Post-prostatectomy shrinkage (or is it?)

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I have the exact same issue after RP last September. Same protocol re: blood flow. I shower every morning and keep the area clean with a wash cloth during the day if necessary. I have no issues regarding irritation. I find that leaning forward with hand on the wall changes the angle enough to avoid the scrotum area.

 

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@donegatf Don’t pee sitting down, since you say it’s better when you’re standing up. And, yes, most of us a barrier/diaper cream. I highly recommend Calmoseptine. It may seem expensive but you don’t need much. If you don’t see it on the shelf, ask for it from your pharmacist because it’s a commonly stolen product so they often have it behind the pharmacy counter.

Calmoseptine emits far less of an antiseptic odor than does Desitin, but it does still have some of that mineral-oil stank. Being oil-based, it will stain your clothing and bedding, so only use it with underwear you don’t care about having oil stains, or better, with diapers. It stays in effect for days if you don’t wash it off with some force. It works quickly and thoroughly.

Men are so lucky they don’t HAVE to sit to pee. The last thing my decrepit knees need is getting up and down off the toilet seat as often as I have to pee, thanks to OAB. I’ve tried all kinds of funnels and this cardboard thing called p-mate, etc. to make it so I can pee standing up. They all leak. Women aren’t made to pee standing up because we need urine to run down our lips to keep them bacteria-free. Ever wonder why a woman has to pee immediately after intercourse, even if she peed right before intercourse, and doesn’t have OAB? It’s the female body’s natural way of getting clean after sex. Nature is so fascinating!

Men who’ve had prostate surgery and have had shrinkage, I really, really feel for you. I know penis size is the most important thing to a man and that most men aren’t as big as they’d like to be to begin with, let alone after a prostatectomy. All of my partners have told me they wished they were larger even when they were already slightly too big for a woman’s comfort.

Perhaps you can feel less alone knowing that any woman who has had a partial or complete hysterectomy has had at least the top/inner 1/3 of her vaginal canal cut out, too, as well as her cervix, some of the nerves going to her bladder, some of the nerves going to her intestines, at least 1/3 of her uterus if a partial and all of her ovaries, eggs, and 100% of her uterus if a full hysterectomy, leaving her sexless. Parts of the pelvic floor muscle may be removed, also. Mine was done internally, but most women have to be cut through their abdominal wall for the procedure to be done internally. The male doctors never warn you that they’re going to remove part of your vagina before you go into surgery! Removing the top third of a vagina and the cervix is removing the roots of the entire female pleasure system. The vaginal canal is the tree trunk. The clitoris is the branches and leaves, but none of those can work without the roots at the back of the vagina and in the cervix. But hey, I’m cancer-free. I guess it was worth it but I haven’t been myself since my hysterectomy.

And then, because of the persistent dryness, even when doing hormone therapy, the actual vaginal canal shrinks, rendering sex excruciating. Many parts are removed during a hysterectomy.

I hate that word, hysterectomy; it implies that every woman is hysterical, and that removing a woman’s sex organs renders her free of hysteria. It’s a stupid old-fashioned term that’s completely inappropriate and discriminatory. It’s rude to the mentally ill, and it’s rude to all women. “Prostatectomy” isn’t linked to any meaning about a man’s emotional personality. I call for the word hysterectomy to be removed from all of human history and replaced with a word that just refers to the region of the body and not to a woman’s emotions.

33%-40% (depending on one’s ethnicity) of all women have to have a hysterectomy in their lifetime. The comparable surgery in a man would be if you had removal of your prostate, your testicles, and the top 1/3 of your penis (the head) - all at once - leaving you 100% devoid of testosterone. Very few men experience that. Only 6.5% of men have radical prostatectomies, and only in first-world countries.

So men, you are not alone in experiencing “shrinkage” and loss of ability to have sexual intercourse. Far more women have had hysterectomies, leaving them eunuchs. Just keep that in mind.

 

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@snow I'm sorry I'm new here and don't know you yet, so I can't tell if you're serious or sarcastic with some of your comments. I will just add that men do have to defecate also. In my case at least, that requires sitting down. And usually urination happens simultaneously. These would be the times my issue arises.

 

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@donegatf I didn’t realize you have to urinate when you sit down to defecate. I don’t.

 

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@donegatf What if, before you defecate, you get all of your pee out when you’re standing up, then when you sit down, you have any pee left to run down your scrotum?

 

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My PA asked me if I peed standing up or did I sit down, with my retention and anxiety. I said it depends, and she said I want you to sit down only, I have to admit it has been better for me. It did help my pain from retention and the worry.

 

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@snow very well said.

I have a very small prostate, and I have had impotence most of my adult life, premature ejaculation's along with the bladder issues and much smaller then even the smallest! But I found other ways to pleasure and feel I was pleasing. Yes that is very important

 

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@Boomersway Well done, friend!

 

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I haven't had a RP yet but having BPH for 2 years girth and length have been affected.

 

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The doctor has scheduled a consultation 8 weeks post-RP to report back on histology but also, apparently, to ready the Cialis prescription. After reading this thread and in terms of blood flow etc., does 8 weeks sound like we're acting quickly enough? I want to get started sooner rather than later am looking for reassurance that we're not being too slow in terms of the whole "use it or lose it" aspect. Would it be too early for me today (5 1/2 weeks post-op) to get a pump at least? (cuz you don't need a prescription for that). Thanks

 

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I would definitely get a pump and start as soon as possible.

I don't see how that could hurt and definitely could help!


+God+bless+

 

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Re: pump, if doctor orders it, insurance might cover it? I believe it was around 8 weeks when I started but other restrictions were lifted after only 4 weeks. You should ask your doctor. My protocol was to use the pump for 18 minutes every other day along with 50 mg. dose of Viagra. Now I have 100mg. pills to use as needed , but I’m still a long way from good erections. My number one concern is the incontinence.

 

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Speak with your surgeon first - the surgeon will know if are any special considerations.




Below is a text file that I saved to be able to recount my experience with Penile Rehabilitation.

I am recounting my experience - I am NOT a medical professional.
Penile Rehab / Penile Therapy - Just my experience.

Updated January 27, 2023 - Prostatectomy Sept 2020 age 55; Male Urethral Sling Surgery Sept 2021

My penile rehabilitation.

1) Week 2 ==> tadalafil (generic cialis) 10 mg daily (started day catheter was removed)

2) Week 9 ==> Bathmate HydroXtreme penis pump

3) Month 6 ==> Trimix penial injections - started at 6 months (doctor wanted to start sooner, but I needed more time to mental adjust to inserting a needing into my penis).

At 9 1/2 months, I have some natural erections using daily 10 mg tadalafil (generic cialis purchased using GoodRx (prescription required)). I use the Bathmate HydroXtreme penis pump 3 to 5 times a week (extreme has a hand pump) (link below). I started Trimix penis injections at 6 months. Using Trimix once or twice a week, I was able to have an erection without Trimix starting around 8 months after prostatectomy. I still use the Trimix once a week (March 2021 to Sept 2021).

At 9 1/2 months, I was incontinent leaking about 20 ounces a day (4 pads a day). In Sept 2021 (12 months after Prostatectomy), I had the male urethra sling surgery and am continent.

The longer version of above :

1) Just after treatment (prostatectomy) Daily cialis is about getting blood flowing to the penis and pelvic area to help the nerves to heal. It took 3 months to notice any firmness about 50%. I use GoodRx to find a good price - a grocery chain store pharmacy had the best price for me.

2) My urologist recommended the Bathmate penis pump. Unless you have a firm pelvic area, you will want the Bathmate with the hand pump - HydroXtreme. I went from 5 1/4 inches before prostatectomy down to 4 inches, then back up to 4 3/4 inches after using the Bathmate pump for 3 months.

The Bathmate HydroXtreme pump is more about penile rehabilitation than producing an erection to constrict (ring to hold erection) and try to use for sex.

I sit on the corner of my tub with cups of warm water to fill the cylinder (about 100 degree). The instruction are to pump for 3 minutes, massage for 2 minutes (I use shampoo plus conditioner to reduce friction), and repeat twice for a total of 3 times 15 minutes.

The Bathmate uses water in the cylinder and seems to work on girth more. I am not looking to get bigger than I was, just to restore my pre prostatectomy size.

Bathmate website - sign up with your email to get 20% to 30% off.
Get the Xtreme because of the hand pump. I purchased the comfort cushions to reduce the chance of pulling a testicle into the pump (very painful). The size of the cushion ring goes with the size of the pump.

Bathmate Direct - World's Best Penis Pump (Official Site)

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bathmatedirect.com

Cushion Rings

Bathmate Cushion Rings help ensure that your testicles stay out of your Bathmate penis pump, with skin-safe material preventing any damage. Available for all our hydropump sizes, these cushion rings add an extra level of security to your workout.

bathmatedirect.com

YouTube search for instruction - note - most are not using the pump for rehabilitation. Sign into YouTube with a gmail account to see adult versions.

Bathmate

Bathmate is the #1 best way to optimise male sexual health - experience gains, improve stamina and add confidence in the bedroom. With over 1 million satisfied users, Bathmate is the world’s best-selling hydropump. With a 92% complete satisfaction rate, we guarantee you will feel the difference...

www.youtube.com

I also purchased the Vacurect. I used it a few time with the rings, but the ring to hold an erection was to constricting. I also used it a few times for blood flow (pump 2 minutes, release 2 minutes). I prefer the Bathmate.



3) Trimix injections - I had a difficult time starting and using these. I was shaking inserting the syringe at first. Do NOT use an auto injector - it was not the thing for me to do. I had to stop for a while because I was putting too much mental pressure on myself to use the Trimix when I was not ready.

I also had concerns about using Trimix for every erection or orgasm. I would use Trimix, then not feel like trying for an orgasm for 5 days. That was okay. After 6 weeks on Trimix, I noticed on the days trying for an orgasm without Trimix that my erections were getting firmer and at 8 weeks of using ( month 8 ) I was getting to 90% hard.

Trimix is ordered from a compounding pharmacy. It comes in a 5 ml bottle. My initial does of 0.15 cc or 0.15 ml produced a 6 hour erection. Some member in the Facebook group (link below) also reported that they had to return to the doctors office. Make sure you get your initial dose in the morning so that if there is a problem, you can return to the doctor. After 4 hours, I contacted my doctor - I took 4 30 mg Sudafed (the 4 hour pill not the 12 hour pill).

I found that 0.05 cc gave me a 4 hour erection in the beginning. You can prefill a few syringes. I found that adding an extra 0.05 cc for storage. Before use, you shake the syringe and squirt out the extra trimix. (Trimix is compounded and needs to be shaken before each use for better results.)

Trimix tips
0) Trimix is stored in the refrigerator or freezer
1) comes in a 5 ml vial
2) make sure the order comes with 20 to 40 syringes
3) Ask the doctor to include the "Undo" injectable or pills so that you do not have to go to the emergency room.
4) Have 30 mg generic Sudafed tablets on hand (After my 5th time injecting, I started taking FOUR 30 mg Sudafed tablets after one hour and each hour until my erection started to soften.)
5) I found eating and drinking 32 ounces of water worked better than the Sudafed at deflating the erection. Part of it is that I am taking my attention away from the erection. I will watch an hour of Television.

 

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I have a pump but am not going to use it until 6 weeks post op (2 weeks from now). I'm sure others have started sooner, but my surgeon said he wants me to give everything in there 6 weeks of healing before I do anything beyond walking. And I have to believe a vacuum pump will add stress to that brand new urethra/bladder connection. I've been on sildenafil for ten days but have not seen or felt anything in terms of tumescence. Those nerves are apparently a long way from kicking back in.

 

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@AUG168