Pump usage post prostatectomy? lost size?

I suspect that they are representing the position of the NHS Trust. When I first joined here, it was standard all around the country that men could have a pump after RP but more and more Trusts have withdrawn it in recent years - some are honest and say they can't afford it while others hide behind the 'lack of evidence' thing. However, there are still plenty of areas of England & Wales where the NHS funds a pump for any man who needs it (prostate cancer, diabetes, heart disease, spinal injury to name a few). 

I don't think there is any doubt in the urology world that the pump helps to keep penile tissue healthy and prevents atrophy. What is lacking is any hard evidence that using the pump will help a man to recover natural erections.  

I am a relatively young patient  and almost a year ago I had an operation which involved removing my bladder and prostate with no nerves spared. I have 0 erections at this point and am getting heavily depressed. I also have other issues in my life and am not doing well at all here. I am not suicidal but am getting increasingly desperate and terribly sad with my situation. Being without a partner and no prospects of ever having one doesn't help at all either. I am also heavily sexually frustrated.

To get to the point, I attended my andrology clinic 3 months ago where I was told that there is no good evidence to indicate the use of a pump and hence he never prescribed one for me. He said there is no need to use one at all. I got a pump for myself regardless and I just recently starting pumping however I want to ask you here what are your thoughts of my andrologists position?

In addition, I noticed that after my surgery my flaccid penis size looked quite the same and I was quite reassured in myself however after 4-5 months the flaccid state rather suddenly shrunk. Now when its a bit cold outside (10c) my dick virtually disappears!. I got shocked. I have to push against my pubic skin to actually find it. I was never like that pre-surgery. When I am home and sat down the muscles seem to relax and my penis comes out again to a more or less normal flaccid length. I do know that with cold your penis shrinks but this level of shrinkage is new to me. For some reason when I am sat down for some time the penis does come out again. Is all this the result of my surgery? is it because I haven't had erections for a while so the pelvic muscles when I stand get quite tight and relaxed when I sit down?  If I get dressed and go out my penis will quickly shrink a lot before I get the chance to expose myself to the cold.  I just do not get it. 

I am soon to try injections for the first time so am not sure what is my erect length at this point and whether the flaccid length is a good indicator or not. Inside the pump I manage to pass 5 inches before feeling uncomfortable. Pre surgery my pubic bone pressed length was 6 inches. I have just started using a pump regularly and am reading reports from various people that after pump usage they were able to gain back some lost length. Is there any truth to this? How did you measure before and after surgery? are you sure of your pump gains? How much  you lost had how much you gained back?

Lastly, for those without any nerves, who get 0 natural erections, is there a way for the glans to swell? (without using a pump). what about with injections? Do your glans flare up at all when you inject or do they remain as flaccid as they were before the injection? Thus far what I read is with injections the glans do not swell and those reports that say they do is probably because they still have nerves in place and they don't know it.

Any contributions welcome! I am panicking here that I will also lose my penis. It is not enough I lost my erections now I can't even self pleasure myself properly.  

Thanks I thought it would be the SomaErect Response. That is the one I was prescribed as well. However, I purchased the Vaccurect device before and had abandoned it (as I could not get to work). It is all I use now. 

Have I gained the length and girth back? My natural erection size is pitiful compared to what it once was, however the pumped up version is close enough to its former glory! I don't know if the pumped up erection length is a realistic indication  or just artificial.

Thanks Pratap, that’s an interesting read, it implies having good blood flow helps to keep the length. I had nerve sparing 6 months ago and get some erections, although not like before. I use the pump for sex but not rehab daily. I am currently taking Tadaladil daily for blood flow. I wonder if it would be good to take indefinitely to keep the  blood flow going, I read somewhere that 12 months is enough for the daily medication, although recovery can take up to 2 years.

https://pubmed.ncbi.nlm.nih.gov/23102441/

Shows that on average, a man, who's done no penile rehabilitation, after a prostatectomy, loses 10mm length.

Because I've got lots of time on my hands I've done a lot of research on the effects on the penis after prostatectomy. After 67 years, I've become rather attached to mine.

It seems, considering it's so important to men, that there has been very little research in the subject. 

The rehabilitation efficacy of pumps is rather inconclusive. I could put links to this but can't really be *rsed. 

Most research suggests that after a couple of years the average man will regain most of his penile length.

If I lose half an inch,  I can live with with that 5% reduction. 😁

Edited by member 19 Feb 2024 at 10:30  | Reason: Not specified

Hi Jimmy

The information about whether a vacuum pump can re-establish the length off a penis to something like it was before prostatectomy is not available. However a urethra is a flexible/extendable part of the urinary system so it is obvious that if you use a pump regularly over a few months your penis will regain at least some of the apparent loss of length. Here is my experience: I started using the NHS prescribed Somaerect about 8 weeks after my surgery; it was a messy business because I was still leaking urine! After further 4/5 weeks of practice I was able to inflate my penis up to about half way up the vacuum cylinder (4 inches) and we were able to have penetrative sex, showing that both you and wife/partner can experience orgasm even with a relatively quite short penis! Gradually over the next 4/5 months I was able to inflate my penis to about 2 inches (2/3 finger width) short of the top of the cylinder. I have just measured the length of the vacuum cylinder which is just under 8 inches. So I am able to achieve an erection about 5.5/6 inches long, which appears to be the average size of an erect penis; I always knew that I am an average sort of guy!

I love the touchy subject videos and info, Victoria has such a lovely way of describing things.

Thanks Chris