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Penile Shortening After Urethroplasty?
Greetings All,
It's three weeks after my excision primary anastomosis urethroplasty to correct a stricture in the bulbar urethra. I'm unsure of the stricture's exact length -- when I phoned to ask, I was told it wasn't included in the surgical notes -- but it was estimated 1.5-2.0 cm.
The reason I'm writing is that I've noticed a pronounced penile shortening, or rather a reduced erectile length, and am wondering about others' experiences. Has anyone else had this? Or, was your erectile length always the same? I'd say my erectile length is only at best about 50-60% of what it was before surgery. I'm hoping others have seen this and that the issue resolved fully in time.
When I asked one of my doctors about this over the phone, he reminded me that he warned of possible erectile dysfunction for up to six months after surgery. ED to me means difficulty attaining or maintaining an erection, not penile shortening (!), but I guess that's beside the point. The doctor added that the catheter prevents full erection, which I can accept, but the catheter is out now and I see no improvement. He assured me that I should return to normal in time and emphasized that I'm not achieving a full erection because that my penis underwent significant trauma.
The doctor also said that he's never seen erectile shortening with the type of surgery and stricture length I had, but I'm seeing medical surveys online showing 22-25% incidence of penile shortening after the same operation and stricture size. I don't doubt my physicians, but am just struggling to reconcile apparently conflicting information.
I specifically asked my doctors before the surgery multiple times about possible complications and cosmetic outcomes and never once was possible penile shortening mentioned. Stroke, heart attack and death were mentioned as risks during surgery and failure, recurrence, and ED were mentioned as possible side effects of the procedure. Also, scars at the incision site, of course.
I plan to ask my doctors again at a follow-up if the condition doesn't improve, but in the meantime, I would really appreciate any insight others can share.
Erectile length probably shouldn't matter if the surgery is otherwise successful, but I would've preferred at the very least a warning about the risk of shortening -- even if temporary -- so I could've at least psychologically prepared for the possibility or perhaps opted for another treatment.
I'm really hoping someone out there can confirm this reduced erection length is normal and temporary.
As a 32-year old single guy who wasn't overly thrilled with my length before, cutting it in half is not an idea I relish, to say the least. :/ Hope you can understand.
Thanks very much for reading and especially for sharing any insights. I searched the boards to see if this has been discussed before and didn't turn up anything, sorry if I just missed it.
It's three weeks after my excision primary anastomosis urethroplasty to correct a stricture in the bulbar urethra. I'm unsure of the stricture's exact length -- when I phoned to ask, I was told it wasn't included in the surgical notes -- but it was estimated 1.5-2.0 cm.
The reason I'm writing is that I've noticed a pronounced penile shortening, or rather a reduced erectile length, and am wondering about others' experiences. Has anyone else had this? Or, was your erectile length always the same? I'd say my erectile length is only at best about 50-60% of what it was before surgery. I'm hoping others have seen this and that the issue resolved fully in time.
When I asked one of my doctors about this over the phone, he reminded me that he warned of possible erectile dysfunction for up to six months after surgery. ED to me means difficulty attaining or maintaining an erection, not penile shortening (!), but I guess that's beside the point. The doctor added that the catheter prevents full erection, which I can accept, but the catheter is out now and I see no improvement. He assured me that I should return to normal in time and emphasized that I'm not achieving a full erection because that my penis underwent significant trauma.
The doctor also said that he's never seen erectile shortening with the type of surgery and stricture length I had, but I'm seeing medical surveys online showing 22-25% incidence of penile shortening after the same operation and stricture size. I don't doubt my physicians, but am just struggling to reconcile apparently conflicting information.
I specifically asked my doctors before the surgery multiple times about possible complications and cosmetic outcomes and never once was possible penile shortening mentioned. Stroke, heart attack and death were mentioned as risks during surgery and failure, recurrence, and ED were mentioned as possible side effects of the procedure. Also, scars at the incision site, of course.
I plan to ask my doctors again at a follow-up if the condition doesn't improve, but in the meantime, I would really appreciate any insight others can share.
Erectile length probably shouldn't matter if the surgery is otherwise successful, but I would've preferred at the very least a warning about the risk of shortening -- even if temporary -- so I could've at least psychologically prepared for the possibility or perhaps opted for another treatment.
I'm really hoping someone out there can confirm this reduced erection length is normal and temporary.
As a 32-year old single guy who wasn't overly thrilled with my length before, cutting it in half is not an idea I relish, to say the least. :/ Hope you can understand.
Thanks very much for reading and especially for sharing any insights. I searched the boards to see if this has been discussed before and didn't turn up anything, sorry if I just missed it.
Best Answer
Also, I forgot to ask, How long did you guys wait to get back into physical activity or exercise? I love sports and Crossfitting, but I DO NOT want to mess up anything. If you guys have any insight on this it'd be very helpful!
Thanks for the reply! I had my surgery about three weeks ago, the catheter is coming out on tuesday. I blame myself for not asking questions,most of the time when I went to see my urologist, I was going in for a cystoscopy, so i would usually take ativan, or some old T3's to calm me down, the procedure freaked me out, but then I would be spaced out after and not ask proper questions. He didnt mention anything about this shortening, I hope at 20 years old my ears would have perked up for that, but I am definitely going to bring it to his attention. Thansk for the informative posts, Wish you all a speedy recovery!
Hey youngguy33! Most of us here seem to have had anastomotic urethroplasty where the stricture is cut out and the urethra is then reconnected without a graft. WONTGOUP and I think one or two others have had the buccal mucosal onlay graft you're talking about, you may want to message them directly or maybe they will post here. Which surgery is recommended depends on the size and location of the stricture, I think. I believe that the incision in both anastomotic and graft is through the perineum (in my case, the incision went well into the scrotum as well, but I wasn't warned about that, even though I asked where exactly and how large the incision would be). Hope this helps. Good luck!
Hello and welcome MUALFE. Sorry to hear about all the trouble you've been having with your recurrent stricture. Urethroplasty seems to be the standard of care in many similar cases here in the United States, but each patient and his best treatment is unique. I also had a number of unsuccessful cystoscopies and urethrotomies before finally being referred for a urethroplasty. Even with the negative side effects, I'm glad I underwent a urtheroplasty, but that is just my experience and I can only speak for myself. Not every doctor or surgeon is trained, experienced, or comfortable with performing every procedure; I remember that one of my urologists said that while he *could* perform the urethroplasty, it was a complex surgery and he wanted a more experienced surgeon to operate, so he referred me to another doctor in a larger city nearby. I would recommend finding surgeons who focus and specialize in genitourinary reconstructive surgery, specifically urethroplasty, and see what they have to say about your case.
I found these Brazil doctors in a cursory Internet search, maybe you could start there, but please perform your own queries. It seems like urethroplasty may not be as common or well practiced in Brazil. Perhaps that's why your doctors are reluctant to suggest or perform the surgery? I can't blame them, in that case, I wouldn't want someone inexperienced operating either. That's another question each patient should be sure to ask of surgeons: how many of these procedures have you performed? What percentage experience complications? Maybe you could consider traveling abroad, depending on your circumstances. I wish I had gone to this center in California:
http://www.centerforreconstructiveurology.org/urethral-stricture/open-repair-urethroplasty.htm
Brazil Doctors:
Dr. André G. Cavalcanti
http://urologiareconstrutora.com.br/equipe/andre-g-cavalcanti/
Dr. José de Ribamar Rodrigues Calixto
Dr. Gustavo Cavalcanti Wanderley
Dr. Sergio Ximenes
http://sergioximenes.site.med.br/
I found these Brazil doctors in a cursory Internet search, maybe you could start there, but please perform your own queries. It seems like urethroplasty may not be as common or well practiced in Brazil. Perhaps that's why your doctors are reluctant to suggest or perform the surgery? I can't blame them, in that case, I wouldn't want someone inexperienced operating either. That's another question each patient should be sure to ask of surgeons: how many of these procedures have you performed? What percentage experience complications? Maybe you could consider traveling abroad, depending on your circumstances. I wish I had gone to this center in California:
http://www.centerforreconstructiveurology.org/urethral-stricture/open-repair-urethroplasty.htm
Brazil Doctors:
Dr. André G. Cavalcanti
http://urologiareconstrutora.com.br/equipe/andre-g-cavalcanti/
Dr. José de Ribamar Rodrigues Calixto
Dr. Gustavo Cavalcanti Wanderley
Dr. Sergio Ximenes
http://sergioximenes.site.med.br/
Hey WONTGOUP. First and foremost, I wish you a good recovery. I hope that you're healing and the pain is diminishing day by day. Thanks for sharing your experience and the fact that your doctor -- like the rest of ours -- did not mention possible changes in penis length or angle.
I have yet to learn of a single case of a doctor in the United States warning urethroplasty patients of this possible complication ahead of time. That's very worrying. I thought that my experience was perhaps rare, that I was one of few. Sadly, the opposite seems to be true.
I'm considering ways we can help improve doctor-patient communication and education nationwide on this point and if anyone has suggestions, they are most welcome. About your question, can we sue, I'll share my thoughts below in a reply to norcali22. Thanks for posting and again, I hope you get better soon.
I have yet to learn of a single case of a doctor in the United States warning urethroplasty patients of this possible complication ahead of time. That's very worrying. I thought that my experience was perhaps rare, that I was one of few. Sadly, the opposite seems to be true.
I'm considering ways we can help improve doctor-patient communication and education nationwide on this point and if anyone has suggestions, they are most welcome. About your question, can we sue, I'll share my thoughts below in a reply to norcali22. Thanks for posting and again, I hope you get better soon.
Hey, i was wondering, the urethroplasty you guys had, was it repaired with a buccal mucosal graft? and was the incision made through the perineum?
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And for your question; my erections are only about 60-70% of what they were before surgery, i sometimes am able to flex the slightest bit now, but hardly at all. It's as if it doesnt have it in it anymore. I too am a bit worried about this one, i mean im only 18 years old! Wish my doctor had warned me about this. I wasnt to thrilled with my size before either. Now im almost embarressed! I go back for a checkup in 1 1/2 months. i will ask him about this then, and keep you posted if the asnwer is any different than what you had been told. On the bright side, the flow is stronger than ever! Hope you have a speedy and full recovery too!