If you are reading this you have probably read so many things about penis size and the penile implant that you are probably confused. Let me start by telling you that if you are impotent your penis is not seeing as much oxygen as it did when you were potent. Remember those 5 to 10 erections you had every night while you were potent? They were feeding and exercising your penis to keep it healthy. When this stops, your penis begins to fibrose or scar.
Because your erectile bodies are vested by a fibrous material called the tunica and these bodies begin to atrophy. While muscles can bounce back from atrophy while the tunica cannot. In other words, impotence leads to loss of penile length and girth. The institution where I trained (University of Miami) published a study looking at the loss of penis size following a radical prostatectomy. With a radical prostatectomy we are able to identify the DAY you are rendered impotent. Starting the day after surgery patients can loss between .5 and 5cm’s in 14 months. In the real world of impotence, these figures can be applied to any process that renders you impotent. You might be the .5cm guy which is barely perceivable to the naked eye or you might be the 5cm guy which is like losing 30 feet on a boat!
Many years ago, I presented an abstract that addressed this atrophy to give my patients a realistic expectation of what you will have after your implant. In that abstract we performed a penile stretch test (you simply pull on the penis as hard as you can and measure), an artificial erection (i.e. fill the penis to its maximum with saline and recreate the erection you would have on that day) and a postoperative measurement of the penis after surgery. Guess what? They were same!
What you bring to the OR you will bring home when it comes to penis size.
Undoubtedly you have read of many ways to maximize this post-operative length. Most serious implanters incorporate all these methods into their procedure. If you understand the physiology described above you must certainly understand that nature has left you with exactly what you got, indeterminate of the surgical approach used. Be careful of anyone offering you a bigger penis. Remember, if you don’t use it you lose it.
There are a few talented surgeons performing certain concomitant lengthening procedures but these come with significant risks and the gains are variable. At Perito Urology we believe that proper patient education and expectation leads to the maximal penile length and satisfaction after penile implant surgery.
Once a penile implant is in place, if cycled frequently and with zest, the penis will begin to grow in both length and girth. All serious implanters understand this because we are always able to upsize a penis on any replacement. I will never apologize for the loss of length that occurs with impotence because it is a reality.
The take home messages here are:
- Impotence leads to penile atrophy.
- The penile implant does NOT make the penis shorter.
- Regardless of the approach to penile implantation, surgeons only have so much tissue to work with.
- The only treatment for erectile dysfunction that stops all atrophy is the penile implant.
MTP 72: Penile Implant Upsizing
MTP #50: Determining the Correct Size for a Penile Implant
