Prostate Removal May Cause Penile Shortening

Medically Reviewed

If you’ve had your prostate surgically removed recently, don’t be too concerned if your penis appears to be nearly an inch shorter. A new study suggests that it will be back to its regular size a year from now.

Researchers in Japan reported that men who underwent prostate removal had a reduction in overall penile length 10 days later. The authors stated that this occurred because the urethra, the tubular passageway for urine and semen that runs through the penis and prostate to the bladder, shifted slightly from the surgery. Over time (up to a year), the urethra moved back to its normal position and the penis returned to its presurgical length. The findings were published online in February 2017 in BJU International.

Prostate removal is performed for patients with cancer confined to the prostate. Some patients complain after the procedure that their penises—along with their self-esteem—have diminished.

How the study was conducted

To gauge penile shortening, the Japanese researchers studied 102 men after prostate removal. The patients’ penises were measured from base to tip with a ruler before and 10 days after surgery, then again at set intervals for two years.

MRIs (magnetic resonance images) also were taken 10 days and one year after surgery to determine what might cause surgery-related penile shortening. An average penis reduction of 20 millimeters (slightly more than three-quarters of an inch) was recorded 10 days after surgery.

Likewise, imaging results showed that the urethra temporarily shifted an average of 4 millimeters (less than one-seventh of an inch) toward the pelvis 10 days after surgery. Penis lengths increased gradually over the following months and were back to their approximate presurgical length one year later.

The study, however, did not specifically address the mechanisms that might cause erectile dysfunction (ED) following surgery, caused by damage to the nerves that control erections.

“The real issue is not the temporary shortened length of the penis produced by urethral tension from the surgery, which is by no means universal,” says Jacek Mostwin, M.D., professor of urology at Johns Hopkins School of Medicine. “More significant is the long-term health of the erectile tissue.”

Bottom line

If you’re experiencing sexual dysfunction after your prostate surgery and have difficulty achieving or maintaining a firm erection, Mostwin says a rehabilitation program that offers stimulated or enhanced erection therapy can help you regain function sooner.

Injections or popular prescription erectile dysfunction drugs, such as sildenafil (Viagra) and tadalafil (Cialis), also are treatment options.

“If you are about to undergo prostate cancer treatment, especially surgery, it’s worth inquiring about what sort of rehabilitation or support programs are available afterward,” Mostwin says.