Penile Shortening After Prostate Surgery: Causes, Management, and Staying Optimistic
Prostate cancer surgery, such as radical prostatectomy, is a common and often life-saving treatment for localized prostate cancer. While it effectively removes cancer, it can also have side effects that impact quality of life.
One lesser-known but significant side effect is penile shortening. And needless to say, this can have serious effects on both physical and emotional well-being.
So let’s take a moment to unpack this sensitive subject—and talk a little bit about why it occurs, how you can minimize or reverse it, and most importantly, how to stay positive and optimistic in spite of it.
Why Does Penile Shortening Happen?
Penile shortening after radical prostatectomy is a complex phenomenon caused by several factors:
-
Changes in Pelvic Anatomy
The prostate supports the base of the penis. After its removal, the penis can retract toward the pelvis, resulting in a shorter appearance. -
Nerve and Blood Vessel Disruption
Even with nerve-sparing techniques, surgery can damage the cavernous nerves and blood vessels, reducing blood flow. This leads to tissue atrophy and a loss of elasticity. -
Fibrosis and Scarring
Scar tissue may develop, especially in the absence of regular erections, causing the penile tissue to contract. -
Disuse Atrophy
A lack of erections after surgery can cause the penile tissues to shrink over time, contributing to length loss.
Studies show that penile shortening is relatively common: Most shortening occurs within the first 3 to 6 months after surgery, and on average, men may lose 0.5 to 1.5 cm in stretched penile length. But some recovery may occur within 12 to 24 months if appropriate measures are taken.
The good news is that penile shortening doesn’t always happen, and even when it does, there are effective strategies to address it.
How to Mitigate or Reverse Penile Shortening
The first important strategy is penile rehabilitation by increasing blood flow to the pelvic area.
A diet rich in nitrates, L-arginine, citrulline, and flavonoids (from foods like beets, berries, and dark chocolate) promotes NO production and supports blood flow. But PDE5 inhibitors like sildenafil (Viagra) or tadalafil (Cialis) also improve blood flow and prevent tissue atrophy.
The same goes for natural supplements that include ingredients such as fenugreek and L-Citrulline, which promote nitric oxide production and therefore promote circulation to the pelvic area. (Our very own XYVGGR features both of these key ingredients.)
Vacuum Erection Devices (VEDs)—which increase blood flow, reduce fibrosis, and maintain length with regular use—are another effective tool for penile rehabilitation.
Penile Traction Therapy (PTT) is also an option. This strategy involves mechanical devices that gently stretch the penis over time, promoting tissue expansion. And studies show that consistent use of these devices can restore some lost length.
Improve Mindset Around Sexuality
Penile shortening is not just a physical concern—it can also impact self-esteem, body image, and emotional well-being. That’s why adjusting your mindset is so crucial for overall recovery.
Focus on Recovery, Not Loss: Understanding that penile shortening is often temporary and manageable can help you approach the situation with a proactive mindset.
Redefine Intimacy: Sexual intimacy isn’t limited to penetration. Explore other ways to connect with your partner, such as sensual touch, mutual stimulation, and open communication about needs and desires.
Seek Support: Talking with a therapist, support group, or sexual health counselor can help address emotional concerns and foster a sense of empowerment.
Remember: The body is resilient. With creativity, patience, and the right support, it is possible to navigate these changes and continue building a satisfying and meaningful intimate life.
Much Love,
Dr. Geo Espinosa