Most Challenging Urologic Complaint of Men Ever After- Short Penile Length: What is the Situation in Turkish Men Volume 1 - Issue 2

Ayse Veyhurda Dikmen*

• Consultant Urologist, Ankara, Turkey

Received: December 21, 2019   Published: January 07, 2020

Corresponding author: Ayse Veyhurda Dikmen, Consultant Urologist, Ankara, Turkey

Abstract PDF

Introduction & Objectives: Short penile length is probably the oldest symptom of men for centuries. It can be troubling enough for many men although not short in fact. Urologists often meet cases attending with complaints of insufficient penile length, but it is known that the measures of penile length are normal in majority of cases. It is known that nearly all of the cases do not have any knowledge in terms of normal penile length. In the literature, many studies have dealt with measures of penile length in flaccid position. In order to build up a nomogram of the population, erectile penile length and penile circumference should be measured.

Material & Methods: In this study, cases attending with complaints of insufficient penile length and/or penile curvature were evaluated retrospectively via results of self-measurement of erectile penile length by photographs taken by the patients at home and circumference and its photographic documentation by patients. 1470 cases, aged between 19-73, attended outpatient urology clinic between March 2010 and April 2019 with complaints of short penile length and/or penile curvature. They were evaluated with IIEF scores (International Index of Erectile Function), all of whom scored between 36 and 70, measurement of serum total testosterone, BMI (body mass index) values and the outcomes of self-measurement of penile length and circumference and its documentation by the patients. The patients were told to measure the erectile length of penile shaft with a ruler from the skin of penile root to the glans penis and the erectile penile circumference with a tape measure around the root of the penis while alone and they were asked to document this process via a photograph taken at home alone and bring it to the clinic in the control visit.

Results: None of the patients had any penile curvature in erectile form in documentations and they were told not having any problem of this kind. The mean BMI of cases was 23,3±2,9 and the erectile penile length was14,10±1,58cm with penile circumference being 11,24±1,51cm. The cases were found to show correlation between measurements of erectile penile length and penile circumference.

Conclusion: The penile length of 14,10±1,58cm in this study is greater than the dimensions, defined in the literature. This study can be used to define normal erectile penile length and penile circumference in this population and to compare the attending cases. Knowing to have a normal erectile penile length will re-establish their courage. All these efforts are worth to try after seeing the patients, pleased with themselves upon learning that thay are not “short” in fact.

Keywords: Penis; Shortness; Dimension; Erection; Diameter

For decades, urologists have met thousands of men attending urology clinics with complaint of penil shortness. Although there are dedicated medical doctors who are really in favor of measuring the real penile length during erection yet, there is still very little knowledge about the process of self-measurement of penis by the patients themselves alone. Not enough data is present today whether the types of behavior a man adopts to become erect for self-measurement really affects his erect penile dimensions. In fact, to design a study to detect the real penile length in erect status for a great population of patients, the physicians should first decide to provide a study in which men would be convinced to report accurate information about their penis size. It is somehow of great importance to take into account that the associations between men’s erect penile dimensions, the method of measurement and the social circumstances of the population. It also needs great courage to trust the patients, who are motivated to take part in self-measurement process in terms of their information of selfreported erect penile length and circumference. Herbenick et.al. measured the Erect penile length and circumference dimensions of 1,661 sexually active men [1]. Penile dimensions which are out of social expectations cause a personal dissatisfaction, especially for the men themselves and may create significant impact upon the sexual lives of the partners, even leading them to undergo utopic andrological surgeries.

Short penile length is probably the oldest and the most challenging symptom of men for centuries. It can be troubling enough for many men although not short in fact. Urologists often meet cases attending with complaints of insufficient penile length, but it is known that the measures of penile length are normal in majority of cases. It is known that nearly all of the cases do not have any knowledge in terms of normal penile length. In the literature, many studies have dealt with measures of penile length in flaccid position. In order to build up a nomogram of the population, erectile penile length and penile circumference should be measured. This study was carried on adding further insights into usual opinions and practices of physicians in terms of penile measurement and is the most unique study in the literature of its kind.

In this study, patients attending outpatient urology clinic with complaints of insufficient penile length and/or penile curvature were evaluated retrospectively via results of self-measurement of erectile penile length by photographs taken by the patients at home and circumference and its photographic documentation by patients. It is a usual medical attitude to inform the patients with complaints of penil shortness how to measure their real penile length in erect status when they are alone and document the outcome with a selfphotograph. 1470 cases, aged between 19-73, attended outpatient urology clinic between March 2010 and April 2019 with complaints of short penile length and/or penile curvature. The mean age was 32.8. They were evaluated with IIEF scores (International Index of Erectile Function), all of whom scored between 36 and 70, the measurement of serum total testosterone, BMI (body mass index) values and the outcomes of self-measurement of penile length and circumference and its documentation by the patients via photographs. The patients were told to measure the erectile length of penile shaft with a ruler from the skin of penile root to the glans penis and the erectile penile circumference with a tape measure around the root of the penis while alone and they were asked to document this process via a photograph taken at home and bring it to clinic in the control visit. Since the patients have documented the measurements of their erect penises when they were alone themselves, the outcomes are free of bias, in fact. For this reason, this study provides us the real unaffected measurements of erect penile dimensions and inform the real genital knowledge unique to population beyond limits.

Since the cases of penile curvature were excluded from the study, none of the patients had any penile curvature in erectile form in documentations and they were informed about not having any problem of this kind. The mean BMI of cases was 23,3±2,9 and the mean erectile suprapubic skin-to-penile tip length (penile length) was14,10±1,58cm with mean penile erect shaft circumference being 11,24±1,51cm. A nomogram was constructed and statistical analysis was performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.241, P < 0.001) to tip, and a weak negative correlation between age and both erect penile length measurements (skin to tip r = -0.187, P < 0.0008). The cases were found to show correlation between measurements of erectile penile length and penile shaft circumference.

In the literatüre many physicians have reported to have measured the real penile length of the patients via the method of “measuring from suprapubic skin to penile tip”. Zhang et al. [2] also measured the penile length of the patients from tip to skin preoperatively and post-operatively. Cevrot et al. [3] offered penile extenders as the first-line treatment for patients demanding for penile lengthening procedure. They have declared that cosmetic surgery of the penis could be associated with a high risk of forensic exposure and surgery should have been reserved only after a multidisciplinary consensus, with enough time given to patients for decision-making. It is of utmost importance to demonstrate the real dimensions of the penis via thorough urologic consultation in cases, presenting with complaints of penile shortness. The mean erect penile length of 14,10±1,58cm, identified in this study is greater than the dimensions, defined in the literature. This study can be used to define normal erectile penile length and penile shaft circumference in Turkish population and to compare the newly attending cases. Knowing to have a normal erectile penile length will re-establish the courage of the patients. All these efforts are worth to try after seeing the patients, pleased with themselves upon learning that they are not “short” in fact. Finally, a healthy and normal sexual life cycle as always expected in the population can be supplied with the self-conviction of men on an individual basis, first.

1. Herbenick D, Reece M, Schick V, Sanders SA (2014) Erect penile length and circumference dimensions of 1,661 sexually active men in the United States. J Sex Med 11(1): 93-101.
2. Zhang X, Huang Z, Xiao Y, Kuang L, Zhang M, et al. (2019) Suspensory ligament release combined with acellular dermal matrix filler in infrapubic space: A new method for penile length augmentation. Andrologia 51(9): e13351.
3. Chevrot A, Droupy S (2017) Cosmetic surgery of the penis. Rev Prat 67(6): 623-627.