below.

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mikejf | @mikejf | Apr 28, 2024

I have APC never had surgery but had chemo infusions. Have been on ADT meds for several years (no breaks). Penis and testicles have shrunken significantly. Basically it was chemical castration

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wagner1557 | @wagner1557 | Jun 5, 2025
In reply to @tomf "I beg to differ on the miniscule aspect of a prostate removal's affect. If a prostate..." + (show)
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I beg to differ on the miniscule aspect of a prostate removal's affect. If a prostate is approximately the size of a walnut, and your urethra goes through the prostate, then you lose that much urethra after a prostatectomy. The reconnection doesn't add any artificial urethra where the prostate used to be. That walnut sized difference doesn't get made up for. My surgeon said the hope is that the bladder will drop towards the penis and not that the penis will draw up towards the bladder after the reconnection, but there are no guarantees. While I am sure you are correct about the atrophy and the nerve damage, I think we have to attribute more than a miniscule amount of penis shortening to the loss of the prostate.

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I’ve had the same thing happen. I’ve lost at least two inches in length having an erection. I’ve also experienced lack of fullness of girth as well as a curvature of my penis. It’s difficult to have sex.

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wagner1557 | @wagner1557 | Jun 5, 2025
In reply to @trusam1 "Retired MD here (not a urologist). Yes, my understanding is about 1.5 inches of the urethra..." + (show)
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Retired MD here (not a urologist). Yes, my understanding is about 1.5 inches of the urethra comes out, as it travels thru the prostate. That's why men with enlarged prostate have difficulty peeing. When the urethra is sewn back together, the penis will be pulled inside a bit, as the urethra is firmly attached to the penis.

I found Australian sexologist Melissa Hadley Barrett to be very helpful in showing ways to get the penis on the road to working again when the nerves return some function. Headline: viagra drugs, vacuum pump and masturbation help during first year post-op.
https://melissahadleybarrett.com/penile-rehabilitation-program/

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I can feel like my penis wants to extend longer but have the feeling that the urethra has been pulled up too tight restricting me from getting my original length back. I can actually feel the tightness pulling when I attempt an erection.
I have lost fullness and do have a degree of curvature now after surgery. Prior to surgery my penis was very straight. Now I have an upward curvature that makes it difficult to have sex.
I have used viagra and cialis as well as a vacuum pump for over a year to regain my size. I am now 19 months post surgery. Nothing seems to work.
In addition, my flaccid appearance looks like I’ve never been circumcised due to my size reduction. Any help is appreciated.

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alive15years | @alive15years | Jul 23, 2025

I have not found any confirmation of my theory regarding penile tumescence, but here it is: Erection occurs when the smooth muscles in blood vessels restrict blood from leaving the spongy erectile tissue. Blood pressure inflates the penis causing erection. I suspect that even when the penis is flaccid it has partial pressure which prevents it from deflating completely. So what happens when the nerves are cut? I think you loose this partial inflation, causing the flaccid penis to become smaller immediately after surgery and that causes changes over time, possibly resulting in scaring of the tissues and progressively smaller penis size and worsening erectile dysfunction.

I am a retired medical doctor (internist). 15 years ago (2010) I had a robotic prostatectomy by a surgeon who was very experienced with the DaVinci system at Vanderbilt. I am thankful for being cancer free with PSA=0. My father died of metastatic prostate cancer at age 94 diagnosed by PSA at about 84 but only treated with hormone suppression.

Immediately after surgery I noticed a significant decrease in length and it has only become worse over the years. Erectile function is only partially preserved.

My wife did research in the 1970's measuring nocturnal penile tumescence in hemodialysis patients who had impotence thought to be caused by zinc deficiency resulting in low testosterone levels.

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alive15years | @alive15years | Jul 23, 2025

I found on this site men who have had green light ablation of the prostate and they experience the same problems as prostatectomy. That must also result in nerve damage (see above).

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alive15years | @alive15years | Jul 23, 2025

I have now found confirmation that the flaccid penis is actually in a partial state of erection. This was found using PubMed regarding physiology of erection.

The penile erectile tissue, specifically the cavernous smooth musculature and the smooth muscles of the arteriolar and arterial walls, plays a key role in the erectile process. In the flaccid state, these smooth muscles are tonically contracted, allowing only a small amount of arterial flow for nutritional purposes. The blood partial pressure of oxygen (PO2) is about 35mmHg range. 1 The flaccid penis is in a moderate state of contraction, as evidenced by further shrinkage in cold weather and after phenylephrine injection.

(see above two comments)

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jimgaudette | @jimgaudette | Jul 24, 2025
In reply to @wagner1557 "I’ve had the same thing happen. I’ve lost at least two inches in length having an..." + (show)
Profile picture for wagner1557 @wagner1557

I’ve had the same thing happen. I’ve lost at least two inches in length having an erection. I’ve also experienced lack of fullness of girth as well as a curvature of my penis. It’s difficult to have sex.

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I got an IPP. Talk to your urologist. I am VERY happy with the results and so is my wife.

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heavyphil | @heavyphil | Jul 24, 2025
In reply to @alive15years "I found on this site men who have had green light ablation of the prostate and..." + (show)
Profile picture for alive15years @alive15years

I found on this site men who have had green light ablation of the prostate and they experience the same problems as prostatectomy. That must also result in nerve damage (see above).

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Hey Doc, great info. I had a Green Light Laser at age 58 on medial lobe. Suffered no loss in penis size or hardness of erection.
But robotic prostatectomy at age 64 destroyed my penis completely in terms of function. Interestingly, my flaccid state is identical to what it was before surgery - even after radiation and ADT. Even my wife commented that she sees no difference…
I wish it were the other way around - right now I have a “show dick” but nothing more than that.

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surftohealth88 | @surftohealth88 | Jul 24, 2025

Did any of you who have changes in size or the "look" have preoperative treatment with Cialis and than continued to use it after the surgery for "penile health" ?

Also, there are recommended "exercises" for penile tissue and urethra with a pump - did you do it ?

This is a good video on a YouTube covering that protocol - Google "Saving Your Sex Life After Prostate Cancer"

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