Penile Atrophy After Surgery & Radiation |
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- เผยแพร่เมื่อ 8 ก.พ. 2025
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0:26 What is penile atrophy?
1:35 Can penile atrophy be preemptively avoided before surgery?
3:33 How would a patient learn to give themselves penile injections?
4:23 When should a patient approach their urologist about penile injections?
5:28 When should a patient begin taking medication's like Viagra or Cialis?
7:15 Can radiation treatment cause penile atrophy?
8:54 Are there atrophy treatments other than Viagra/Cialis and injections?
9:23 What is the process of obtaining and using injection treatments like?
10:54 How can a patient broach the use of injection treatment with their partner?
12:15 Alex's conclusions
14:24 If you need more help
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Radiation/Lupron- nothing was said to me about atrophy. Dr. Almost made a joke blaming it on weight, part of which caused by shot and Im sure, on age (71). It has been debilitating for me, and not just because of sex, but it disappeared which makes normal urination impossible. Doctors have a LONG way to go regarding knowledge and empathy. Im grateful for this channel.
Well, at the infamous CROSS CANCER INSTITUTE, I was coerced, deceived, extorted and intimidated into getting one six-month injection of Eligard ADT CASTRATION without any counseling about penile atrophy or the extremely long testosterone recovery or high risk of permanent CASTRATION level T.
It seems doctors assume that after 50 or 60, noone has sex anymore and no one cares about sexual function.
I refused further ADT and my T remains extremely hypogonadal even almost two years after that ADT toxin was supposed to expire. I am convinced that if I had permitted the two years on ADT, that toxin would have killed me faster than the cancer.
Dr. John Mulhal's videos saved me from the usual penile atrophy.
I made it a daily committed task to stimulate erections and was fortunate enough to be able to achieve them without injections by mental, visual and physical stimulation, even with zero libido.
Spot on that penile atrophy and injections don't come up in pre-treatment discussions. After the surgery/radiation/hormone therapy, too many other considerations. "Penile atrophy" needs to be part of the early discussions on prostate cancer treatment, but it often isn't. This is unfortunate.
This channel would be my first recommendation to anyone facing prostate cancer treatment.
Couldn't agree more. At no time was there any discussion about best chance of keeping erections. That is just wrong.I had 42 radiation sessions and 6 months of Hormone therapy . During that time I could care less about having sex. After I got my desire back I wanted to get erections and at that time we had the discussion which I now know it was too late. I did the shots did nothing, had shock therapy did nothing and then talk about the penile implant which I was not going to do. After all of that my Doc talked about the pump which did work and I can have sex again. I am angry that I could have had a chance of keeping my erections if I now know what could have been.
I've been doing injections for years. They are very effective. I refused hormone therapy after my prostatectomy. It was the best decision i ever made. One point the doctor missed is that because bimix and trimix are compounds they are at times not consistent with the level of potency and can throw of the potency which effects the dosage. When first starting the injections you should start low and slowly increase until you find an effective dosage. The doctor is absolutely right that you should start as soon as you can . Failure to get the system back on track could hurt your ability to have an active sex life.
I started over ten years ago and it's still effective.
Best of luck!
Thank you all . My sister has said a few times that I seem so calm about my prostate cancer. I've said to her that it's because of the research I've done online. And much of what I have learned has come from your TH-cam channel. Many thanks, really.
When I was told that I would need RRP I was told bluntly by the surgeon that he would not be able to spare the nerves and I would "never have an erection again". That was pretty much the end of the conversation, no discussion about loss of penile length, atrophy or anything. I felt really let down by my surgeon.
Because you were let down by your surgeons. That's terrible.
Pretty common situation. They don't like to talk about these things for obvious reasons.
Coming up on the two year anniversary where my urologist told me if he didn’t extract my prostate I would die. ( Gleason 3+4 = 7, PIRADs 4). Immediately went on active surveillance, predominant plant based diet and hired Mark Scholz. 🙏🏻Thank God.
I've been diagnosed the same as you. I live in FL. I'll look into dietary changes.
@@tims997p9also look into LDR brachytherapy. Over in Sarasota FL great group.
Maybe a second opion
As someone who has recently been diagnosed with PC, I can say this channel has been instrumental in helping me deal with the shock of my new reality. Education is a great conduit for escaping this emotional abyss. Keep up the good work.
I chose brachytherapy and external beam radiation with 18months of ADT. The subject of penile shrinkage did not come up at all. I literally had zero interest in sex and zero erections for 18months. Erections finally returned but the penis size is half of what it was which has been humiliating. Orgasm returned as well, but because of the shrinkage, an active, confident sex life is almost impossible.
It's critical that urologists discuss this early in the process and offer options to keep erections a regular part of life even in the absence sexual activity JUST to keep the penile tissue intact and working. I had no idea. Use it or lose it is sadly true in this case.
So very true, it was almost like this penile shrinkage was just ignored. 50% lose is a big barrier and whilst I can climax it is a dry one and I now have no sex life which wasn’t discuss at all. The testosterone blocker was the key and I stopped early as it made life intolerable and if the cancer returns I will not have this again and wish I hadn’t had it in the first place. This is such a great place to learn and wish I knew about it before treatment.
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Following the same treatment plan. Started hormone therapy last week . Brachytherapy done in March. Last EBR yesterday. NO MENTION OF THIS by my doctors. Unbelievable! Thanks to this channel I can get great information to act upon. Shaking my head.
Great empathy from you both towards men going through a very distressing time . Thank you
I’m glad I found this channel because that was one of the reasons I went with radiation treatment not to mention the surgery is very invasive. Be problems with the urinary track and nothing is 100% guaranteed. Everyone knows that they’re a reoccurrences with surgery.
Too late but at least I know the reason and as you say I realise I am not alone. Thank you 🙏
Your not alone
ADT is chemical castration, plain and simple.
On ADT, there will be no nighttime erections and hence, no oxygenated blood into penile tissue and permanent atrophy will result.
With a little help from Cialis etc and maybe trimix or Alprostadil Injections it should be possible to achieve sufficient erections to maintain penile health and prevent atrophy, even with zero libido IF extra effort is made to stimulate daily erections with the help of visual, mental and physical stimulation.
It may seem like a waste of effort with no intrinsic libido and no capacity for orgasms, BUT consider it a mandatory task that will preserve penile function long term.
Dr. Mulhall is a leading advocate for the preservation of sexual function and deserves a Nobel prize for medicine.
Most doctors are completely indifferent to their patients' sexual wellbeing and long term quality of life.
Thank you for shining light on this deep dark secret.
Men mistakenly assume penile injections are done into the sensitive tip which would be painful.
But the injections are made way back along the insensitive shaft and should be almost painless. A 30 gauge ultrafine needle should be used, not the usual 27 or 28 gauge that are usually given. Ultrafine needles are so thin that they are almost painless and it helps to gently stretch the shaft while inserting the needle.
It is only as uncomfortable as a mosquito bite and erections result in a few minutes with mental, visual and physical stimulation and usually last over an hour.
The only significant risk , if too much medication is injected, is possible priapism or prolonged erections that won't go down which can be a medical emergency, but this is extremely rare .
Patients should first try to make special efforts to achieve erections with low dose 5 mg daily Cialis /tadalafil with self stimulation helped maybe by mental visual and physical stimulation. Watching their favorite porn and masturbation will often compensate for the total loss of intrinsic libido that the ADT causes, but it is even more important for preserving penile function as weight training exercise is for preserving muscle mass and function. Once penile tissue atrophies, the damage is permanent. Unlike loss of muscle mass, which could be regained with great effect after Testosterone recovers or is replaced, penile atrophy is permanent.
This is the first video you have produced that addresses this critical issue that preserves long term quality of life and sexual health for prostate cancer patients.
Thank you for your great work .
Unfortunately, these injections are horrifically expensive but the basic ingredients are very cheap. Compounding pharmacies and drug companies are ripping us off big time. Someone needs to start a pharmacy to compound these injections for an affordable price.....
I've been on orgovyx for 3 weeks now..had sex twice..i take 20 mg cialis every 3 days.. it definitely helps. Years ago i took proscar/finasteride and saw dramatic penile shrinkage and was able to restore it after the fact with cialis
@@DeathSentryCoH
Good luck with the Orgovyx.
But be aware that ADT CASTRATION side effects take a long time to show up. After 4 or 5 months on ADT, you will likely find the side effects getting much worse as muscles waste away, severe mood swings, and dangerous brain fog. Be very cautious driving as your brain will be incapable of multitasking and you will need to really focus on one thing at a time.
I suggest that you make a big effort to get erections every day, because ADT will likely end all LIBIDO. and no more nocturnal erections, and therefore no oxygenated blood into penile tissue resulting in permanent shrinkage and atrophy.
But, if you dig down for some intellectual libido with visual, mental and physical stimulation, you should be able to preserve most of your sexual function, with the help of 5 mg daily Tadalafil.
@@robwells230 sigh..yeah, i do wish thre was something better.. doc says i should really do the 18 months to get the full 10% reduction on recurrence risk/metastisis.. will be lucky if i can even do 4 months! So far i was able to have sex a few times over this time period..but, like you said, will get worse.. if it does, i may just stop it
@@robwells230thank you for the info
You both are amazing...thanks for every video....
All of these videos are so helpful, and provide such hope for a normal life after treatment.
I sure wish I had known to inject starting very soon after surgery all those years ago. Too late now, damage is done. Thanks for the warnings, docs. But, OTOH, what about Peyronie's disease as a side effect of repeated injections? I have communicated with a number of men who developed Peyronie's after surgery and blamed it on the injections.
I wish medics would get up to speed with this. Another reason for educating yourself.
boys, get rid of the bad prostate. anything else is kicking the can down the road. my surgeon told me gl and see you in 6 months. then I saw a doc at MSK (Mulhall) and he brought up injections. whatever you do, before you do it, do your own research, reach out to other patients, talk to your family and ask questions to your docs, all of them. I am the biggest punk and I am ok after losing my gallbladder then 1 month later my prostate. boys, we have your backs - ask questions & stay strong, people need you 👊
The first two times I was given Trimix - I fainted. The third time the injection was extremely painful. I never got to the stage of being able to attempt injecting myself .
I really wish I newer had my treatment.
"Treatment" meaning radiation/ADT (or surgery, if that's what you chose)?
In my opinion, age and quality of life are two factors that men must contemplate before treatment. Staying healthy is paramount to getting the best outcome.
Maybe a month after my prostatectomy, I was having trouble sleeping, so I took some Trazadone. This medication has a possible side effect of Priapism (an uncontrolled erection occurring for hours.) That's precisely what happened, and I was both intrigued and relieved that I was still able to.
That aside, I highly recommend people who go the surgery route to be as "active" as possible when they're able and to do so regularly, even if it's masturbation. I think that's what spared me.
Trazadone, ehhhhh? Thanks for the tip! -EK
My radiation was in 2020. Me ED gets worst as time goes by. Cialis doesn't work anymore. I never had hormone therapy.
You had ONLY radiation and developed "gradual impotence" ?? And NO ADT (hormone blocking therapy)??
@@edwardkirby7679 Yes. I also still have cancer and now I can't have radiation or removal.
This is a great conversation program !!!
Thinking I am going with Proton therapy in San Diego. Was given a Gleason score of 3 + 4.
In my case my gleason score was a 9 the PET scan showed no spread. I chose to forgo ADT and just do HDR and IMRT. My PSA has gone from 5.8 to 0.827. I have noticed some atrophy you have to research and go with a treatment that suits you the best.
I would add that even though I knew about these issues anxiety about getting an erection on top of ADT made it even more difficult. My urologist was very open about discussing this even though I did radiation.
Most of these 'experts' don't divulge the full extent of erection and sexual problems after these procedures. Think long and hard no pun before you choose your treatment and decide what you can cope with after your treatment. I had focal therapy still get erections no sperm and a loss of libido and this is one of the less invasive procedures. I was 56 at the time.
Prostate cancer fear is an enormous money making racket.
Depends of your Gleason score G8 NOT a good candidate for focal
This was Never mentioned when i had my surgery. Why?
Because...would you choose surgery if you knew ? Of course not. Guess how urologist make their $$? Surgery.
@@vespatrixie2555 They dont in England we have a National Health Service (just about )
Great information as always. Thank you both!
None of this was discussed with me prior to or after my surgery, followed closely with salvage radiation and ADT. I now have massive atrophy so I'm not sure how injections could be administered. What can I do.
What is "massive" atrophy? Youre saying your entire organ is, effectively, non-functional and has been rendered "vestigial"?
I was told the lose of penis size is due to the prostate no longer being there, so the urethra is now attached directly to the bladder, instead of the prostate.So that can shorten the penis.
What are the chances of erections coming back naturally after stopping the drugs , not having surgery but did have radiation
Slim.. just try the cialis
Would radiation therapy have helped if my prostate was totally cancerous? Which it was diagnosed after it was removed. I was able to get an erection after my surgery. It’s been about six weeks since my surgery and I’ve had several erections. So I’m just going to take it easy and let nature take its course. I wish you guys the best success! Stay Strong!
That's pretty rare getting elections so soon after surgery
Erections
Doesn't surgery remove up to an inch of urethra and result in shortening the penis.
Not so much an inch BUT because the uretha is CUT in 2. Some shortening is happening
I totally agree, until recently I hadn't realized that Mario updated his favorite way to tackle ED and it's a relief! Although what he previously suggested was pretty good, it was a real pain to follow... I just go'ogled the latest in Mario's Thunderous Erections and it's so much simpler and potent now!
Four years post prostate removal, and this is the first I've heard about muscles in the penis that need to be exercised.
I've always had the impression, probably because of poor communication and reluctance of others to speak explicitly and in detail, that regaining erections was all about blood flow through pills, trimix, and/or vacuum pumps. Never about exercising muscle tissue.
I've mistakenly thought for four years that non-erect, or semi-erect, swelling might be doing some good because it was at least getting some blood flowing. I wish I could go back and find a much better doctor.
Penus pump.
Have you used a penis pump? If so, how long after your surgery did you start using it?
@@fredlevinssr3021 Yes I used it (unfortunately a little too late imo) while on the test blocker. But I had radiation not surgery. But dont see why you wouldn’t use one in either case. Mainly if you’re on the test blocker because you just never get erections. Thus no blood flow and potential atrophy.
@@fredlevinssr3021 And I would use it within two weeks if possible at least once a week.
@@clintcarter thanks! The best to you!