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User
Posted 27 Aug 2023 at 11:09

Hi, 


Had a radical prostatectomy June 26th and noticed my todger has shrunk both in length and width?


What the hell is that all about? 


If it's not bad enough what we've been through, this happens to depress me even more.


Think I had a nerve sparring operation, but can't get a erection yet. Waterworks aren't too bad considering its only been 4 weeks since the opp & bladder weren't great prior to the opp.... apart from my nemesis...coughing!!!! 


Thanks for any advice

User
Posted 28 Aug 2023 at 22:00

At the risk of repeating myself, my advice is to start using a pump, massage your penis and scrotum (it is fun if your wife massages your penis and scrotum while you use a vibrator on her, win win!) once you think you have recovered sufficiently. After doing this for a 3 /4 weeks try putting a ring on and have penetrative sex. We did this and  neither I or my wife thought about the size of my penis. Trust me you don't need a massive erection to have mutually satisfying sex/orgasms. We both started having orgasm like old times, even though we are not  young now. That was 12 years ago and we are still using pumps and vibrators. Less preoccupation about the size and more action will do the trick!

Edited by member 28 Aug 2023 at 22:01  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 29 Aug 2023 at 20:26

I commonly hear men told to hold off using the pump until 6 weeks after the op or 6 weeks after catheter out. It's really a question for your surgeon.


However, doing continuous dosing with Tadalafil from now (or even a couple of weeks before the op) is usually considered a good thing if you had nerve sparing. This is either 5mg daily low dose or 2 x 20mg/week. This is unlikely to enable erections so soon, but it improves blood flow in the area which improves nerve healing. The 2 x 20mg/week regime might enable you to start getting erections shortly after taking the doses earlier than you could without the medication.

Edited by member 29 Aug 2023 at 20:27  | Reason: Not specified

User
Posted 29 Aug 2023 at 20:57

No harm in asking for a prescription from your GP or the hospital. Your GP might only be prepared to give you the standard ED dose (20mg/week), not really understanding that's not the current purpose of it. Some might refuse to prescribe Tadalafil at all and prescribe Sildenafil (Viagra) instead, but that doesn't work for nerve healing because it can't achieve continuous dosing (well not unless they prescribe it 3x per day) because it's so short acting.


If your surgeon tells the GP t prescribe it, the chance is better of getting the right thing, although not even that is always successful as some areas seem to have a blanket ban on prescribing Tadalafil. If you want to buy it yourself, still ask your GP or hospital to write a private prescription so they're still verifying that there's no medical reason you can't take it and it's recorded on your medical record. (There has been some talk of making one brand of Tadalafil available without prescription in the UK, but that hasn't happened yet as far as I know.)

User
Posted 27 Aug 2023 at 13:59

Well your penis is about twice as long as it looks, at least that's what I tell the ladies. About half of it sticks out the front of your body and the other half is inside your body. The prostate surrounds some of you penis (about an inch), when they chop the prostate out they also chop out this amount of penis, and then stitch it all back together. I don't know if some surgical techniques can preserve a bit more or less of the length. 


 

Dave

User
Posted 27 Aug 2023 at 14:39

Although shrinkage is inevitable, from my personal experience a lot of problem is about perception and how it looks just after the surgery. Nobody will or can tell you about your situation, it is a question of wait and see what happens. I started using the SOMAerect  pump as soon as I could and quite surprisingly after a few months neither I or my wife noticed any difference. I has prostatectomy 12 years ago and we still use a pump to create an erection. Just relax about it, masturbate (don't need an erection for that) massage it (better still get your wife to do it!), use a pump everyday and gradually you will find that your penis will be long and wide enough to do its job. Neither a man or his wife/partner requires a large penis to achieve orgasms; having and giving orgasms is more to do with the technique rather than the size. 

Edited by member 28 Aug 2023 at 11:46  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 27 Aug 2023 at 16:40

A pump a day keeps the shrinkage at bay!😊

User
Posted 27 Aug 2023 at 18:46

I think you have to wait for a few weeks, not sure though as I didn’t have RP. I’ve had HT and RT and will have 3 years at least of what you are encountering, and I also developed Peyronie’s disease as a result of the treatment and lack of use. I’ve found the pump really helps to keep things working and am also on a low dose of daily Tidalafil and Vitamin E.


As Pratap says it’s not size that really matters anyway and what I’ve found is that technique HAS to change. I have zero Libido but when touched in the right places still get immense pleasure which can to dry orgasm. Likewise I have ways of pleasuring my partner without Penetration, which is not possible at the moment because of the Peyronie’s, which has now started to improve thanks to the pump.


No it’s not the same, but my point is you can still have a lot of fun and pleasure, you just have to adapt the way you do things😊. Hopefully for you things will get back to more normal as you recover…as for me, well I’ll have to wait another 2 - 3 years before I get my libido back, but hopefully my cancer is cured so I can live with that.


As my Pharmacist said time when handing over another pack of sildenafil “All the best!”🀣🀣


Derek

User
Posted 27 Aug 2023 at 18:49

BTW,….there are pumps…..and there are pumps! I bought one from Lovehoney which was not nearly as good as the Somaerect, which you should be able to get on prescription. Don’t be fobbed off, you may have to fight for it but I think you are entitled to it.


Derek

User
Posted 27 Aug 2023 at 19:18

It's Tadalafil (Cialis) which is given before and after the op.
There's no evidence Sildenafil (Viagra) is of any benefit for improving blood flow, and it probably isn't because it's so short lived, whereas Tadalafil easily achieves continuous dosing with the 5mg daily low dose or 2 x 20mg/week. To achieve that with Sildenafil, you would need 3 x 20mg spaced out through the day (the 20mg dose is slow release, and not normally used for ED at all).


Sildenafil is sometimes given in this country for this too, but that's because some GP's won't prescribe Tadalafil, and falsely believe Sildenafil is equivalent, not understanding why it's been prescribed.

Edited by member 27 Aug 2023 at 19:21  | Reason: Not specified

User
Posted 27 Aug 2023 at 21:48

Hi Dry Guy,


Sorry that you've had to join this club...


Firstly, it's quite usual not to have any erectile function at such an early stage after your surgery.  If they didn't tell you this, they were remiss.


I had a prostatectomy in June '22 and still have erectile dysfunction, but you might recover more quickly.  It's 'pot luck', it seems.


I believe that it's usual practice to wait until after your first out-patient review with your Urologist (usually about 6 weeks after surgery?) before starting to use a pump.  Ask them to refer you for an NHS vacuum pump.  I had to be referred to the Erectile Dysfunction Clinic by the Urologist first, and it was they who then recommended my G.P. to prescribe the pump.  This delayed the provision of the pump by a few months, so, once you've seen the Urologist, I would suggest that you start using your cheap pump while you're waiting for the real one to arrive.  There is some suggestion that use of the pump within 3 months of surgery can reduce risk of permanent penis shrinkage.  It is recommended that you use the pump daily. 


As Andy 62 has said, you should also be asking for Cialis ('Tadalafil') tablets from your G.P. in order to ensure continuous arterial blood to the penis.


If you have a Kindle device, there is a good book called "Saving Your Sex Life- A Guide for Men with Prostate Cancer" by Dr. John Mulhall.  ( The print version is extremely expensive, I believe).  He goes into a lot of detail about all manner of things, some of which will not be relevant to your situation.  It is also written from an American point of view, so private health insurance is assumed.  But he covers all the important stuff, such as erectile dysfunction, urinary incontinence, penile length, vacuum pumps, injections (such as Alprostadil) and Cialis.  It was written about 8 years ago, so the science may have moved on a bit since then, but I think you might find some good information there.


Best wishes going forward.


Jed See.

User
Posted 27 Aug 2023 at 23:04

Thanks Jed See, I'll have a look for the book, information is king, I know little as I suppose we all did just 4 weeks in. Been a unbelievable whirlwind with my health and my good Mrs.


I've got first appointment on Sept 19th with consultant at Blackburn which is 8 week after opp, so I'll mention everything there. Hope my Psa is 0


Think I'm impatient, want things to get right yesterday like they were. I overdo things. .. rush when I shouldnt


Hope things get right for you quickly


Thanks Stephen πŸ‘πŸ‘

User
Posted 27 Aug 2023 at 23:30
Way to early to be pumping or thinking about erections. Discuss it at your appointment.

I used a pump too soon, the blood that resulted stopped me using one for another 6 months!
User
Posted 28 Aug 2023 at 21:17
Dry Guy, although other opinions can be found around the internet, my view is that the smaller size of your flaccid penis is related to the fact that you are not yet recovering erections.

There is no reason why removing a bit of urethra inside the pelvis (the bit contained within the now removed prostate) should affect the urethra and surrounding penis on the outside - including the bit Dave64 mentions that isn't poking externally, it is still on the outside of the pelvic floor.

All of us men have experienced (and female forumites may have observed) that the flaccid penis length is not constant. In particular everyone's penis shrinks in response to vigorous exercise or cold. That is caused by changes in the amount of blood in the erectile tissues, just that the increase to a "normal" flaccid penis needs much less blood flow than a full erection. However the shock to the nerves caused by a prostate operation (even if nerve sparing) means it takes quite a long time for normal control of blood flow to resume. As others have said, the only things you can do to help are take tadalafil and use a pump - and wait.
User
Posted 29 Aug 2023 at 06:18

Thank you both for your replies,


As I've not had a erection or anything like one yet, think I've noticed the size & weight when having a pee & weight change like you state because there's no blood flowing like as before.


I shouldn't look at the negatives look at the positive that I'm still here & hopefully cancer free!


I thought that if he had nerve spared that I would get a erection or semi after, but nothing? I'm just worried & rushing.


I'll stop rushing things, it's a trait I always do run before I can walk. I'll wait till I see the consultant, hopefully I'll will have healed by then too.


Thanks Stephen πŸ‘πŸ‘


 


 


 

User
Posted 29 Aug 2023 at 12:40

Hi DG
Even if you had nerve sparing then it's highly likely that the nerves were, for want of a better word, 'bruised' by the procedure and will take time to recover - it could take 6 months to a year to get a natural erection back.
Masturbation with a floppy willy is very achievable and I have to say, in my case, I enjoy it a lot more without all that mess - my wife enjoys oral now as regardless of what the porn industry would have you believe, most of them prefer you not to ejaculate in their mouths.
I think I started with the VED about 8 weeks after the op taking it gently - I lost about 2cm in length after the op and seem to have recovered half of that but the VED has increased the girth beyond what I had before. Of course when using the VED before intercourse, you have some control over the size that you present to your wife.


As others have said - be patient, it will take time and those nerves just went 8 rounds with Mike Tyson!

Edited by member 29 Aug 2023 at 12:40  | Reason: Not specified

User
Posted 29 Aug 2023 at 12:52

After 2 weeks on Tadalafil, as suggested by the ED nurse I took  a 100 mg sildenafil. The only difference I noticed was that it gave me a headache! I didn’t see any difference in my erection, which is reasonable although because of the Peyronie’s I can’t have penetration….still can have fun thoughπŸ˜‰πŸ˜‰


one thing I have noticed though is my foreskin is VERY tight, it’s always been quite tight but now with an erection it really doesn’t retract at all. Anyone else on the RT/HT route noticed this?

User
Posted 29 Aug 2023 at 13:20

A similar question (although specifically mentioning lichen sclerosis) came up in the facebook group just recently, which I responded thus...


There do seem to be some chains of events which prostate cancer patients should be aware of...


Treatments often result in loss of erections.
Some treatments and/or loss of erections leads on to penile shortening.
Loss of erections does sometimes seem to lead on to phimosis.
Penile shortening and/or pubic fat growth can cause "buried penis", making standing to pee impractical.
Phimosis or buried penis leads on to inflammation because cleaning becomes impossible.
Inflammation and/or constant urine contact due to incontinence may cause lichen sclerosis (I don't think this is fully understood).
Lichen sclerosis is a known cause of penile cancer (although I haven't come across a case starting from prostate cancer treatments).


I think it's important men keep their penises working properly, even if they have no interest in erections or sex. They probably still want to be able to stand to pee, and to keep themselves clean and inflammation/infection free. That probably means any man who isn't getting regular spontaneous erections should be regularly using a pump for penile physio, again regardless if you are interested in erections or sex.


If you do have phimosis, simply stretching things can make it worse by causing micro-scarring and more fibrosis, so you will need to get that sorted by going to see your GP or urologist before you start using a pump. Steroid creams sometimes help, but if that fix doesn't persist when you stop them, circumcision might be required. (I don't think you can simply stay on steroids forever without getting other problems.)

User
Posted 29 Aug 2023 at 20:57
Following up to Decho. Where I am the advice about a pump and tadalfil (including the prescriptions for getting them) only came at a follow-up appointment with the PC nurse a couple of months after the operation. The first few times using the pump my glans and foreskin were VERY tight, to the extent I had to limit the vacuum or it hurt. However over time things improved.
User
Posted 29 Aug 2023 at 21:48

https://www.boots.com/cialis-together-tadalafil-10mg-tablets-4-tablets-10329996


£17 for 4


I'll buy some just for the future improvement then hopefully I'll get a prescription.


Thanks Stephen πŸ‘πŸ‘

User
Posted 29 Aug 2023 at 22:12

That's a ridiculous price for 4 half dose tablets.

User
Posted 30 Aug 2023 at 19:09

Hi Dry Guy,


I agree with Andy62 that £17 for four tablets (which are only half the usual dose) seems very expensive.  Have you tried other online chemists or providers?


Best wishes,


JedSee.

User
Posted 30 Aug 2023 at 19:27

It may be expensive, but hopefully this is a one off until you get a prescription (free for cancer patients).

Dave

User
Posted 30 Aug 2023 at 20:17

You are obviously in the UK so the NHS prescribed pump is as goos as it gets. I am quite happy to exchange private messages with you, if it helps. By nature I am modest but if there is something I know a lot about is VEDs. since our intimate life for the past 12 years has been maintained by VEDs. Cheap pumps from sex shops are ok for practice and fun but otherwise they are useless! Good luck. By the way I have posted a survey of popular pumps with my recommendations for best buys on this side. You can access it if you follow this link:


https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life


 


 


 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 30 Aug 2023 at 21:14

Originally Posted by: Online Community Member


Looked at Pharmacy2u?? £10 for 4 of 20mg which seem cheap but they need a prescription?? 


If I had a prescription I'd get them from doctors???   Probably for people who uses more than they can get prescribed?


There are two types of prescription private or NHS.


When you buy online you don't need a prescription before you go on the website, and you will have a private prescription by the time you leave the website.


You decide what you want, you add it to your cart. You will then have to answer a few medical questions. A doctor employed by the online pharmacy reviews your answers and then issues a prescription, if he thinks appropriate, they then charge your credit card and send the drugs.


I would be happy to buy meds online from a UK based website.

Dave

User
Posted 30 Aug 2023 at 22:36

I would use any UK pharmacy. The site will somewhere have a logo with a green cross and a number (about 8 digits on it) and the words "Registered pharmacy" if you click the logo it will take you to this website https://www.pharmacyregulation.org/


Check all the details such as web address, registered address all match. Between the two sites. I'm sure fraud and fakes could still happen, but I think you will be ok.

Dave

User
Posted 11 Sep 2023 at 16:45
Menschem.co.uk
I have used for over a year and are very good. Next day delivery via Royal Mail.


I also have seen people on here suggest splitting tablets. Tadalafil are not designed to be split and you cannot accurately predict the strength of the resulting 2 halves of tablets.
User
Posted 12 Sep 2023 at 09:04

I actually take the 20 mg tabs every other day, Tadalafil lasts for up to 36 hrs so in theory you get 2 nights out of each tab. Also, that menschem  pharmacy sends out an email each month offering 15% discount once you have placed your first order.


People have experienced strong side effects taking this dose. Either I've been lucky or my body has adapted, as I am fine. I have an hiatus hernia and scarring and have done for years, but suffer no adverse side effects from tadalafil.

Show Most Thanked Posts
User
Posted 27 Aug 2023 at 13:59

Well your penis is about twice as long as it looks, at least that's what I tell the ladies. About half of it sticks out the front of your body and the other half is inside your body. The prostate surrounds some of you penis (about an inch), when they chop the prostate out they also chop out this amount of penis, and then stitch it all back together. I don't know if some surgical techniques can preserve a bit more or less of the length. 


 

Dave

User
Posted 27 Aug 2023 at 14:39

Although shrinkage is inevitable, from my personal experience a lot of problem is about perception and how it looks just after the surgery. Nobody will or can tell you about your situation, it is a question of wait and see what happens. I started using the SOMAerect  pump as soon as I could and quite surprisingly after a few months neither I or my wife noticed any difference. I has prostatectomy 12 years ago and we still use a pump to create an erection. Just relax about it, masturbate (don't need an erection for that) massage it (better still get your wife to do it!), use a pump everyday and gradually you will find that your penis will be long and wide enough to do its job. Neither a man or his wife/partner requires a large penis to achieve orgasms; having and giving orgasms is more to do with the technique rather than the size. 

Edited by member 28 Aug 2023 at 11:46  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 27 Aug 2023 at 16:40

A pump a day keeps the shrinkage at bay!😊

User
Posted 27 Aug 2023 at 17:02

I bought a pump last week as I read they helped with the shrinkage & getting blood back in it.


Not used it yet as it's only just over 4 weeks since operation. Not sure when it's safe to do so?


Although I'm chuffed my cancer is gone ( hopefully) I'm a tad depressed about not having jizz, lesser orgasms & now smaller todge.... Still early days for me as the last 3 months have been a whirlwind of emotions. All with living with a hellish autoimmune disease called fibromyalgia.


Cheers πŸ‘πŸ‘


 

User
Posted 27 Aug 2023 at 17:06

Just got one, not used yet as I'm still healing....hopefully soon.


Can't believe I need one at 53....still getting my head around things.


Thanks πŸ‘πŸ‘

User
Posted 27 Aug 2023 at 18:46

I think you have to wait for a few weeks, not sure though as I didn’t have RP. I’ve had HT and RT and will have 3 years at least of what you are encountering, and I also developed Peyronie’s disease as a result of the treatment and lack of use. I’ve found the pump really helps to keep things working and am also on a low dose of daily Tidalafil and Vitamin E.


As Pratap says it’s not size that really matters anyway and what I’ve found is that technique HAS to change. I have zero Libido but when touched in the right places still get immense pleasure which can to dry orgasm. Likewise I have ways of pleasuring my partner without Penetration, which is not possible at the moment because of the Peyronie’s, which has now started to improve thanks to the pump.


No it’s not the same, but my point is you can still have a lot of fun and pleasure, you just have to adapt the way you do things😊. Hopefully for you things will get back to more normal as you recover…as for me, well I’ll have to wait another 2 - 3 years before I get my libido back, but hopefully my cancer is cured so I can live with that.


As my Pharmacist said time when handing over another pack of sildenafil “All the best!”🀣🀣


Derek

User
Posted 27 Aug 2023 at 18:49

BTW,….there are pumps…..and there are pumps! I bought one from Lovehoney which was not nearly as good as the Somaerect, which you should be able to get on prescription. Don’t be fobbed off, you may have to fight for it but I think you are entitled to it.


Derek

User
Posted 27 Aug 2023 at 19:03
I did buy a cheap one, I'll stick my Dyson vac on it if it doesn't work 😬
I will go to the doctors, hopefully I'll get some pills & pump.

I've read they give Viagra to Americans before & after the opp to keep veins flowing. Sounds like a good idea to me.

If you were me when would you go to the doctors? It will be 5 weeks this Wednesday since prostatectomy.
Thanks Derek, bloody heck that sounds painful....hope heals quickly πŸ‘πŸ‘
User
Posted 27 Aug 2023 at 19:18

It's Tadalafil (Cialis) which is given before and after the op.
There's no evidence Sildenafil (Viagra) is of any benefit for improving blood flow, and it probably isn't because it's so short lived, whereas Tadalafil easily achieves continuous dosing with the 5mg daily low dose or 2 x 20mg/week. To achieve that with Sildenafil, you would need 3 x 20mg spaced out through the day (the 20mg dose is slow release, and not normally used for ED at all).


Sildenafil is sometimes given in this country for this too, but that's because some GP's won't prescribe Tadalafil, and falsely believe Sildenafil is equivalent, not understanding why it's been prescribed.

Edited by member 27 Aug 2023 at 19:21  | Reason: Not specified

User
Posted 27 Aug 2023 at 21:48

Hi Dry Guy,


Sorry that you've had to join this club...


Firstly, it's quite usual not to have any erectile function at such an early stage after your surgery.  If they didn't tell you this, they were remiss.


I had a prostatectomy in June '22 and still have erectile dysfunction, but you might recover more quickly.  It's 'pot luck', it seems.


I believe that it's usual practice to wait until after your first out-patient review with your Urologist (usually about 6 weeks after surgery?) before starting to use a pump.  Ask them to refer you for an NHS vacuum pump.  I had to be referred to the Erectile Dysfunction Clinic by the Urologist first, and it was they who then recommended my G.P. to prescribe the pump.  This delayed the provision of the pump by a few months, so, once you've seen the Urologist, I would suggest that you start using your cheap pump while you're waiting for the real one to arrive.  There is some suggestion that use of the pump within 3 months of surgery can reduce risk of permanent penis shrinkage.  It is recommended that you use the pump daily. 


As Andy 62 has said, you should also be asking for Cialis ('Tadalafil') tablets from your G.P. in order to ensure continuous arterial blood to the penis.


If you have a Kindle device, there is a good book called "Saving Your Sex Life- A Guide for Men with Prostate Cancer" by Dr. John Mulhall.  ( The print version is extremely expensive, I believe).  He goes into a lot of detail about all manner of things, some of which will not be relevant to your situation.  It is also written from an American point of view, so private health insurance is assumed.  But he covers all the important stuff, such as erectile dysfunction, urinary incontinence, penile length, vacuum pumps, injections (such as Alprostadil) and Cialis.  It was written about 8 years ago, so the science may have moved on a bit since then, but I think you might find some good information there.


Best wishes going forward.


Jed See.

User
Posted 27 Aug 2023 at 23:04

Thanks Jed See, I'll have a look for the book, information is king, I know little as I suppose we all did just 4 weeks in. Been a unbelievable whirlwind with my health and my good Mrs.


I've got first appointment on Sept 19th with consultant at Blackburn which is 8 week after opp, so I'll mention everything there. Hope my Psa is 0


Think I'm impatient, want things to get right yesterday like they were. I overdo things. .. rush when I shouldnt


Hope things get right for you quickly


Thanks Stephen πŸ‘πŸ‘

User
Posted 27 Aug 2023 at 23:30
Way to early to be pumping or thinking about erections. Discuss it at your appointment.

I used a pump too soon, the blood that resulted stopped me using one for another 6 months!
User
Posted 27 Aug 2023 at 23:53

Thanks for your reply, I'll not touch it, don't want to risk damaging something.


I had it in my head to start early so things wouldn't get as bad as it could do if blood didn't circulate.


Think I've read some duff info.


Thanks ste πŸ‘πŸ‘

Edited by member 28 Aug 2023 at 13:59  | Reason: Not specified

User
Posted 28 Aug 2023 at 14:52

Good luck with getting small doses of Tadalafil prescribed. My trust won't. Took a while for my very sympathetic GP to prescribe Viagra (for sexual purposes). Been referred to the sexual health clinic twice but not received an appointment yet. As you can see post operative rehabilitation is patchy across the NHS. 


Buying your own pump a good idea. I use mine daily. I understand that it can take up 2 years for things to get back to 'normal' if ever. I have seen small improvements over the last year.

User
Posted 28 Aug 2023 at 17:15

Thanks Jim for reply, oh no not another type of pill that I'm going to struggle with. 


I live in Burnley but have to travel to bury to get a painkiller & lidocaine plasters for fibromyalgia as East Lancashire won't prescribe because of the expense.


I just thought it wouldn't be a hassle at 53 to get them.....arrrgh!!


Thought the doc stated he would do a nerve sparring procedure....thought things would work.


See what happens


Thanks Jim πŸ‘πŸ‘

User
Posted 28 Aug 2023 at 21:17
Dry Guy, although other opinions can be found around the internet, my view is that the smaller size of your flaccid penis is related to the fact that you are not yet recovering erections.

There is no reason why removing a bit of urethra inside the pelvis (the bit contained within the now removed prostate) should affect the urethra and surrounding penis on the outside - including the bit Dave64 mentions that isn't poking externally, it is still on the outside of the pelvic floor.

All of us men have experienced (and female forumites may have observed) that the flaccid penis length is not constant. In particular everyone's penis shrinks in response to vigorous exercise or cold. That is caused by changes in the amount of blood in the erectile tissues, just that the increase to a "normal" flaccid penis needs much less blood flow than a full erection. However the shock to the nerves caused by a prostate operation (even if nerve sparing) means it takes quite a long time for normal control of blood flow to resume. As others have said, the only things you can do to help are take tadalafil and use a pump - and wait.
User
Posted 28 Aug 2023 at 22:00

At the risk of repeating myself, my advice is to start using a pump, massage your penis and scrotum (it is fun if your wife massages your penis and scrotum while you use a vibrator on her, win win!) once you think you have recovered sufficiently. After doing this for a 3 /4 weeks try putting a ring on and have penetrative sex. We did this and  neither I or my wife thought about the size of my penis. Trust me you don't need a massive erection to have mutually satisfying sex/orgasms. We both started having orgasm like old times, even though we are not  young now. That was 12 years ago and we are still using pumps and vibrators. Less preoccupation about the size and more action will do the trick!

Edited by member 28 Aug 2023 at 22:01  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 29 Aug 2023 at 06:18

Thank you both for your replies,


As I've not had a erection or anything like one yet, think I've noticed the size & weight when having a pee & weight change like you state because there's no blood flowing like as before.


I shouldn't look at the negatives look at the positive that I'm still here & hopefully cancer free!


I thought that if he had nerve spared that I would get a erection or semi after, but nothing? I'm just worried & rushing.


I'll stop rushing things, it's a trait I always do run before I can walk. I'll wait till I see the consultant, hopefully I'll will have healed by then too.


Thanks Stephen πŸ‘πŸ‘


 


 


 

User
Posted 29 Aug 2023 at 12:40

Hi DG
Even if you had nerve sparing then it's highly likely that the nerves were, for want of a better word, 'bruised' by the procedure and will take time to recover - it could take 6 months to a year to get a natural erection back.
Masturbation with a floppy willy is very achievable and I have to say, in my case, I enjoy it a lot more without all that mess - my wife enjoys oral now as regardless of what the porn industry would have you believe, most of them prefer you not to ejaculate in their mouths.
I think I started with the VED about 8 weeks after the op taking it gently - I lost about 2cm in length after the op and seem to have recovered half of that but the VED has increased the girth beyond what I had before. Of course when using the VED before intercourse, you have some control over the size that you present to your wife.


As others have said - be patient, it will take time and those nerves just went 8 rounds with Mike Tyson!

Edited by member 29 Aug 2023 at 12:40  | Reason: Not specified

User
Posted 29 Aug 2023 at 12:52

After 2 weeks on Tadalafil, as suggested by the ED nurse I took  a 100 mg sildenafil. The only difference I noticed was that it gave me a headache! I didn’t see any difference in my erection, which is reasonable although because of the Peyronie’s I can’t have penetration….still can have fun thoughπŸ˜‰πŸ˜‰


one thing I have noticed though is my foreskin is VERY tight, it’s always been quite tight but now with an erection it really doesn’t retract at all. Anyone else on the RT/HT route noticed this?

User
Posted 29 Aug 2023 at 13:20

A similar question (although specifically mentioning lichen sclerosis) came up in the facebook group just recently, which I responded thus...


There do seem to be some chains of events which prostate cancer patients should be aware of...


Treatments often result in loss of erections.
Some treatments and/or loss of erections leads on to penile shortening.
Loss of erections does sometimes seem to lead on to phimosis.
Penile shortening and/or pubic fat growth can cause "buried penis", making standing to pee impractical.
Phimosis or buried penis leads on to inflammation because cleaning becomes impossible.
Inflammation and/or constant urine contact due to incontinence may cause lichen sclerosis (I don't think this is fully understood).
Lichen sclerosis is a known cause of penile cancer (although I haven't come across a case starting from prostate cancer treatments).


I think it's important men keep their penises working properly, even if they have no interest in erections or sex. They probably still want to be able to stand to pee, and to keep themselves clean and inflammation/infection free. That probably means any man who isn't getting regular spontaneous erections should be regularly using a pump for penile physio, again regardless if you are interested in erections or sex.


If you do have phimosis, simply stretching things can make it worse by causing micro-scarring and more fibrosis, so you will need to get that sorted by going to see your GP or urologist before you start using a pump. Steroid creams sometimes help, but if that fix doesn't persist when you stop them, circumcision might be required. (I don't think you can simply stay on steroids forever without getting other problems.)

User
Posted 29 Aug 2023 at 20:11

Thanks everyone for your replies, wow it's a lot to take in, I'm keeping myself clean, sometimes taking 3 showers....coughing is my nemesis!


I'm mainly dry....which I'm taking some confidence. Been sleeping pad-less for the last 2 weeks which is only 2 weeks post opp.


I'm still not sure when to use pump as I've read a week after catheter removal is safe??? 


Think I need to buy a quality one as my eBay special might not cut mustard...they seem to be very integral part of getting the norm back.


Thank you so much everyone who has commented, I appreciate your help and time.


Stephen


πŸ‘πŸ‘

Edited by member 04 Jan 2024 at 09:34  | Reason: Not specified

User
Posted 29 Aug 2023 at 20:26

I commonly hear men told to hold off using the pump until 6 weeks after the op or 6 weeks after catheter out. It's really a question for your surgeon.


However, doing continuous dosing with Tadalafil from now (or even a couple of weeks before the op) is usually considered a good thing if you had nerve sparing. This is either 5mg daily low dose or 2 x 20mg/week. This is unlikely to enable erections so soon, but it improves blood flow in the area which improves nerve healing. The 2 x 20mg/week regime might enable you to start getting erections shortly after taking the doses earlier than you could without the medication.

Edited by member 29 Aug 2023 at 20:27  | Reason: Not specified

User
Posted 29 Aug 2023 at 20:41

 


Thanks Andy for reply


Do you think I should buy some Cialis? Or go to the doctors to try and get prescription which will be before my consultant psa opp?


 

User
Posted 29 Aug 2023 at 20:57
Following up to Decho. Where I am the advice about a pump and tadalfil (including the prescriptions for getting them) only came at a follow-up appointment with the PC nurse a couple of months after the operation. The first few times using the pump my glans and foreskin were VERY tight, to the extent I had to limit the vacuum or it hurt. However over time things improved.
User
Posted 29 Aug 2023 at 20:57

No harm in asking for a prescription from your GP or the hospital. Your GP might only be prepared to give you the standard ED dose (20mg/week), not really understanding that's not the current purpose of it. Some might refuse to prescribe Tadalafil at all and prescribe Sildenafil (Viagra) instead, but that doesn't work for nerve healing because it can't achieve continuous dosing (well not unless they prescribe it 3x per day) because it's so short acting.


If your surgeon tells the GP t prescribe it, the chance is better of getting the right thing, although not even that is always successful as some areas seem to have a blanket ban on prescribing Tadalafil. If you want to buy it yourself, still ask your GP or hospital to write a private prescription so they're still verifying that there's no medical reason you can't take it and it's recorded on your medical record. (There has been some talk of making one brand of Tadalafil available without prescription in the UK, but that hasn't happened yet as far as I know.)

User
Posted 29 Aug 2023 at 21:48

https://www.boots.com/cialis-together-tadalafil-10mg-tablets-4-tablets-10329996


£17 for 4


I'll buy some just for the future improvement then hopefully I'll get a prescription.


Thanks Stephen πŸ‘πŸ‘

User
Posted 29 Aug 2023 at 22:12

That's a ridiculous price for 4 half dose tablets.

User
Posted 30 Aug 2023 at 19:09

Hi Dry Guy,


I agree with Andy62 that £17 for four tablets (which are only half the usual dose) seems very expensive.  Have you tried other online chemists or providers?


Best wishes,


JedSee.

User
Posted 30 Aug 2023 at 19:27

It may be expensive, but hopefully this is a one off until you get a prescription (free for cancer patients).

Dave

User
Posted 30 Aug 2023 at 19:36

Hey JeeSee


No, never bought any from anywhere. I weren't too sure if some of the cheaper ones were fakes of scam websites.


Looked at Pharmacy2u?? £10 for 4 of 20mg which seem cheap but they need a prescription?? 


If I had a prescription I'd get them from doctors???   Probably for people who uses more than they can get prescribed?


It's a minefield what to do, I just want to do what's right to get future erections and to stop winky shrinkage. But been advised by one of the gents not to use a pump yet as it's 5 week today since opp.


Thanks for much needed advice


Stephen πŸ‘πŸ‘ 


 

Edited by member 30 Aug 2023 at 19:43  | Reason: Not specified

User
Posted 30 Aug 2023 at 20:17

You are obviously in the UK so the NHS prescribed pump is as goos as it gets. I am quite happy to exchange private messages with you, if it helps. By nature I am modest but if there is something I know a lot about is VEDs. since our intimate life for the past 12 years has been maintained by VEDs. Cheap pumps from sex shops are ok for practice and fun but otherwise they are useless! Good luck. By the way I have posted a survey of popular pumps with my recommendations for best buys on this side. You can access it if you follow this link:


https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life


 


 


 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate


 


 

User
Posted 30 Aug 2023 at 21:10

A quick google search just turned up 20mg Tadalafil for £2.12 down to £1.40 per tablet depending on qty.
The 5mg daily low dose around £1 per tablet (more for low numbers, less for high numbers). These are from a UK online pharmacy. They'll also write you a private prescription for a few pounds if you don't have one.


If you find much cheaper than that, they're probably produced in India and not EU/UK certified, and maybe not manufactured and tested to the standards they would be if EU/UK certified. There are fakes around too.


If you want branded Cialis, it will be several times the price.


Like I said, if you can't get them on the NHS in your area, at least ask for a private prescription from your GP to start with, so your GP is certifying you're OK taking them, and it's recorded on your medical notes, in case anything happens as a result.

Edited by member 30 Aug 2023 at 21:11  | Reason: Not specified

User
Posted 30 Aug 2023 at 21:14

Originally Posted by: Online Community Member


Looked at Pharmacy2u?? £10 for 4 of 20mg which seem cheap but they need a prescription?? 


If I had a prescription I'd get them from doctors???   Probably for people who uses more than they can get prescribed?


There are two types of prescription private or NHS.


When you buy online you don't need a prescription before you go on the website, and you will have a private prescription by the time you leave the website.


You decide what you want, you add it to your cart. You will then have to answer a few medical questions. A doctor employed by the online pharmacy reviews your answers and then issues a prescription, if he thinks appropriate, they then charge your credit card and send the drugs.


I would be happy to buy meds online from a UK based website.

Dave

User
Posted 30 Aug 2023 at 22:07

Thanks Andy, Dave & Pratap for your time & ongoing help.


Which website should I use? Any recommendations?


Thanks in advance


StephenπŸ‘πŸ‘

User
Posted 30 Aug 2023 at 22:36

I would use any UK pharmacy. The site will somewhere have a logo with a green cross and a number (about 8 digits on it) and the words "Registered pharmacy" if you click the logo it will take you to this website https://www.pharmacyregulation.org/


Check all the details such as web address, registered address all match. Between the two sites. I'm sure fraud and fakes could still happen, but I think you will be ok.

Dave

User
Posted 30 Aug 2023 at 22:55

Thanks Dave, you're the man! I'll have a butcher's


πŸ‘πŸ‘

User
Posted 11 Sep 2023 at 16:45
Menschem.co.uk
I have used for over a year and are very good. Next day delivery via Royal Mail.


I also have seen people on here suggest splitting tablets. Tadalafil are not designed to be split and you cannot accurately predict the strength of the resulting 2 halves of tablets.
User
Posted 11 Sep 2023 at 18:12

Thanks Speedster, I'll have a look as I need some daily ones as I just got 20mg.


Actually might wait as I see my consultant next week, he may send me to see a Stiffy quack.


I won't split them as previous gents said they give bad indigestion.


Thanks again mateπŸ‘πŸ‘

Edited by member 11 Sep 2023 at 18:54  | Reason: Not specified

User
Posted 12 Sep 2023 at 09:04

I actually take the 20 mg tabs every other day, Tadalafil lasts for up to 36 hrs so in theory you get 2 nights out of each tab. Also, that menschem  pharmacy sends out an email each month offering 15% discount once you have placed your first order.


People have experienced strong side effects taking this dose. Either I've been lucky or my body has adapted, as I am fine. I have an hiatus hernia and scarring and have done for years, but suffer no adverse side effects from tadalafil.

 
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