Abnormal sensation and shorter penis after radical prostatectomy

Hello, I wish your husband a fast recovery and I also wish for strength for you as you walk this road with him. My husband also had a radical prostatectomy and the shorter penis is a thing. The weird sensation is also a thing and in our case both things were permanent. His penis will feel foreign to him and also to you. With time, it may normalize a bit but it will never feel/be the same. That was at least our experience. All the best to you and your husband.

This is normal, unfortunately. My surgeon told me to expect it, but, he didn't tell me to the very last minute.
Horribly oversimplified but....

A) in this surgery they take some of the urethra out, (the area where the prostate is and whatever margins they take) then pull the two ends together and attache the ends with stitches. Think removing the part of a hose where a hole is and putting the two parts back together, it's gonna be a little shorter.

B) for about 4-6 mos it seemed to me there was a lot of turtle-ing happening think dip in cold water. My guess is as a result of what the body just went through. Even when that improved, you still have some loss of size.

C) it likely feels different because some nerve damage was done at the same time. It takes a LONG time for nerve to heal and grow, how much things go back toward normal is different for everyone. It depends on surgical skill, how much tissue had to be removed and other factors.

I had radical prostatectomy 1 year ago and to me he is experiencing normal symptoms. I’m not a medical person. I’m a patient. I experienced changing sensations all along the way as the healing process continues. A shorter penis is documented as well. You can look this up. 2 weeks from surgery is very early in the recovery. Hang in there as you will improve. We all heal at different rates however I don’t expect to ever be the same as pre surgery. So far I have not had a prostate cancer recurrence thankfully.

Hello,
This is not uncommon. My husband dealt with the same issue. Best to ask your physician about options.
Best wishes,
Dee

@havhav, In addition to the helpful replies you've received already, you may appreciate the posts in this related discussion where @jeanadair123 aked similar questions:
- Shrinking penis after surgery and radiation https://connect.mayoclinic.org/discussion/shrinking-penis-after-surgery-and-radiation/

Thank you for your response. It’s helpful though daunting to realize that this may be a long term concern. He is starting Cialis as there are studies that have shown it any be of some benefit however we realize that some changes will be more permanent. We might as well do what can at this early stage for what it’s worth. I’m sure we can adjust over time, just weren’t expecting the change of sensation portion of it in particular.

Thanks for your response, and the pep talk. Much appreciated. Prostate cancer is a tough road to follow.

Hi. My husband suffered in pain for 12 months with a catheter, often ending up in tears. We had to get a new bedroom carpet because he forgot to close his nightbag properly on night. My husband is a big strong powerful (physically) man and I would see him in tears with the pain and frustration knowing there was a long waiting list for the prostate op, he just wanted to rip it out at times because he coukdnt stand it anymore. He felt he'd lost his masculinity, wouldnt want to go anywhere and when we did, it had to be somewhere where he could empty his bag. He wasnt an easy man to live with, he also worried because I had to go without intercourse. Having a new cartheter every 3 months would see him pale, sweating and virtually unable to walk. Ill never understand why men aren't given a sedative or something for this procedure.
Anyway, in January he finally had his prostate removed and when that final catheter came out, he was overwhelmed. Few months on now, his willy is a bit smaller, his orgasms, he says, seem to be more intense though dry but his sensation isnt good. He cant get a full erection and intercourse is more of a miss then a hit. He's on the waiting list to see somebody about this, he has tried 2 over the counter generic viagra pills which dont work. He stresses about this but I have my husband back, healthy, pain free and after exercises, strong bladder control. We are in our early 60s, healthy and looking forward to our retirement. Ive got the man I want back and im sure in time Mr Willy will rise to the occasion. If it doesnt, Ive still got my husband back.

I'm not a medical professional nor an expert in this area, so take my layman comments with a grain of salt. That said, I had NS RARP at age 70 in 06/2024. I also had some shrinkage and loss of sensation. On this site I discovered the concerpt of "penile rehab after prostate surgery". There's some excellent material and youtube videos from sites like UCSF, Mayo, Memorial Sloan Kerring, etc where doctors (with excellent credentials) discuss the topic. I spoke to my medical team about it and they put me on a plan. For me (which certainly doesn't happen for everyone) I was able to very slowly improve until I believe I fully recovered from my ED, shrinkage, and loss of sensation by around 15 months. Strangely enough, my (otherwise outstanding) medical team never brought the topic up. But when I asked them about it, they responded very positively to my questions, prescribed a plan, etc. I suspect it's just not a comfortable topic for many people in our culture so it's often not discussed unless the patient asks about it. To help get you started on the topic, here's 3 links that helped educate me on the topic (although you'll really want to discuss it with your medical team and a good mens sexual health doctor). You should note that I went through this 2 years ago, so there's undoubtably newer stuff out here, but here's 3 links that I happened to use during my journey. Hopefully they can help get you started educating yourself on this topic so you can more effectively communicate with your medical team. Best wishes.

UCSF document on ED, which includes people after prostate cancer surgery: https://www.ucsfhealth.org/conditions/erectile-dysfunction

Standford webinar on penile rehab after prostate cancer:

Agree with retired ITGuy, need to get going on penile rehab when cleared. There is a lot of surgical swelling the first 3 months down there and it contributes to what you are seeing “or not seeing”.
Keep in mind that for most men the RP procedure requires that the bladder be detached from the pelvic wall and dropped down into “the space of Retzius” and re-attached. This minimizes penile shortening by closing the gap somewhat and thereby minimizing pulling up on the urethra.
Give it time, take the 5 mg cialis daily, and get a good vacuum erection device, use twice daily. “Vacurecct” is a descent device available on Amazon. Once you get it, pump it up and use a sharpie to mark the clear tube with where your SPL (stretched penile length) is. That should improve monthly. If erections dont start by 3 months, consider Trimix injection therapy. Hang in there , we have all been down the road.