Shrinking penis after surgery and radiation

Posted by jeanadair123 @jeanadair123, Oct 13, 2020

My husband had his prostrate removed by surgery in 2003, in 2011 his PSA was high so he had 38 treatments of radiation. Slowly his penis has shrunk to the point that he said it is getting difficult to pee standing up. Is this a side effect of the surgery/radiation and is there anything that can help? Thank you.

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When you mention his psa was high in 2011, may I ask how high was it in 2011? I'm going thru a very similar experience. I had radical prostatectomy in 2013 and about 8 years later after having psa results <.1, I blew a .2 then .3 right before about 38 radiation treatments. I just receive a new ultrasensitive psa result today saying it's <0.02, which I think may mean it's undetectable and regular psa test required. Scheduled another for 6 months out. I've been on a 6 month regime of Orgovyx with one month left to go. Thank you in advance!

Kindest regards,
Nate

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@jakedduck1

@rcs
I tried all the oral medications too with no results.
An acquaintance of mine suggested I try an injectable medication called trimix that works well for him. The thought of injecting my penis sounded painful but was pleasantly surprised when I barely felt it. The next time I used it I didn’t feel the injection at all.
The only problem is it has to be prepared at a sterile compounding pharmacy which makes them expensive and are not usually covered by insurance.

@colleenyoung
Please correct me if I'm mistaken but the stretching device you referred to last year, I thought any length gained was as a result of straightening any curvature that may exist from Peyronie’s Disease or another condition.
If any length is gained I don't believe is long lasting.
Good luck @rcs,
Jake

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You're correct @jakedduck1, the RestoreX device was originally developed to treat penile curvature due to Peyronie's disease. It works by applying gentle, dynamic pressure to stretch and shape the penis. The length gain is in part due to curvature correction. Research is now being conducted to see if the same approach could be used to improve penile form and functioning after prostate cancer surgery. Here's an article about a preliminary study:
– New device helps restore penile length and sexual function after prostate cancer surgery https://www.newswise.com/articles/new-device-helps-restore-penile-length-and-sexual-function-after-prostate-cancer-surgery

And the full study
Efficacy of a Novel Penile Traction Device in Improving Penile Length and Erectile Function Post Prostatectomy: Results from a Single-Center Randomized, Controlled Trial https://www.auajournals.org/doi/10.1097/JU.0000000000001792

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@colleenyoung

You're correct @jakedduck1, the RestoreX device was originally developed to treat penile curvature due to Peyronie's disease. It works by applying gentle, dynamic pressure to stretch and shape the penis. The length gain is in part due to curvature correction. Research is now being conducted to see if the same approach could be used to improve penile form and functioning after prostate cancer surgery. Here's an article about a preliminary study:
– New device helps restore penile length and sexual function after prostate cancer surgery https://www.newswise.com/articles/new-device-helps-restore-penile-length-and-sexual-function-after-prostate-cancer-surgery

And the full study
Efficacy of a Novel Penile Traction Device in Improving Penile Length and Erectile Function Post Prostatectomy: Results from a Single-Center Randomized, Controlled Trial https://www.auajournals.org/doi/10.1097/JU.0000000000001792

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Yes its is severe

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Is the penile shrinkage an issue with only surgery?

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@albert48
No.
The saying “use it or loss it” holds true in this situation.
Although it doesn't shrink as much.
Nocturnal erections and sexual activity prevent shrinkage.
I believe age also can cause slight shrinkage.
Take care,
Jake

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@albert48

Is the penile shrinkage an issue with only surgery?

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Not for me, I had SBRT in 9/2020 and penile shrinkage happens with radiation only.

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@kujhawk1978

Yeah, not exactly something your urologist tells you about the surgery, shrinkage in the penis, both length and girth. My urologist and radiologist both discussed the possibility of ED as a side affect but not the shrinkage. I have never had it explained in layman's terms but mine and many other men on various forums mention it as a SE and that their medical team did not discuss it as a SE.

So, like may things with this disease, you simply move forward and adapt as an individual and couple. Sex changes, if you are fortunate enough to have erections wit medical assistance (Viagra, Cialis, VEDs, MUSE, Implants…) and you have a partner interested in still having intimacy and sexual relations, then you can. It may take more foreplay, different positions…

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My urologist was not a font of information either. My PSA levels went from 4 to 11 and he decided that I would have the robot assisted surgery. I told him to calm down; I wanted to research my options. After a week I told him to go ahead and set up the robotic surgery.
I had read that my penis might shrink by a half inch, but I'm 70 years old. My penis had been shrinking slowly throughout my 60s. My roommate of 25 years is no longer interested in sex so not being able to get an erection is not a cause of strife. I'm 15 years older than her so I knew the difference in our ages would catch up with me sooner or later.
I had my prostate cancer surgery on June 16th of this year. I am still a bit incontinent and have gotten resigned to wearing Depends when I go out – which is not often.
I would like to be able to masturbate, if nothing else. So far my favorite sex videos don't produce any physical reaction at all. I am not going to get Viagra or anything similar. If I never get hard again I guess I'll get used to it, but I doubt I'll ever really be at peace with that condition.

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@ctpaul

My urologist was not a font of information either. My PSA levels went from 4 to 11 and he decided that I would have the robot assisted surgery. I told him to calm down; I wanted to research my options. After a week I told him to go ahead and set up the robotic surgery.
I had read that my penis might shrink by a half inch, but I'm 70 years old. My penis had been shrinking slowly throughout my 60s. My roommate of 25 years is no longer interested in sex so not being able to get an erection is not a cause of strife. I'm 15 years older than her so I knew the difference in our ages would catch up with me sooner or later.
I had my prostate cancer surgery on June 16th of this year. I am still a bit incontinent and have gotten resigned to wearing Depends when I go out – which is not often.
I would like to be able to masturbate, if nothing else. So far my favorite sex videos don't produce any physical reaction at all. I am not going to get Viagra or anything similar. If I never get hard again I guess I'll get used to it, but I doubt I'll ever really be at peace with that condition.

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Interestingly, I "discovered" that masturbation and orgasm is not tied to erection.

It took a good 12 months after my surgery before I began to have any hint of erection but under the use it or lose it part of penile recovery therapy I "masturbated" 2-3 times a week. Though flaccid, I did orgasm. That's when I learned an erection was not necessary for an orgasm. Even when I was on 18 months of Lupron and my genitalia shrunk to it's pretty-pubescent phase I could masturbate and achieve orgasm though certainly no erection. I

I am one of the fortunate ones, by 18 months after nerve sparing surgery I was able to achieve an erection albeit not what it was before.

I was one of the 20% or so who do not lose their libido while on Lupron,

Today, over eight years from my surgery I can achieve a pretty good erection with Cialis and stimulation. There is no intercourse with my wife though, she quit awhile back

It may be early given your surgery to begin having erections orgasms but both are possible though you may find only one, orgasm.

Do much depends on your pre-surgery function, whether your surgery was nerve sparing, the skill of your surgeon and your rehabilitation therapy.

I am probably outside the norm in terms of my recovery of function, sadly, I am probably well within the normal when it comes to my wife of 32 years and no sex, and I mean none!

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@kujhawk1978

Interestingly, I "discovered" that masturbation and orgasm is not tied to erection.

It took a good 12 months after my surgery before I began to have any hint of erection but under the use it or lose it part of penile recovery therapy I "masturbated" 2-3 times a week. Though flaccid, I did orgasm. That's when I learned an erection was not necessary for an orgasm. Even when I was on 18 months of Lupron and my genitalia shrunk to it's pretty-pubescent phase I could masturbate and achieve orgasm though certainly no erection. I

I am one of the fortunate ones, by 18 months after nerve sparing surgery I was able to achieve an erection albeit not what it was before.

I was one of the 20% or so who do not lose their libido while on Lupron,

Today, over eight years from my surgery I can achieve a pretty good erection with Cialis and stimulation. There is no intercourse with my wife though, she quit awhile back

It may be early given your surgery to begin having erections orgasms but both are possible though you may find only one, orgasm.

Do much depends on your pre-surgery function, whether your surgery was nerve sparing, the skill of your surgeon and your rehabilitation therapy.

I am probably outside the norm in terms of my recovery of function, sadly, I am probably well within the normal when it comes to my wife of 32 years and no sex, and I mean none!

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Thank you for being candid. It means a lot, particularly since most of the guys I know would be uncomfortable talking about this.

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@kujhawk1978

Interestingly, I "discovered" that masturbation and orgasm is not tied to erection.

It took a good 12 months after my surgery before I began to have any hint of erection but under the use it or lose it part of penile recovery therapy I "masturbated" 2-3 times a week. Though flaccid, I did orgasm. That's when I learned an erection was not necessary for an orgasm. Even when I was on 18 months of Lupron and my genitalia shrunk to it's pretty-pubescent phase I could masturbate and achieve orgasm though certainly no erection. I

I am one of the fortunate ones, by 18 months after nerve sparing surgery I was able to achieve an erection albeit not what it was before.

I was one of the 20% or so who do not lose their libido while on Lupron,

Today, over eight years from my surgery I can achieve a pretty good erection with Cialis and stimulation. There is no intercourse with my wife though, she quit awhile back

It may be early given your surgery to begin having erections orgasms but both are possible though you may find only one, orgasm.

Do much depends on your pre-surgery function, whether your surgery was nerve sparing, the skill of your surgeon and your rehabilitation therapy.

I am probably outside the norm in terms of my recovery of function, sadly, I am probably well within the normal when it comes to my wife of 32 years and no sex, and I mean none!

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Thanks for your candidly honest comments. I am in a similar circumstance to yours but I’m probably 20 years older. I don’t have much to add to what’s already been said; however, regarding your relationship with your wife, I would get a good couples and/or sex counselor. If your wife won’t go, then you go. There are many reasons a woman gives up on sex. Some, perhaps most, can be overcome, if she’s willing. You seem willing to communicate openly about this. I truly hope your wife is. If she’s not and sex is really that important to you, then you may have another decision to make. You’re young yet. I wish you and your wife well.

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