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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.
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
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.
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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.
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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
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
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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
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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    
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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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Avatar universal
Hi! It's better to get your stricture fixed asap as with time you may have various complications and recurrent infections (uti). Stil it's up to you. Does it somehow affect your life (pains, low flow, infections, prostatitis and so on)?
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Avatar universal
Hey guys i am 18 and wondering if i should get a Urethroplasty? I can pee relatively normal just my stream isn't great. Should i wait until after i get married and have kids? Anything would help thanks guys.
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Avatar universal
Also my doc recommended using vacuum erector device to stretch the penis as it helps a lot to stretch the urethra. You may do it two months after surgery (15 minutes, twice a day). In some cases penile extender may be used, but you should do it very carefully not to damage the urethra (better to consult your doc).
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Avatar universal
Hi all! I'm from Russia and had urethroplasty done about 5 years ago when I was 30 (the urethra was badly injured by a catheter in Moscow). I had a long stricture about 15 cm from bulbar section to penile included.
I underwent the surgery on march 2010. In fact, the doctor decided on a combined method - the penile urethra was mended by penile graft and the bulbar urethra by buccal graft. I went to Israel for that and met a very trained and experienced doc. He is a professor and the Head of Urology Department in Jerusalem Clinic. His name is Professor Ofer Z Shenfeld. By this time he's done over 1000 urethroplasties and though he confessed that every case is quite complicated, no matter, whether a patient had a short stricture or a long one, I should say that he did an excellent job regarding my case (though now in five years after I have a small restricture about 1 cm in the bulbar part).

Right after the surgery that had lasted about 9 hours I had no much pain anywhere, but in my mouth. I was taken home on the 5th day. I should say that the most annoying thing was the night erections and orgasm with the sperm leaking out while the catheter was in - I couldn't sleep at nights.
The numbness in the scrotum didn't trouble me much. After I was relieved from the two catheters I started urinating very well, but one thing I was worried about is my penile length - in fact it was half length while erected as compared to the length before the surgery. But be sure, that in several months you'll have exactly the same length as you used to have before (the doc also said that end-to-end may shorten the length for the rest of life, but oral graft urethroplasty is most unlikely to affect the length). At least, in my case. Everything came back - the length, the angle. The quality of my sexual life is the same as compared to it before the op. By the way, my girfriend is now pregnant, so it doesn't affect fertility. But one thing I miss very much - the sperm only leaks out when I have orgasm. Still I got used to it. Now I'm scheduled for another urethroplasty to fix my small restricture in the bulbar urethra, but not afraid of it as I trust my professor and know him to be very efficient.
He also said before the op that these kind of surgeries should not affect your phisycal erections for better or for worse, at least in case of anterior urethroplasty.

Hope, I somehow helped you sharing my experience.
Be well.
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1 Comments
Hey Innuendo91,
Thanks for your post, it gives me hope that erections will return to normal. I was wondering, however - you said in several months things will go back to normal - how long exactly did it take for you? It has been 3 months now for me without much improvement
Avatar universal
Hello,
My name is Lee and I’m from Cleveland, Ohio. I am a 28 year old male who has recently had a urethroplasty with buccal graft (almost 4 weeks ago). I thought I might share my pre-op experience with those who are interested with the pro’s/con’s etc.
Roughly 6 months ago, I had UTI (my 3rd one) and my wife encouraged me to see a urologist. I was also having some weird things like constant nightly urinations, a very weak stream, and trouble draining my bladder. I must admit, I was nervous going in to see a specialist, as I was expecting they might find something life-threatening.  A cat scan revealed my kidneys were very swollen and my bladder looked unhealthy and distended. Further, a cystoscopy revealed that I had massive scar tissue build up. This was I guess something I was born with.  So the decision was made that I would need a urethroplasty  with a buccal graft. However, before they could perform the procedure, they needed to put a SP catheter in to reduce the swelling in my kidneys an return my bladder to normal shape.
The Supra-Pubic Catheter:
I had the SP Catheter for 6 weeks before my operation. I would recommend anesthesia when inserting the SP catheter, I made the mistake of being awake and doing it in my doctors office. I had very painful bladder spasms in the beginning and was in bed for a few days. Once I had the SP tube changed (2-3 weeks later) to a silicone one, it became more comfortable and felt some what ‘normal’.  A couple times my tube became clogged and I needed to rush to the hospital and get it unclogged.  I must stress the importance of drinking a lot of water to avoid those kinds of problems. I was also able to continue a healthy sexual life style with this catheter, which was a big plus.

The  urethroplasty with buccal graft:
On August 7th I had my surgery. I was obviously nervous, as the incision was going to be in the area between my anus and testicles.  When I woke from surgery, I was a bit nauseous. The pain at the incision site was actually fairly dull, however, my mouth was in a TON of pain. I also had the addition of a Foley Catheter, so I was now sporting two catheters. I spent two nights in the hospital. Between the morphine and the painkillers, I was fairly comfortable. When I left the hospital, I was worried about having two catheters, but it really wasn’t that bad. Most the pain I had really stemmed from my mouth.  I was given antibiotics, Vicodin, a Stool Softener, and an anti-boner pill for night-time.  After three weeks, they took the Foley out. For a week now I have been peeing on my own (my stream is like a pressure washer- my confidence has been totally boosted. Peeing at first was a bit uncomfortable for a few days. My testicals were swollen after surgery which I was not expecting, however, eventually the swelling reduced (about 1-2 weeks).   My SP catheter is pinched off and they say I will have it for another week (mostly there as a precaution). I have not been allowed to have sex yet, my doctor plans on talking to me about it next week when he takes out my SP.  I do get a nightly erection now and then which can be sometimes kind of painful. Also, I can still feel a little tingling down by my incision site.  Hopefully I will be able to resume physical and sexual activity soon. I will update next week (week 5).
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Avatar universal
I thought it best for me to share my experience with a urethroplasty.  I like most of you had a urethroplasty about 8 months ago.  Unlike some of you I woke up one morning with an inability to urinate and went to the local emergency room were they punctured my urethra while trying to relieve my full bladder.  After several excruciating hours a urologist walked in and saved the day.  I was dilated via catheters increasing in size and was told to wait for six weeks.  After which they removed the catheters and I was able to pee more so then before.  I have no idea what caused the initial problem in the first place but this is where my life got turned upside down.

Before I tell the rest of the story I just want to share my experience I have no idea what any of you should do for your situation.  As you will see after reading my situation I chose the wrong path.  Any way on with the story.  After three months I had lost all my stream and ability to pee.  I contacted the same urologist that saved the day impressed by his abilities from the previous nightmare I thought I was in good hands.  He did a consult told me of my options and advised me that Erectile dysfunction can occur but very rare so I said lets do the plasty.  Recovery was followed by the letter no direct pressure on the incision area.  No sex for six weeks. (I waited longer).  Let yourself heal or lay low as he put it.  I have been in constant pain if I have sex for almost a year.  Not one person can figure out what is wrong.  I have no infections, the stream is just fine but if I have sex I have burning in my urethra, sometimes bladder, my penis is sore for days afterwards.  I am now starting to have erectile dysfunction didnt have it before (could be psychological because I hate sex now) on the account that it is constantly disappointing.  And like so many of you not one person told me about penile shortening.  I lost an inch or so but the part that upsets me is the pain you can have the inch I want sex without having soreness.  I have given up on seeing my doctor because he just tells me it takes time to heal.  I think he just dont want to deal with me anymore.  I am constantly on pain medications for the pains that come and go.  Feelings of being kicked in the balls, sore and painful shaft, burning after sex discomfort.  I can deal with most of it but I am so sick of the damn pain and the meds.  I wanted to be somewhat normal after this I can accept maybe less than normal but this constant pain *****.  If I had a do over I would have done something different.  If I lose the ED battle I think I will have a sex change and try that out just kidding.  Lastly I wish all of you the best I am not the best person to listen to as far as basing a decision.  I also wanted to ask do others have spots of numbness or loss of feeling.  There is a quarter size patch on my penis of course on the sensitive side that has little to no feeling.  Love to hear your posts wish you all the best.  
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Avatar universal
hey my name is Vinay from india... i am about 25 yrs of age and have a 1.5 cms long stricture on my bulbar urethra... i know all the complications from urethroplasty and my doctor said first get married and have kids then go for surgery but since india is a tropical country with warm summers that worsens my stricture in summers... i am afraid if i went for surgery and have any erection problem then i wont be able to marry anyone in future and if i delay the surgery then i will be in pain during summers ie most of the times... i am not getting what to do now... plz do recommend what could be done... i dont wanna have erectile dysfunction... is there any other way to sort out this problem??
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Avatar universal
Hey All,

I'm a 26 year old male with a ~2cm stricture and I'm scheduled to go in for an anastomotic urethroplasty in about a month. I was curious as to whether or not you gained any size back?

My doctor mentioned NOTHING about size loss or any other issues, and his chances of side effects were minimal...less than 5% for any type of side effect. Everything I've found online has pegged this guy to be a lying sack of **** wrapped in scrubs.

Furthermore, I wasn't offered the option of buccal mucosal surgery, were any of you?
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Avatar universal
Hi i had sex to early after my urethraplasty i had sex the day after i got my superpubic catheter out and i cant get erections and my penis also is very sensitive at all anymore. The reason i had sex so early is because i was really high on painkillers and misunderstood what my nurse said and it was 4 months ago this happened and i thought it was something that would get better but it hasnt (ive been masturbating once a day hoping it would get better.) Im not really sure what to do if i wait will it get back to normal and i will get erections???
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