From Michael Dorso, M.D.
A DOCTOR OFFERS HIS PERSPECTIVE ON PENILE SHRINKAGE
[After my question to the lists, Dr. Michael Dorso offered his view.]
This is an interesting question. I chose to answer you privately because I've seen at least one opinion posted, and I didn't want to be in the position of contradicting anyone. Also, it's easier to discuss personal, intimate observations privately.
The size of a man's penis at rest reflects a balance between the elastic fibers in the penis and its state of engorgement with blood. Normally there is a steady state of tone of the arterial and venous muscles controlling blood flow in and out of the penis. Typically there is some minimal engorgement of the corpora cavernosa (erectile bodies) throughout the day.
This is all mediated by the nerves running through the prostate gland.
Damage those nerves and that tone is gone. The elastic fibers are unopposed, and the penis shrinks to its minimal size. I was in that position temporarily as a result of my radiation and hormonal therapy. It was pretty startling to look in a mirror and see my shrunken penis.
If this is all that is going on, a vacuum pump should be able to get the erect penis to full size - which in my case was truly reassuring. If left unopposed, he elastic fibers will keep the penis shrunken, and eventually loose some of their ability to stretch fully. At that point a man's penis will not obtain former size regardless of the source of erection. The old adage, "use it or lose it" is in full operation here.
The advice here is to keep exercising the penis - be it with a VED, pills, suppositories, or injections - especially if you are hoping for the injured nerves to recover. Even if you aren't, who wants to watch his penis shrink?
I personally have noticed that Viagra will increase the vascular tone in my penis for about twelve hours - looking in the mirror is much more satisfying as I swagger to the shower with vitamin V on board.
Many of us are on hormonal suppression therapy as well - with it's loss of testosterone support to the tissues of the penis. It's hard to factor that in, but it's real.
Finally I ask you to think about the surgery itself. The prostate urethra is cut away. About an inch and a half is missing! The surgeon solves that problem by pulling down on the urethra projection from the bladder, and pulling UP on the urethra as it rises into the pelvis from the penis. He then sews them together around a catheter. I can't imagine that makes the penis feel or look any longer!
BTW Phoenix5 is becoming quite a resource. Congratulations.
All The Best,
[I told him I was going to build a page on the topic and asked if I could use his letter. This is his reply.]
You're welcome to use any part of that letter that you wish. I need to point out that this is just conjecture on my part.
I doubt that anyone has done much investigation on penile size post RRP.
The [journal abstract] you sent was certainly interesting. The authors as much as said they too were guessing what was going on here.
Michael Dorso MD
[Dr. Dorso is the author of Seeds Of Hope; A Physician's Personal Triumph Over Prostate Cancer, which is published by Acorn Publishing at
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