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Avatar universal

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.
54 Responses
Avatar universal
Hey! Thank you for replying to my post! Very helpful information. As you stated, day-by-day my symptoms are improving aswell. My erections are still painful, more in the urethra area than anywhere else. My testicule pain is slighty weird, it improves, then comes back worse. Hopefully it heals up soon.
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!
Avatar universal
It will take time to recover from the surgery 6 months to a year in most cases.  Usually the shortening of the penis is not temporary.  With that said, please keep in mind that a vagina has no depth perception.  Don't be afraid to ask your doctor for a drug to treat your temporay ED.  In the future be vigilant about questioning your surgical proceedures and do the research.  
Avatar universal
Thank you for taking the time to post a comment. While I appreciate the sentiment, a vagina is not part of the issue, just a mistaken assumption of yours. As I wrote originally and we agree, penile length shouldn't matter (as long as biological/sexual functioning is otherwise unimpaired). However, I think it's safe to say that no male would be happy with shortening his penis -- temporary or not -- especially as a surprise. Or, to make it more general, if anyone woke up one morning with a suddenly smaller limb or appendage of any kind without warning, I think they'd be concerned and concern would be a normal reaction. That was one of my points, and I think it stands.

Bearing that in mind, my goals here are to:
-- share my experience with urethroplasty
-- learn from others' direct experience with urethroplasty
-- highlight for patients the possibility of penile shortening as a result of urethroplasty
-- encourage patients and physicians to discuss the possibility of penile shortening, in addition to other possible complications, of urethroplasty so patients can be better informed and prepared

Ideally, doctors should provide patients a comprehensive printed list of common, occasional, and rare side effects/complications specific to the procedure. The list should be compiled by a third-party accredited professional association. Physicians should discuss the list with patients and patients should check off each side effect once it's been addressed to patient satisfaction. The patient should then sign the list and both parties should keep a copy for their records.

You suggest that I ask for drugs to treat ED. But, I've had no trouble in developing or maintaining erections. Rather, my penis is shorter. My doctor implied ED may be to blame. I accept that possibility and I'll happily seek ED treatment, if ED is truly the cause. On the other hand, penile shortening -- entirely separate from ED -- is a possible complication of urethroplasty, so I'm trying to learn others' first-and experience, while sharing my own.

When you wrote: "In the future be vigilant about questioning your surgical proceedures and do the research," it's good advice (could be phrased, spelled, and punctuated better), but it fails to recognize two things: that I did so in this case and that patient education is also the responsibility of health professionals. You must have missed the relevant paragraph in my original post. To elaborate further, I asked my doctor the following questions, among others, and took notes at every meeting:

"What are the possible side effects or complications?"
"What are the possible negative outcomes?"
"What are the possible cosmetic effects?"

In his answers, the doctor did not mention penile shortening. I researched complications in online and print resources before the procedure, and penile shortening did not come up. I think I did my due diligence, but I'm not a medical professional. Since I'm not a urologist or a genitourinary surgeon, it was impossible for me "to know what I don't know" in this case and that's why I supplemented my research by asking questions and relying on my physician to impart information on possible complications to me as a patient.

My post and questions here on MedHelp were directed more toward other urethroplasty patients to promote an exchange of experiences on possible penile shortening in an encouraging and supportive way. It can be easy to dismiss or minimize someone else's worries, especially if you haven't been through the same thing. A little more context about you -- for example, are you a physician, patient, etc -- and your sources of information would have been helpful.
Avatar universal
Hey Lothson, i had a severe motorcycle crash more than three years ago with several fractures in legs, knee, pelvis... Because i fractured my pelvis my membranous urethra was completely torn off. In the beginning after urethroplasty i had ED and had to take drugs, i also noticed a penile shortening. After time spontaneous erectile function came back, but the glans always stays cold and is not swollen during erections only if i push the penis downwards and it's hard to say but penile shortening got worse. I lost 1-1,5 inch depending on the time relayed excitement. I know this posts dates from a few months ago but i am glad i found some people to share this with. I am from Belgium and here in our proper language you can not found anything about it (penile shortening and stuff) and it is hard to try to explain it to someone who is not really affected or confronted with it. So i Hope you will still read this and to hear how everything is going for the moment.
Avatar universal
I had a anastomic urethroplasty for 2.5 cm stricture. Now , 24 days after the surgery and the penis is SHORTER. This question for people who did the surgery more than 3 months or so , Is that temporarily   ?
I am 30 years old.
Please let me know
Avatar universal
Hey Haya, thanks very much for posting. First and foremost, I'm really sorry to hear about your accident! I hope that with time, function can continue to improve for you. I wish you only the best. It's been about 8 months since my surgery. I'd estimate that I've also lost about 1-1.5 inches and it looks like it will stay that way. On another issue, the force of my ejaculation is completely gone, it just leaks out slowly. I wonder what others' experiences are with this? This is another thing my doctors did not warn me about. I asked at my 6-month follow-up appointment and the surgeon said that it's likely because a muscle involved in ejaculation was cut during the operation and that normal function probably will not return if it hasn't by now. The doctor did mention that some patients' ejaculatory function improves after the surgery, while others' is reduced like mine. I suppose it shouldn't matter, but ejaculation just doesn't feel the same or as enjoyable as before. Otherwise, the surgery seems to have succeeded, so I am grateful. I'm still a little sore and I have sharp, shooting pains as well as dull aches that come and go, but overall the discomfort seems to be lessening with time. Thanks again for commenting and please don't hesitate with any questions or if you just want to commiserate -- everything is easier in company and when you share, right.      
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