It’s been called the final indignity: after men have their prostate removed to treat cancer there, at least two-thirds find that their penis has shrunk, typically by nearly an inch. But in a much-needed glimmer of hope, a new study finds that, after the penis hits a nadir 10 days after surgery, it usually recovers to its pre-surgery length after a year.

The study of 102 prostate cancer patients in Japan “can help men to better understand the risks of a radical prostatectomy and make an informed choice when selecting a treatment option,” said Dr. George Suarez, a urologist in Miami who was not involved in the research, which is published in the journal BJU International (formerly British Journal of Urology). “At the end of the day, no man wants to risk sexual potency or have their penis shortened, the latter even if [it’s] only temporary.”

The shrinkage hits men especially hard because it’s a side effect that surgeons usually don’t warn patients about. While one small study (of just six men) found that the most common reaction to the loss of length was resignation — prostate cancer patients are often simply glad to be alive — on social media and in private discussions, many patients have a less sanguine view. They say in one internet chat room they were unprepared for the shrinkage, experienced adverse psychological effects, and resented having “to find this out for ourselves after the operation.”

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There is a continuing debate among prostate cancer experts over whether men are more likely to die (from prostate cancer or any other cause) if they are treated with surgery or radiation, but a 2016 analysis of 19 observational studies gave surgery an edge. That conclusion comes with an asterisk, however, because men who opted for surgery could be different — healthier, wealthier, under better medical care — than those who chose radiation, in which case it would be something about the patients and not the treatment that led to higher survival.

For their study, physicians at Kanazawa University School of Medicine in Japan followed 102 men who had undergone radical prostatectomy — surgery to remove the prostate — as part of cancer treatment. Using a ruler, they measured the length of each patient’s stretched penis (considered a proxy for an erect one) at room temperature while the men were lying down, before the operation and again eight times over the next two years.

Penis length was shortest 10 days after surgery, having lost an average 0.8 inch from before the operation. The larger the size of the prostate, the greater the shrinkage. But penis length “gradually recovered,” Dr. Atsushi Mizokami, a prostate cancer specialist, and his colleagues reported, until it was “not significantly different from [the] preoperative” length.

Their scrutiny of the anatomy, they wrote, offers the first detailed explanation of both shrinkage and recovery. Although animal studies had implicated nerve damage, the researchers found something else.

After the prostate is removed, the part of the urethra at the very top of the penis (it’s called the membranous urethra) retracts into the pelvis, MRIs showed. Anatomically, the tissue surrounding the urethra as it travels from the bladder through the (now-removed) prostate to the tip of the penis, the membranous urethra, and the penis itself act as a single integrated structure. As a result, the shaft of the penis gets pulled up into the pelvis, too. “Slight vertical repositioning of the membranous urethra after [prostate surgery] causes changes in [penis length] over time,” the researchers wrote.

But over the next 12 months the tension in the connective tissues that hold the pelvic organs in place loosens, they explained, allowing the membranous urethra to return to its original, lower position. The penis follows.

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  • My doctor did say my penis would be short but 3 inch like mine is and did tell me i would leak pea out eather and how long after cathater comes out to see if it gets hard or not

  • My doctors never said a thing to me about losing length in your penis your lucky I can find it this was back in 2013 haven’t had sex since then don’t trust doctors anymore had 13 inches of my colon taken out in 2011 found nothing as long as you can live a healthy life these doctors will lie to you and say you need and operation just to put money in their pocket and buy their fancy cars and big houses,this is all because they change the way health is paid to them they found a loop hole to get around and make more money but its people like us that pay the price

  • How can you regain a healthy sex life after your partner has had prostate removed 7 years ago . I am his new partner and have not had intercourse yet. But unsure what to expect .. please can you advise what I can expect and if there’s anything I can do to help . Thank you

    • It depends on what they did during the surgery, ie. nerve sparing, how much urethra was removed, etc. There may not be an easy fix, but I have found a helpful website for ED and prostate surgery victims. Check out franktalk.org

  • I had prostate cancer surgery 10 yrs ago and I only read your first comment I have exact same problem my penis it seems disappeared into lower abodomen. Now what?????

    • same problem along with not being able to hold going to bathroom. When it hit you better not try and hold it. big mistake.

  • I often come to these sites because im interested in the reasons for the shrinkage. My shrinkage was the exact same way as I read about as far as prostate or hernia surgery, and how it somehow causes shrinkage..But I had neither surgery, I had acl surgery. And now I can’t get one urologist to believe anything happened due to it, it looks fine. But we know our bodies. We know and feel when something isn’t right…and when i woke from that acl surgery, I knew right away..it’s been almost 3yrs ago, and nothing has changed..I lost girth , as well as lenth, and that includes faccid. I just wsh I knew what to do, it mentally prays on me day after day

    • Tim, You are not alone. The last visit I had with my urologist, he didn’t get to talk much! He told me he had never had anyone as animated about this as I was. Since it is worse when sitting, I retired a little early to get away from having to sit down as much. I am more than 1 year post surgery and haven’t had one day of peace from it. Not that I don’t miss sex, but the flaccid length (lack of) is what drives me nuts. I have done a lot of research and there seems to be no way to fix a shortened urethra other than penectomy. I researched what land mine survivors do and even the transsexual men. There is no good way to lengthen the urethra. I am at my wits end. I wish you the best. Doctors don’t want to talk much about the “FAILURES”

  • Dr. Miles Houston denied that I had shrinkage! Funny thing is I cant find it anymore. Tried several different methods to try and get some length back no go. This is so messed up would have been nice to know I would be losing my sex life. Sad thing is lied said he got it all which he did not never did zero out. PSA is at 1.4 and not doing a damn thing they ruined enough of our lifes!

  • Another Mike! I had the robotic Prostatectomy 11 months ago and lost 2.5 inches. It was like having a second belly button, except very uncomfortable to even painful when sitting down. It was like a tug of war was going on inside. I bought a penis expander for the shortest penis I could find. It was somewhat painful using it, especially at first, just to stretch it out long enough to strap into the device at its very lowest setting. After 8 months of using this barbaric device I have gained only 1″ of flaccid length back. At this point a bottom end sex change would be an upgrade!!@!!! I have had erections from about the end of the forth month, but too short to do anything.

  • This article is BS. I had a Robotic Prostatectomy 7 years ago. Shortly after surgery I was told my prostate was 3 inches long. I was circumcised shortly after birth. Now, all this years later, my foreskin is three inches beyond the tip of my penis and I need another circumcision surgery. I am incapable of any kind of sex. The surgeon was Dr. Carol Salem in San Siego, and I want her to know she is NOT forgiven for what she did to me.

  • I am not an expert on this topic and I know very little about complications from BPH treatments and the side effects those kind of treatments have, thats why when my doctor told me about surgery I just did avoit it and told him I did not wan to go through it so He gave another option, a natural treatment based on a better alimentation and a natural supplement named alpha rise, i think natural remedies are better and have less side effects, it helped me a lot.

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