Penile cell damage and recovery -- permanent tissue changes?

We’ve all seen the studies that indicate finasteride’s action via prostate involution, ie apoptosis, ie cell death. From what I understand there have also been studies showing that this can ultimately lead to cell death in penis tissue, most notably in the corpora cavernosa.

This is due to damage to the cavernosal nerve, which is largely responsible for allowing erections to be continually furnished with NO and nutrients through adequate bloodflow. This nerve damage is very possibly the cause of the physical changes to the penis that many of us have, such as numbness, skin changes, and shrinkage (fibrosis?).

I’ve been thinking a lot about tissue regeneration, and I understand that there is evidence that with a return of androgens, these tissue changes are reversible (info from the studies in this forum).

I have a very rudimentary knowledge of cell regeneration and nerve damage regeneration, but from what I understand is that all cells with the exception of the central nervous system can regenerate, correct?
I also understand that nerve cell damage can be permanent in cases such as a complete sever of a nerve, but in most cases nerves also regenerate (I had arm surgery as a result of a broken bone, and have some slight nerve damage in my hand which is what got me thinking about this).

So following this logic is seems rational to conclude that even a worst case scenario, penile cell death and cavernosal nerve damage, is reversible given enough time and the return of androgens (and I believe that most users here report at least a partial if not full return of androgens over a long period of time).

However, the main problem for the shrinkage issue is not that the cells die and are incapable of regenerating, but rather the deposition of collagen and even possibly plaque. This is characteristic of Peyronie’s disease, which is usually treatable.

Ultimately, if there is a return or at least a partial return of androgens, then I see no reason for the physical changes of the penis to be permanent. Though of course treatment is necessary, such as use of sildenafil at night.

I guess I mostly posted this to sort out the information logically, and make me more optimistic about recovery of shrinkage and other physical changes. Comments are appreciated.

I also found an interesting article concerning penile rehabilitation:
medscape.com/viewarticle/576471_5

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Can you post the keywords you used to find the article (and tell us what page, or link to the Google search page), or locate it at another source, since the above requests we log in?

I used keywords “prostatectomy fibrosis treatment” and found it on the 8th page near the bottom.

Keep in mind it discusses rehabilitation as a result of radical prostatectomy, like the studies previously posted.

It’s interesting that VED treatment was discounted, considering the success it has with the men at peyronie’s forum.

I found it to be mostly good news, with the distinct exception that it mentions that rehabilitation start within 4 months after surgery before “irreparable structural damage to erectile tissue occurs, and it is probably related to such factors as age at the time of surgery and preoperative erectile function.”

This is disheartening to me, because the physical changes to my own member have lasted between 1.5 and 2 years, although I’ve only been off fin for 8 months.
I try to remain optimistic because I’ve definitely seen improvements in erection quality (though not in size or skin changes), and throughout this whole time I’ve masturbated regularly.

There is also the obvious fact that none of us actually had a RP, and may have less severe side effects.

I found some more studies concerning the physical changes to the penis after RP, and the efficacy of penile rehabilitation.

pubmedcentral.nih.gov/articl … id=2441891
pubmedcentral.nih.gov/articl … id=2531200
andrologyjournal.org/cgi/con … l/28/2/223

Personally since taking fin I’ve lost about .75 inches in length and 1.25 in girth, which gives me a worthless needle dick that has caused me to avoid all sexual situations for 1.5 years.

Im going to have to accept the fact that there is no way I will ever return to my former self. If I had quit earlier and began penile rehabilitation earlier (unfortunately it seems that treating it early is key as a prolonged state of hypoxia is likely to produce IRREVERSIBLE and PERMANENT damage), I would have had a chance, but not now.

This has given me the most impossibly bleak feeling of depression imaginable. I’m 21, in my senior year of college, good looking and athletic, and had sex with a grand total of 1 girl, who was my girlfriend that royally humiliated me and fucked me over. It burns me up inside that the only girl who experienced me as I’m supposed to be hurt me so badly. I’ve never even got the chance to heal from that as most guys do, meaning go fuck some girls and move on.

I feel like I’ve developed some complexes due to my shrunken dick, which seems completely unfair since I used to be significantly bigger than average. I don’t even care about complete recovery anymore, I’d be truly happy if I could just partially recover. But it’s become more and more apparent that I fucked myself over with this goddamn drug, all just to keep my hair (which I’m losing rapidly anyway). It’s even worse knowing that Merck will likely never be held responsible.

Frankly I don’t know how well I can continue to deal with this. Before there it seemed like recovery was likely, but now that scientific evidence holds the contrary, I don’t know what to do anymore. Even in the context of this forum I seem alone; not many of you guys seem to have the severe shrinkage that I have, and the ones that have had shrinkage have not had recovery. If my assumption is false, please let me know.

I’ve ruined my life with this drug. I had chances to fix things before it was too late, but I didn’t realize what was going on until it was too late.
Fuck my life and fuck you Merck.

Oneday told me that he had shrinkage and that his penis filled back up and he regained the size he lost while using PCT, so he went back to normal. All I can tell you is to get to a QUALITY Urologist (ie. not like the assface I went to who took a look and said “you’re fine”), one who can recognize cases of penile shrinkage and are aware of what damaging the prostate/androgen deprivation can do to the penis. Not sure where you’re from but see if you can make it to one of those guys in the Doctors section; there’s more experienced Uro’s there who will give your situation a close look with a bunch of tests.

I can relate to your despair and depression, one of the best things in life is to make emotional connections, to date, and to have sex. I made it through age 20 and 21 in probably the same state you are, I’m doing everything I can to determine what happened and reverse it, and I won’t stop until a Dr. recognizes and identifies my situation (most of them are reluctant to look, and when they do they just think you’re small). I know what it’s like to not want to get into any sexual situations too, in fact I met a girl who wanted that in a big way with me but all I could do at the time was push her away. It was very upsetting… but I still think there’s hope. Remember we didn’t have a RP.

So again, it should be PRIORITY ONE for you to make it to a very very good Urologist, one who has studied this issue like Dr. McCullough or Goldstein, and get your shrunken package looked at and analyzed. I don’t think they will let you down because they’re good doctors, and we have a very legitimate situation. We’re rare cases that need to be accounted for.

(BTW - your last link is a study that even was prepared by McCullough… you should definitely see a guy like him well-aware of these cases)

A few things:

  1. When I came down with some form of Norwalk/gastro-enteritis 2 years ago, for 2 days my penis and scrotum blew up to former size when flaccid, with a recovery of some libido. Wether this size change was due to the virus or simply water retention from the saline IV I got at the hospital I don’t know, but it was encouraging that the physical changes were not irreversible to my eyes… although the gains quickly dissipated as I got better.

  2. Many of the penile rehabilitation therapies state that even after 18-24 months, low-dose Viagra before bed can still be useful to induce nocturnal erections and help restore bloodflow to tissues and thus, erectile capacity (and hopefully size). Have you tried this yet?

  3. Numerous studies, including Dr Goldstein’s own work, state that androgen replacement can reverse penile tissue fibrosis. If you have been hormonally left in a state of hypogonadism or otherwise have an imbalance in terms of androgen/estrogen ratio, this may be playing a role in preventing “healing”.

Anyway, I know how you feel and I know how mentally devastating it is as I also have the shrinkage and complete numbness/rubbery-fibrotic feeling penis post-Fin… a Uro with experience in Peyronie’s disease may be a good idea to visit, but some form of penile rehabilitation therapy per the documents you’ve researched also wouldn’t hurt. The penis is a muscle like any other and needs to be excercised regularly to be kept in top form.

Even for myself, it took 2 years before I was even able to make any major progress in obtaining/maintaining erections, even though they are nowhere near as strong as before Fin and require constant physical stimulation. Despite being shrunken when flaccid and the loss of length and girth, I am still able to perform to a certain extent (although it can be hit and miss). Do not let the fact that things have shrunk up stop you… after all and as they say, “it’s not the size of the boat that matters – it’s the motion in the ocean”.

As a side note to this, when I was with my last girlfriend for 1.5yrs, at first my erectile response was very poor. But as time went on and I began having sex on a more regular basis, to the best of my ability (and thus excercising my penis), I found my erectile response improved and it was easier to get and maintain erections. Unfortunately it’s been a year since we broke up and thus my dick no longer gets the same workouts as it did, so my erection strength has diminished substantially again. Regardless, my point is: use it or lose it.

That is not true – YOU CAN hold them responsible by filing a lawsuit (hopefully a class action) in your country. MAKE them pay, through your actions.

thanks for your responses. The scary thought of permanent changes and the fact that it’s been a year w/ improvement in the size arena gave me one of “those days.” I was going to edit the bitching part out, but I needed to vent.

One of the factors that had depressed me was that me, unlike many here, had physical changes to their dick over the long term rather than right off the bat. I’d rather have had severe side effects early on, instead of gradually. After reading these and other studies, the fact that I had these symptoms increase over more than a year makes it hard to believe that there will not be permanent damage. But honestly I don’t care anymore if there is some permanent damage, I’d be very happy with even half of what I lost back.

Mew, I have been taking generic viagra on a nightly basis for almost a month and it does indeed help with nocturnals and occasionally morning wood as well. I take it w/ vitamin E, zinc, and magnesium. I don’t know if you checked out the VED section at the peyronie’s forum, but there has been considerable success with using a VED in terms of size recovery. I’m pretty much ready to go that route, except they cost like $400 - $500 and I really don’t have that kind of money.

I don’t have any trouble with getting erections anymore, though of course they aren’t as good as before. I’m sure I could have sex, but I just CANNOT get over being so freakin’ small down there. It’s really the only thing holding me back from getting laid.

This may sound kind of weird, but it’s my last semester of college, and all the girls who I’ve been friendly w/ and know they want some seem like they’re all being more and more forward, as if they know they’re running out of time. Because really, why wouldn’t I? There was some really cute new girl who’s been laying in on thick, but I know she gets around (which is fine w/ me, no double standard), but I can’t whip it out around her when I know she’s seeing other guys who aren’t having troubles like mine. I’ve got a fucking pencil dick now, 4.25in around; girls would laugh at that shit. Sure as hell wouldn’t enjoy it.

How did I lose over an inch without noticing??? It was so gradual . . .

So I don’t know how much other fin-stricken guys lost, but it’s enough to keep me from any action. I guess I have a complex. It’s weird how even half an inch of penis girth is preventing me from having a relatively normal life.

So for now I’m going to continue my viagra regimen, and look for a cheap VED, and maybe I’ll get enough back with that to bang a couple of the chicks I’m “supposed to.” I might go to a uro, but it seems that all the treatments are the same in most of our cases, am I right?

Anyway, thanks for hearing me out. I recommend EVERYONE take generic viagra at night; I believe if I had done this my shrinkage would not nearly be so bad.

First of all: Can you provide us all the link to where’s the best place to purchase some “good generic viagra” at a good price please?

Secondly: Dude, pump yourself up with a bunch of viagra… Then get into the moment! Tell her you have to have lots of foreplay before you fuck! If you get it hard, and then have lots of foreplay, it will usually get bigger and bigger and bigger… and dude. it sounds like you are freaking out a bit. 4 inches in girth does not sound “small” . Shit, find some asian or chinese women then. But shit, go out and fuck. Its what will get it back! Use it or lose it. Dude, the more i have sex, the much better my erections are. And I am not recovered. Sometimes I too still have total shrinkage, and it does suck! But dude, your tissue changes are NOT permanent, didnt we correspond through PM… Dude, you are just 21 and freaking out a little. If a girl acts weird when she feels it, laugh and say it used to be bigger, but you just have to have sex a few times. Most likely a girl wont even know. Additionally, quite often girls get all sizes. And it doesn’t determine who they stay with. I’ve had girlfriends who I’ve discussed this with personally, and it has nothing to do with who they decide to make their boyfriend. Its the whole love making experience which is much much more important.
READ the Karma Sutra books, and start getting laid my friend. You are very very lucky bro! To be at that place in your life. Pussy doesn’t come that easy later in life. Take it while you can! And if the anxiety is still getting the best of you, go immediately to a doctor and get a prescription to some Ativan. Tell him you get anxiety around girls sometimes, itsruining your college experience, and you just want it so you can use it ‘once in a while’ on weekends, and then just use it when you need to, or at least the first few times until you get more accustomed to the experience bro. Please do this right away and let us know how it worked out. Also, dont tell ‘that’ doctor all the other shit, because then he might think your problems are elsewhere and then maybe wont give you the Ativan. Tell him you dont party much, but just want it because of occasional anxiety, which gets dehabilitating, but you dont want to take some anti-depressant fulltime.
Again, get some Ativan, and get fucking!!! You’ll be fine… I’m telling you. Tell us what happens, we will all be anxious to hear… I’m pretty confident it will work out fine.

Boston, I responded to your pm some time ago with the link. I use 4rx.com.

And damn right I’m freaking out a bit, that tends to happen when your cock shrinks and you don’t know if it will ever come back. I’m under the impression we might have different symptoms; it does not matter how aroused I get, it always remains the same size. It’s not a matter of arousal. It’s as if the corpus cavernosum tissue itself atrophied. It never fluctuates. If I had it back to normal just once I would not be as concerned, but it’s been a year with no change.

And 4 inches is definitely small, much smaller than average. Look it up. Wouldn’t bother me as much if I was always that way, but I used to be lucky in that department. Girlfriends are more tolerable it’s true, but none of the girls that are chasing me are going to be my girlfriend, lol. I graduate soon anyway, I just want to fuck at least once in the last 2 freaking years of college.

I appreciate your optimism, but most studies I’ve read state that fibrosis due to hypoxia over a long period of time lead to permanent structural damage to the penis. My dick was starved of oxygen due to lack of nocturnals, and a year of this fucked up it up majorly. If you have any evidence that says the opposite, I’d love to see it, but I’ve researched this and not seen much myself.

So you are saying viagra doesn’t work??

I thought you could get an erection? What do you mean it always stays the same size??

No the viagra works fine.

I don’t have trouble getting an erection, though it’s still not as easy as before and I don’t get spontaneous erections.

I’m saying that the erect penis does not fluctuate in size; it used to be 5.5in around and now it’s 4.25 around, and it has not deviated even .1 inches since. I say that this is in contrast with others here, who say the size of their dick has returned to its original size at times, whereas mine has stayed the same, indicating structural tissue damage. Viagra has nothing to do with it.

Dude, I swear to you. You are freaking out for no reason.
Take care of your overall issue and attempt to recover, and it is really likely your penis will return to normal size. You are freaking yourself the fuck out. Believe me. I did too for a few weks after Mew first posted those highly disturbing reports regarding this sorts of stuff, but its highly unlikely in our case.
For example… I’m sure you have had nocturnal erections during this time, but probably just do not know it :unamused:
Dude, stop obsessing. Focus on curing, and your penis will return to normal size with time. Don’t be crazy. I am 32 years old dude, listen to me! Don’t read that shit. You still have a prostate dude!!

Yeah, but, shrinkage is still present in us, we’re not hallucinating – it’s real. I don’t think it’s alarmist when you’re pointing out a factual change. The studies offer info possibly related to why we had this reaction, we don’t know for sure why it happened. So yeah, probably very rare, but but also reason to believe the symptom is as the research says, possible effect of androgen deprivation (hence good reason to get it checked out and treated).

Even if he’s had some nocturnals like I’ve had (on and off), it doesn’t reconcile the reduction in size issue, as I know my erections aren’t as strong or large as they were. Nocturnals indicate erectile ability, not necessarily a return to typical size.

And yeah, excessive stressing over this issue isn’t recommended, but making note of a significant change is.

.

Boston, my loss of libido and shrinkage ARE my main problems now. My anxiety has been gone for some time, and depressions is definitely mitigated.
And I don’t see why those reports Mew reported don’t reflect some sort of parallel. You haven’t actually given any reasons as to why they aren’t viable information.

Solonjk, yes I meant 4.25 in width (as in circumference), what do you mean that is something other than shrinkage? I have also lost close to an inch in length as well, which is bad but not as much a concern as the width. I was just under 7 in and now i’m at about 6.

My balls are pretty small, like grapes, so they’ve definitely shrunk although they were never huge to begin with.
Solonjk it sounds like you’ve suffered significant shrinkage as well. Does your case sound similar to mine, and where do you stand now?

Honestly the only positive thinking I have right now is the recent recovery of 19, who had a narrowing that has recovered. I am also considering VED therapy.

Apart from that, the only thing I have yet to do is cardio exercise, which is weird since I used to be a competitive runner, but I haven’t run regularly for like 2 years. But I don’t expect cardio to help much anyway.

Oh btw, Default87, I forgot to mention something to you last week which you can use to help bring your penis back to shape. Its called a penis pump! Remember Austin Powers :wink:
I’m not sure if its ever been mentioned on this site, but it supposedly really does work.
I have a friend who uses one!
Apparently they are really popular in the porn industry as well. A lot of porn stars use them to get their cocks bigger!
If you use them everday, for a long time, your dick does really get bigger! It pumps up the tisue over and over and over again, and engourges it with blood, and stretches the tissue, and the vessels. Makes them dilate. Its just like working out and building muscle.
If you are still paranoid about your “pencil dick” then go buy a penis pump!

Boston I’ve actually looked into that, as per the results posted at the peyronie’s forum. They’re expensive as hell though.
Ha, never would I have thought I would be using one, I don’t think that scene in Austin Powers would be as funny now.

God I hope I’ll one day be looking back on all this simply as wasted time, and not the beginning of the end of my sex life.

Off topic question: Is libido something that most people have recovered here over time, or is it one of the symptoms that has persisted indefinitely for most guys? I’ve read a lot of the posts here but libido recovery seems to be particularly difficult to attain, would you agree?

this.

Some have used HRT/PCT and gotten it back, no one really has waited years and seen their libidos restored. There may be an exception, check the recovery section.

Absolutely man! You see it in life all the time too. I had a 21 year old young player working with me last summer. He’s like a chick magnet ok. ALways the hottest girls… So he was helping me do some maintenaince one day and we really got to talking. I told him about what happened to me. He then told me a story…
He told me about how his appendix burst when he was 19, he was rushed to the hospital and almost died! He told me he thought his life was almost over too because he was left impotent for about 3-4 months… He continued to have ED for about 2-3 years. He says he eventually did recover. Of course it wasn’t like when he was 18. He doesn’t get erections when the wind blows anymore, but he has good erections,libido, and Sex function just like anyone else again, and has totally gotten back to “normal”. He is not worried at all, and still has plenty of ladies, and great rewarding sexual experiences now. He is 24 I guess now.
I have also heard about plenty of people who when they get chemo-therapy they are left with ED or impotence, and sexual dysfunction for a long while after, and it can take them 18 month, sometimes 2-3 years to get back to normal.

Libido and erections usually go hand in hand.
Plenty of people recover their libidos.
I know I have. Panic has. Softie has. Quint has, I think. Galapagos. Many many others.
As your HPTA, prostate, and sensitivity comes back closer to normal, your erections and libido usually follow.
Dude, always keep this in mind. And I am sorry to say this for some of you who actually may unfortunately be ones who are the ones who take this personally, but unfortunately there are probably many on this site who will never “recover”. Or at least to their standards. They will be sufferers forever. I do not want to get into a whole debate over this. But its just the way anything in life goes. As well as the power and influence of the mind. So you have to read this forum objectively.
More importantly, you can recover dude!
Have you seen improvements? Sensitivity return to your penis? This is usually a sign of increased blood flow.
Anyway, I’m not gonna debate stuff, just that I was JUST LIKE YOU when I first got on here 2 years ago, today almost! Read any of my old posts!
Dude, I freaked the fuck out and was in a manic state of panic and despair for a good 8-10 months at least. Until I started having a few encouraging sexual experiences here and there, and signs of what I remembered things to be like. I’m talkin maybe only 2 days in maybe 2-3 months period. I still had all the naysayers, and people who wouldn’t believe, or who disputed everything. ANd thats when I took healing into my own hands. I started wearing very loose fitting pants and clothing, and trying to relax a lot. Stopped listening to a lot of people on this forum. That was most important. Eating only certain foods, and taking lots of hot baths and jacuzzi to help relax things and get them feeling better whenever possible. I decided to start treating the symptoms, because I didn’t know how to treat the cause. I figured this could fix my fight or flight response, energy flow, comfort levels, and stress levels. This is when things started to change for me. The more I did certain things, the more I released pressure and tension, and then things started returning. Feeling and size in particular started returning. Whenever things were shrunken up a little bit, numb or uncomfortable I’d suck my stomach in, and rub it, and try increasing circulation. I still have to do it. Just not as frequently. My body has gotten more used to the normal feeling again. Its like a foot thats lost feeling, fallen asleep wiggle it until you regain feeling. Its not that easy. I definitely still get shrinkage and numbness once in a while, but that also happened here and there when in cold shower, with chills, sick, whatever…even before fin. I think its a fight or flight response, and autoimmune response or something… All connected with hormone distribution and blood flow as well.
ANyway, I will stop rambling. Just rememeber… Do what you can to increase feeling, and size will return towards normal.
There are handfuls of people on here who have regained all of this.
I definitely had a shrunk dick for 12-18 months, no doubt! It scared the hell out of me. But just as Mew has mentioned in the past, he saw his size return once when he got sick. This happened to me more than once also. ANd now finally it is closer to normal size, than shrunk on a regular basis now. Good luck friend. And stay away from the negativity on here. The people who have no hope. Search hard enough, and pm enough people, andyou will find people who’ve had size and function return.
I am about 75-80% if you talk about everyhour of everyday of every month, however I am 90-95% at times. Sometimes, when there is no pain or tightness down below.
And I WAS BAD dude! I shit you not!! I’m talking about CONSTANT AWEFUL PAIN for about 8-10 months straight. URINARY SYMPTOMS, SHRUNK DICK (which was the least of my worries because I had so much pain), and everything people talk about on here. Things REALLY sucked for almost 16-18 months, until I got busy last summer, and was out and more active and not thinking about it so much. There was also about a week at about 11 months, when I went to Mexico for New Years when things felt great! I was having nice fatty erection on the plane once I left Boston, and erections on the bus, and in hotel. We were also hangin with these girls for three days. I was getting horny thinking about them and waking up with nice wood. UNTIL I got absolutely plowed on New Years Eve and it all came back in full force for the rest of my trip and I was tight and stressed out again. So theres something to be said about that story! I always have to remember that as well!
It does and can return if you work hard enough! Peace and good luck. Sorry for the book, but hopefully it was a quick read! Its all accurate and true though.

Boston, wow… I don’t know what screw went loose, but it’s messing with your ability to be objective and respectful. You’re SO sure ppl have recovered their libidos after long-term finasteride sides WITHOUT HRT/PCT? In a forum FOR guys who have not? Do you want to phone a friend or ask the audience buddy?

Yes, it’s possible to feel normal again after being devastated by Propecia, but they need certain treatment in order to get their system rebalanced when it fails to do so itself. In cases like ours, time doesn’t reverse the damage.

Also that’s a great story, but the medical fact is that the cause of his impotence was different from our own, therefore can’t really be applied here pathologically. Nice little parable though…for more seek the bible.

OMG hey you recovered? Where’s your recovery post? Oh yeah, TEH PROCESS~!!!111.

So let me get this clear: you had damaged libido post-fin, and with your good diet and relaxation techniques you got sex drive back and perfectly normal erections/erectile response? No symptoms, no complaints, feeling horny and pop boners? I’m pretty sure this would make you among the first of post-fin victims who have seen a sudden restoration…but then again I didn’t say I believe you are cured. I mean as soon as 2 mo. ago you were still in the same boat as us.

The only thing I think any respectable and honest member of this forum here would take offense to is your tone, as though you have all the answers and something separates you from the rest of us. You crossed the line, like it’s because we’re all negative nellys that our symptoms persist. That’s nearly as bad as saying that we deserved it, or that it was our fault. We have all succumbed to the same problem, henceforth there is a cut and dry solution (rebalancing hormonal health) that will be the cure, but rest assured it’s not because we’re all moping downers who spend time on this site that the problem exists, no matter how many times you want to say otherwise – THAT’S in your head. For you to suggest so is offensive and ignorant on your part, and of course you don’t want to get into a debate over it, because you know you’re not only wrong but it’s wrong of you to posture in that way, so give it a rest.

In fact, it’s obvious that the studies and truths of these issues generate quite a bit of fear in your mind, and you lash out at us for simply being victims, in doing so hoping that will declassify yourself as one, but yet…you still have a reason to be here.

Take your insults, airy protocols of positive thinking, and feigns of superiority elsewhere, because no one appreciates it. If you have recovered from the side effects, please post details of that in the recovery section (instead of just claiming “it happened!” and lecturing us with no substantial treatment methods), but do THE TRUTH a favor and avoid posting about how we can heal ourselves by thinking positively… we do that, it doesn’t heal us.