The surgeon has significant influence on penile length as well, based upon decisions made pre-operatively, surgical technique in the operating room, and post-operative recovery instructions. Penile rehabilitation is increasing in popularity, commonly in association with radical prostatectomy in an attempt to mitigate treatment-related ED. An appropriate rehabilitation protocol consists of proactive use of oral phosphodiesterase inhibitors, intraurethral suppositories, intra-cavernosal injections, or vacuum erection devices to stimulate erections at regular intervals and maintain corporal and glanular blood flow. This can be initiated prior to prostatectomy or at least immediately after to maximize the chances of preservation of corporal tissue to maintain penile length. While more rigorous data is needed, what is available in the literature appears to suggest that phosphodiesterase use prior to prostatectomy is a protective factor for penile length preservation and restoration for the aforementioned reasons.
Mani, S. B., Henry, G. D., & Karpman, E. (2022). Penile Length Loss After Penile Implant Surgery. The Journal of Sexual Medicine, 19(6), 887–889. https://doi.org/10.1016/j.jsxm.2022.02.009
Phosphodiesterase use = taking Viagra. I was taking way more than prescribed (1500mgs+). Don't do that. But obviously do it the right way for whatever your relationship is with that medication.
I think when Viagra got invented back in 1989, it made everyone forget about VEDs even existing, and thus, men being lazy relied on one dose and that worked to get erections. That made their dicks smaller over time, because VEDs are much more cumbersome to use (too much of a hassle) but also a far more effective treatment for fibrosis. I think Dr. Wang wrote about that.
Now, interestingly, you can take a whole bunch of Viagra to solve the problem it caused. Start taking 2 at once, see how it goes. Might as well.
