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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.
Best Answer
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!
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Avatar universal
I had urethroplasty when I was 17 years old and now I am 25. Believe me when I say I was extremely relieved when I first discovered this thread. I thought I was going insane or something. Post surgery, immediately after the catheter was removed, I started experiencing dribbling,  which had never happened to me before. And one of the worst side effect was that my penile length was shortened by atleast 40%. To this day I have a small penis, not that I was born with one, because I perfectly remember my penis size before the surgery and it was great from my point of view. But after the surgery, it was nearly half of its actual size. I also wasn't informed of this side effect. I had a buccal mucosal graft surgery, still I am facing these problems. As it has been years since my surgery, and there has been no improvement whatsoever in the length, I have no hope of so happening in the future as well.I will have to carry a small penis the rest of my life because of what some stupid doctors did to me. I call them stupid beacuse immediately after about six months or so after the surgery, I again suffered from strictures. I did dilation many times over the years and am now literally fed up with going to any hospital.I am from India and planning to go to higher studies in US. Some doctor told me that I should better get all my treatment done here in India before I leave, cause medical services are pretty costly in US. I am in a total fix, I don't what to do, some said you already had a urethroplasty so doing another one might not be suitable before I have kids. I am suffering from strictures still and afraid to go to pee everytime. I don't know what to do anymore, this problem just won't go away. Moreover,  the reduced penile length is not a problem physical, as much as it is a psychological one. For a man who is about to get married more so. I don't want pull my pants down on our honeymoon and become laughing stalk for my would be wife. What hurts more is that I had no say in it. I just wanted to pee like a normal person so I did urethroplasty, which was told to have high success rate. And in the end I ended with half a penis and recurring stricture. Total loss. I have lost all hope, maybe God wants it that I live with these dreadful strictures all my life. But what worries is that I have read that if not treated they lead to further complications like uneven balddee wall as it has to apply more pressure beacuse of strictures to get the urine out and also reflux, the urine might go back to the kidneys and harm them. God knows what else. If someone has had recurrence of stricture even after urethroplasty,please tell me what course of action you took.It will help me tremendously...Thank you
Helpful - 1
Avatar universal
Hello norcali22 and thank you for considered posting. To answer your first question -- can anyone report a return to pre-op penile length or the same angle, even after a year -- it's been about 1 year 4 months since my surgery and while I believe there has been some improvement, which has been encouraging, unfortunately there has not been a return to my previous length, angle, or ejaculation.

The way you describe your doctor's reaction to your report of the complications is very similar to how my doctor responded at my first visit after surgery! He seemed a bit caught off guard or certainly not as accustomed to addressing complaints of changed penile length or angle; in my case, I also reported diminished -- rather, absent -- ejaculatory force and overall altered ejaculation, which he seemed somewhat better prepared to answer and even said that other patients had infrequently reported similar results. Unfortunately, he estimated that there would be no improvement, and after 1+ years I can confirm that there indeed has been no improvement. He did indicate that the reduced ejaculatory force "should not" impact fertility, though I did not express a particular concern about this.

To answer your other question, if any of us has researched a lawsuit: considered, yes, only in passing and only because others suggested it, but I have not researched a lawsuit. If I pursued any sort of action, it would be primarily to seek a change in standard practice to help future patients: I'd like to see the following:

Doctors should provide patients a comprehensive printed list of common, occasional, and rare side effects/complications specific to the procedure, including possible changes in penile length and angle and ejaculation (all problems I've encountered, but was never warned of, even though I asked many questions about possible outcomes ahead of time). 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.

I think that such a simple step would help both patients and doctors alike in many ways, including managing expectations, not to mention improve patient education and experience.

I'm no lawyer by any means, so keep that in mind, and I realize this wasn't your question, but for what my two cents are worth, I suspect that malpractice would be difficult to prove on our cases. Don't let that sway you one way or the other though; if you're interested, even just to set your mind at ease, you can consult an attorney specializing in medicine, medical malpractice, or a related field; many state bar or other associations offer a lawyer referral service and often a quick informal phone consult can be arranged for a reasonable flat fee. I think I paid $40 for 30 minutes on the phone with lawyer who specialized in real estate issues, among other areas. Also, some attorneys offer a free consultation. Here is the link to the California Bar Association lawyer referral service, if it can be of some help. I'm guessing California based on your user name ;)

Keep us posted on your recovery and what you decide! I wish you a full and quick recovery. Take care.

http://www.calbar.ca.gov/Public/LawyerReferralServicesLRS.aspx
Helpful - 1
Avatar universal
Not necessarily directed at Brian, more so everyone.  My question - is there anyone here who can report a return to pre-op penile length or the same angle - even after a year?   I had anastomosis urethroplasty to correct a stricture that was only like 1.0 cm, but I lost probably an inch in length and the angle of my erection, if lying on my back is straight up, where as prior to surgery it was more pointing at 45 degrees (more back towards my head).  It's been 14 weeks, its a better angle than it was 2 weeks after surgery, but it's still concerning.  My Doctor is a good, thorough and I had no complaints about his competency.  I saw him today, my first visit since surgery...and frankly, I think he was blindsided by these complications (the shortening and the angle) - as though it shouldn't have happened.  Even questioning him as to whether it will get better with time, it was somewhat of a guarded affirmation (he wasn't sure, but said "it should" correct over time).  

Let's all be clear...it's not right for this to happen.  If it is not called out as a possibility by the Doctors in advance of surgery, then it should not have happened.  Not that I'm going there, I like my chances for returning to normal, but I'm curious if any of you have researched a lawsuit?  
Helpful - 1
1 Comments
Thinking about it.
Avatar universal
I HAD MY OP 2 WEEKS AGO ,the op where they take skin out your mouth, HURTS LIKE HELL WHEN HARD .POINTS OUT INSTEAD OF UP, I ALSO LOST ABOUT 2INCH   , CAN WE SUE  AS 2INCH A BIT CHUNK .  AT LEAST IT GOES UP haha!!  but very uncomfy ,hurts like hell      my surgeon did not mention shorten penis size WTF
Helpful - 1
Avatar universal
Hey Brian! Oh man, I'm sorry to hear that and I do hope you see some improvement with time. I encourage you to press your doctor about this issue in your follow-ups. I can't believe that doctors are not counseling patients better about this possible complication beforehand, even when we ask, like you and I did! Thanks for sharing your experience. Maybe if other patients and doctors see these postings, patient education and expectation management can improve. Wish you an improved recovery and all the best.
Helpful - 1
Avatar universal
I have had a similar experience. I am 60 years old, and my wife and I agree that I have lost about 2 inches of length! That is substantial, and it is making sex difficult. A certain amount of length is necessary to fully penetrate the vagina and be able to move back and forth without coming out. It is still fairly soon after the surgery (6 weeks), so maybe this will improve, but it sounds like most people are not experiencing any improvement. Additionally, my "erect" penis does not point up, but out, so it is very uncomfortable when pressing against sheets, pajamas, or clothing.

And, like you, I was not told that this was a possible complications, though I asked.
Helpful - 1
Avatar universal
I have had a similar experience. I am 60 years old, and my wife and I agree that I have lost about 2 inches of length! That is substantial, and it is making sex difficult. A certain amount of length is necessary to fully penetrate the vagina and be able to move back and forth without coming out. It is still fairly soon after the surgery (6 weeks), so maybe this will improve, but it sounds like most people are not experiencing any improvement. Additionally, my "erect" penis does not point up, but out, so it is very uncomfortable when pressing against sheets, pajamas, or clothing.

And, like you, I was not told that this was a possible complications, though I asked.
Helpful - 1
Avatar universal
Hey Immortal. It's been about 8 months since my surgery. Soon after the procedure, I could see and feel that my penis was shorter when I have an erection, I'd estimate by about 1-1.5 inches. I was hoping that with time, things would improve, and that I simply wasn't achieving a full erection, but so far everything is the same, unfortunately. The shortening doesn't seem to be temporary, at least not in my case. I plan to give it a few more months, until it's been a year or more for full healing, then maybe ask the doctor about medication for erectile dysfunction as a last ditch effort to see if that will help with the erectile length. Though, to be honest, I'm not too optimistic and don't want to get my hopes up (no pun intended). Over time, I'm getting used to it -- what else can we do? As long as everything works more or less, it's better than nothing. I will keep my fingers crossed for you and I wish you a full and speedy recovery.  Try not to worry too much and take it easy.    
Helpful - 1
1 Comments
What else can we do?  How about sue their ***?  They have ffed with our manhood!
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.      
Helpful - 1
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
Helpful - 1
Avatar universal
47 yo.  It is about 6 months after surgery, and I have lost about 40-50% length with downward curvature. The main erectile strain is on the stitched up area underneath, thus the downward curvature.  Basically, I believe the stitching was made too constrictive.  Will be having followup in one month;  will be considering legal options if he says nothing can be done, as sex is darn near impossible.  I had specifically asked beforehand about this side effect, and was assured this would not be a problem.  Additionally, I still have to sit down to pee, as there is spraying going on.
Very, very angry at the whole situation.
Helpful - 0
Avatar universal
I had an posterior urethroplasty in Feb. I was in a catheter for 4 weeks ( not a lot of fun) I definitely feel that my penis has shortened a small amount maybe an inch. My main concern is erectile function as I do not get an erection after the operation. Presently I am beginning to take 5mg of Cialis  at night to help the blood flow. It is too early to panic so I am hopeful that full function will return.
Helpful - 0
Avatar universal
I had an urethraplasty August 16 of this year. I had two closely grouped strictures and did not receive a graft. I had my catheter removed after two weeks and was told I could return to sexual activity. I wanted to try it out before doing anything with my wife. Pre-surgery I was 7 inches erect. That first time I was maybe 4, pointed straight down,  felt tight, I couldn't flex the head anymore, and was very sore. I went online to see if this was common and found this thread and was devasted reading everyone's story. I called my surgeon and he told me that I had been through a major trauma and would need time to heal. He also told me that my urethra needed to stretch back out. He told me with each erection it would get better and better. I also, after a couple days, started to dribble at the end of urination and had an odd sensation in the shaft of my penis. With this he brought me back into his office. I had a prostate infection from the catheter and he prescribed two months antibiotics. After being on the antibiotics a week my stream was awesome and the odd sensation gone. With the erections I treated it like I was rehabbing an injury. I got and maintained an erection multiple times a day. I would practice flexing in reps. Now, after 2.5 weeks for the first time my erection measured 7 inches again, points outs, I can mostly flex the tip, and the soreness is gone. It does still feel slightly tight and curves a little when it didn't before, but I feel whole again for the first time since the surgery. My surgeon was Doctor Metro with Temple University. I recommend him to any and everyone. I felt a responsibility to write on this thread and share what I did during recovery to get back to normal. Good luck.
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1 Comments
Earlier in my posti said 2.5 weeks, I meant 2.5 months.
Avatar universal
*Uneven bladder
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Avatar universal
have things changed since your post I just had this surgery done and the catheter came out yesterday and I am having the same issues and I was not informed of this posibility and want to know if this improves over time or not
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Avatar universal
I had my surgery 8 days ago and still have the catheter inside. My biggest worry was having an erection during sleep as I thought this would cause stretching and pain to the surgical area. It wasn't until about 4-5 days after surgery I got my first erection during sleep. I want to tell you I am a bit squeemish and don't like looking or feeling around the area that was worked on. So while in sleep during the erection everything became very tight and seems to be very hard. I want to tell my normal erection was at least 6 inches and now seems to be zero inches. In flaccid state the penis stays below the surface and during sleep erections, the penis is still below the surface. Now I'm not going to stretch it while it's flaccid when the catheter is still in but I hope things will be normal. I can't imagine a half inch to 3/4 inch surgery would reduce my penis by a whole 6 inches. My catheter will stay in for 24 days. I will post follow ups.
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2 Comments
This is an update and it has been 13 months since my surgery. Over time my penis kept getting longer as it was healing. However I can tell you that I lost about 1 1/2 inches of my original length, maybe more. Erections are a little painful. I don't know where the other inch and a half went to. My guess is that somehow they restricted it by stitching it in or the tissue implant does not stretch like the original tissue.
Any improvements on the situation? Did you get back the 1.5 inches? Im 7 months in to healing and having the same issue
Avatar universal
Dr. Kulkarni is a well known  expert in urethroplasty surgeon in Pune you can for sure consult him. In Bangalore you can Visit Fortis Hospital  and meet Dr. Mohan Keshava Murthy
Helpful - 0
Avatar universal
Helo guys.... I am from india and suffering from urethral strictures... I am just 23 and don't know how to deal with this problem...... Anyone here from india who knows a well qualified and experienced urologist who can perform a urethroplasty in india?
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Avatar universal
Thank you for your post.  I will be having urethroplasty sometime this year. I go back in April.  I had 5 UTI and I have another this year.  The doctor said the only way to get rid of the UTI are to have by stricture taking out. Its just before the sphincter muscle.  They found it when I was in the hospital they try to catheter me and could not get it in the bladder.  It was a ordeal.  They nurses never said a word to me.  even after I ask what was going on they just took my pants off and stuff a stuff a catheter in me.  It happen so fast.  I have been having  the same kind of problems like you.  Sperm does not shoot out anymore it leaks out.  And I have dry orgasms to.  it go backwards.  At 59 I should not worry about it but like to have fun once in a while.  I'm going to talk to the doctor about a oral graft.  Thanks for the information.  Good luck with the baby..  Have a few more....I have 3.      
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Avatar universal
Hello  First of all have you talk to a doctor. What does he say.  I'm 59 and I had my kids all ready.  After reading all the problems I don't know.  I have a urethral stricture just before the uriary sphincter muscle.  I still like sex any kind.  Had 5 UTI's last year and 1 this year all ready. My doctor said that a uethroplasty is the only way to get rid of them  With all the problems I don't know  Please talk to a good doctor before you decide anything    
Helpful - 0
Avatar universal
This thread has been so helpful!  I have had urethral strictures most of my life (17-49) with two urethral dilutions followed (3 weeks ago) by urethroplasty. I have had 2-6 erections per night since the surgery that are painful and have the wrong angle - 60 degrees south instead of 45 degrees north. I was told the angle might change but had no idea it would be this bad. I told my wife about the reports of shortening (I haven't measured) and she said well that would actually be a good thing ;)  But the angle is unworkable and I found this thread trying to learn whether angles change with time or can be altered. I was excited to hear that there is such a thing as anti-boner medication and wish my doctor (supposedly the best in the state at urethroplasty) had given me some.
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Avatar universal
It's been about 14 or 15 months since the surgery.  Again, this thread started out as a question about shortening. I never had a problem with that.  Urination works better though sometimes is still a split stream.  I had scrotal numbness which is mostly gone but not completely.  The biggest problem I've had is with erectile dysfunction.  I have never had this before in my life.  I am not sure but believe this is associated with pain in the bulbospongiosus muscle in the pelvic floor, which hurt after the surgery and continues to be very sensitive to the touch.That's what they cut through when they did the urethroplasty to get to the urethra.   I have pain during sex. I have pain when walking, sitting, etc. I have had problems maintaining an erection and tried pills for that.  The pills allow me to maintain an erection but now I have problems with delayed ejaculation.    I just started physical therapy for pelvic floor pain which hopefully will address the problem.
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Avatar universal
Hi! Yes, sure. But you'll need a good doctor to treat you. Stricture is a rather complicated issue. Still in experienced hands you may forget about it till the end of your life. Urethroplasty gives best results and a high guarantee with low risk of any complications and side effects. I had 15 cm stricture (penile and bulbar parts were affected by the catheter). I underwent 9-hour surgery and had a few complications that were gone with time.
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Avatar universal
Hello thanks for replying i appreciate it! Yes it hurts to pass urine frequently. Also after my circumcission it feels like my bladder doesn't empty all the way.I think bxo is what caused my strictures do you think a urethroplasty would fix them?
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