Penis Size – The Long and Short of it

Urology isn’t as sexy as cosmetic surgery nor as awe-inspiring as brain surgery, but it certainly raises eyebrows at parties when the only question men want an answer to is… well, you know the question don’t you?

And as much as this topic, usually mentioned tongue in cheek, is treated as a bit of a laughing matter, it is for some men a very personal one… and a question that is surprisingly quite common in urological practice.

Most men who have concerns about penile length usually have another pathological condition that brings them to see their urologist.  Penile shortening is often related to that condition rather than a problem in its own right.

Sometimes however, men present requesting an opinion on the length of their penis and whether or not something can be done about it.  Concerns about penile size can range from a mild anxiety that is easily reassured, to a genuine penile dysmorphic disorder (PDD), which is a subtype of body dysmorphic disorder (where the size or shape of the penis is the main or exclusive preoccupation causing significant shame or handicap). There is almost never an indication to undertake surgery for these concerns.  

Before we get into the nitty gritty though, lets take a journey through the history of the penis and its place in art, sexuality and society over the ages. Many of the concerns relating to penile length and girth, can be traced back to unrealistic perceptions about what constitutes “normal”. You would be surprised at how images of this organ have been portrayed over time, and how this has influenced modern perceptions about what constitutes “normal”.

http://www.bustle.com/articles/115957-the-ideal-penis-in-history-by-each-obsessed-culture-nsfw

http://www.cosmopolitan.com/sex-love/advice/a4522/most-famous-penises-in-history/

The Romans preferred their penises uncircumcised and scrotums seemed to take pride of place rather than the appendage…

The islanders of Rapa-Nui built Moai to honour their ancestors, and which are surprisingly phallic in their design.

So let’s dispel some myths about the penis…. After all, you don’t want to believe everything you read and certainly nothing you find on the internet.

• The Foot/Penis Size Relationship – You know what they say about guys with big feet… big shoes! Regretfully, there have been no scientific studies proving a relationship between shoe size and penis size.
• The Adam’s Apple/Penis Size Relationship – Some believe that a man with a more prominent Adam’s apple must mean they’re also have a more impressive penis. Nope – the size of your Adam’s apple, your ears or your nose, are not indicators of penis size.
• Ejaculation Volume – The myth that men ejaculate mass volumes of semen is perpetuated by the pornography industry.  In reality, the average man only ejaculates about one teaspoon (~3-5mL) of semen when he orgasms.

So with all this history and mythology, it’s not surprising that modern men are confused about what exactly constitutes normal penile anatomy… after all, how long or wide is “normal”? 

Kinsey in the 1940’s and 50’s based his analysis of penile length on a small sample group of self-selected college students and he suggested the “average” penis was 6” or 12.5cm long when erect.

In March 2015, the answer was clarified somewhat with a far more thorough study across multiple ethnic groups and over 15,000 men. The normal penis (that is, 90% of men – worldwide) is between 10 and 15cm when erect, the average flaccid length is around 9cm. Taller men though it seems, DID have slightly longer penises.

Unfortunately, some men with concerns about penile size (or indeed genuine penile dysmorphic disorder) seek surgical solutions where perhaps counselling and support may be more appropriate.  Penile length or girth enhancing surgeries have not yet reached mainstream acceptance because of lack of evidence about their effectiveness and risk.

The Sexual Medicine Society of North America has drafted a position statement on penile lengthening and girth enhancement surgery and it reads as follows:

‘The Society for the Study of Impotence has found no peer reviewed, objective or independently-monitored studies, or other data, which prove the safety or efficacy of penile lengthening and girth enhancement surgery.

We would encourage patients to raise any concerns about their penile size, or body image in general with their GPs.  Often this will be a positive first step in seeking the appropriate counselling and advice. 

This is one instance where surgeons are skeptical of a surgical solution.

Penile Size and Penile Enlargement Surgery: A Review
B.E. Dillon; N.B. Chama; S.C. Honig: Int J Impot Res. 2008;20(5):519-529.
 
Penile Girth Enlargement Strategies: What’s the Evidence?
M.C. Hehemann, M. Towe, L.M. Huynh, F.M. El-Khatib: Sex.Med Review. 2019 Jan4