Relationship between penile size and somatometric parameters in 2276 healthy young men

Abstract

The aim of this study was to determine the average penile length of a group of healthy, young Turkish men, and to investigate the relationship between penile length and somatometric parameters in the same group. The flaccid and stretched length and circumference of the penis was measured in a group of 2276 physically normal, young men. The correlation between penile length and weight, height and body mass index (BMI) of the participants was determined by Pearson's analysis. The mean age of the participants was 21.1±3.1 (18–39) years. The mean flaccid, fully stretched and circumferential length of the participants' penises were 8.95±1.04, 13.98±1.58 and 8.89±0.86 cm, respectively. There was a significant relationship between all of these variables (P<0.01). Although weak positive correlations were found between the mean circumference length and BMI, there were no correlations between both the flaccid and stretched lengths and BMI. The penile length must be known to be able to determine the abnormal penile sizes and to make convenient decisions in the counseling and/or treatment of people with short penis concerns. Our study provides mean penile lengths in a large sample of healthy, young Turkish men, and the penile dimensions were found to be weakly correlated with somatometric parameters.

Introduction

Morphological abnormalities of the penis can affect interpersonal relations and provoke emotional disorders, affecting quality of life.1 Additionally, the penis appears in virtually every aspect of life, such as medicine, religion, art and culture, the media and the common folklore. Concerns over penile size and a desire for a longer penis are common in the male population, and the number of male patients seeking andrological consultations for a ‘short penis’ is increasing.2

Penile length measurement is necessary in many situations. Some of these situations include a diagnosis of micro penis (including hormone deficiencies), anatomic malformations of the genitalia, defining the situations requiring penile-lengthening procedures, evaluating the results of medical or surgical intervention of the penis and experimental studies.3, 4 On the other hand, it would help to educate and inform patients about normal penile sizes, who are anxious about the size of their penis and to manufacture condoms in the correct sizes.5

Many studies have investigated penile measurement and its relationship to somatometric parameters such as height, weight, waist/hip ratio, body mass index (BMI), shoe size and index finger length.6, 7, 8, 9 The largest study on penile length in the current literature was done by Ponchietti et al.9 on 3300 young Italian males. They also correlated it with weight and height, but only for a random sample of 325 subjects of the same set of subjects. So far, this is the largest study to investigate both penile measurements and somatometric parameters like height, weight and BMI.

The aim of this study was to determine the average penile length and to investigate the relationship between penile length and somatometric parameters in a group of healthy, young Turkish men.

Materials and methods

After the Local Institutional Review Board of Dicle University Medical Faculty's approval was obtained contingent upon receiving informed consent, 2276 healthy, adult men, 18–39 years old were involved in the study, which took place between March 2009 and May 2010. Individuals with congenital or acquired genital abnormalities (e.g., Peyronie's disease, penile curvature) were excluded from the study. All measurements were performed by the same examiner (HS) to minimize the inter-observer error and under similar environmental conditions (room light, air-conditioned room and at temperatures varying from 23 to 25 °C).

Penile length was measured along the dorsum of the penis by a ruler with millimeter markings, with the subjects standing up. The penile measurements assessed were the circumference; the diameter at the midpoint of the penile shaft, at the flaccid length; from the pubopenile skin vertex, depressing the pubic fat, to the extremity of the glans, with the ruler placed against the dorsal part of the penis, at the fully-stretched length; and from the pubopenile skin vertex, under maximal—but not painful—extension and depressing the pubic fat, to the extremity of the glans with the ruler placed against the dorsal part of the penis.

All participants' ages were recorded. Their height and weight were measured and recorded, and their BMI (ratio of weight in kilograms to height in meters squared) was calculated.

The statistical analyses were performed by SPSS for Windows 15.0 (SPSS Inc., Chicago, IL, USA). Data were presented as mean±s.d. Results were evaluated using descriptive statistics and a Pearson's correlation analysis (two-tailed Pearson's correlation coefficient, or r). A P-value of less than 0.05 was used as a threshold for statistical significance.

Results

The mean age of the participants was 21.1±3.1 (18–39) years. Of these, 2259 (99.25%) were circumcised. Table 1 shows the characteristics of the study sample. In addition, Table 2 shows the descriptive statistics for the penile dimensions among the members of this sample.

Table 1 Descriptive statistics for the general characteristics of the Turkish adult male
Table 2 Descriptive statistics for penile measurements of Turkish adult male

The mean flaccid, fully stretched and circumferential lengths of the penis of all participants were 8.95±1.04, 13.98±1.58 and 8.89±0.86 cm, respectively. The mean flaccid penile length was shorter than the mean stretched penile length, and there was a positive correlation between them (r=0.672, P=0.000). A positive, statistically significant correlation was found between the mean circumferential length, mean flaccid length and stretched penile length: r=0.608, P=0.000 and r=0.371, P=0.000, respectively.

There was a weak negative correlation between age and the mean circumferential length (r=−0.051, P=0.016), but no correlation was found with other penile measurements (P>0.05). Weight and height were found to have a weak positive correlation with all penile measurements. Likewise, BMI was found to have a weak positive correlation with flaccid and circumferential lengths, but not with the stretched length.

Discussion

There has been a steady increase in the number of people complaining of having a ‘short penis’ and consequently seeking penile enlargement procedures. This is likely a result of many young men who seemingly base their idea of normality on the images of penises seen in pornography. It seems that the percentage of men worried about having a short penis will increase in the near future as a result of misleading messages coming from these media, particularly in the Internet era, where pornographic images of very large penises are often co-marketed with devices or clinics claiming to be able to increase penile size.2 In a recent study, of the 250 patients with a complaint of a small penis, 64% said that their concerns about penile size started in childhood, when they compared their penis with that of their friends, whereas 36% said that their concerns began during their teenage years, after seeing pornography.10 If a man perceives his penis to be inadequate—whether real or imagined—negative feelings invade his interactions with his sexual partner, and even with his professional associates.11

The ‘small penis syndrome’ is defined as an anxiety and found in men with a normal-sized penis, but who are anxious about the size of the penis, in contrast to men who have a truly small penis (micropenis).12 The number of patients visiting sexual dysfunction clinics, who are concerned with having a short penis has been found to be increasing steadily. Mondaini et al.2 reported that most men who seek penile-lengthening surgery ‘overestimate’ the ‘normal’ penile length. In their study of 67 patients complaining of a short penis, none were found to have a severely short penis. Of these, 19 patients (28.3%) still wished to explore the possibility of surgery, despite after a thorough explanation during the visit.

The data from Turkish population about penile length were reported previously.3, 6, 13 In 331 volunteers, 67% of them were satisfactory about their penile size (13.6±2.3), with a desire to have bigger penises during erection.13 Also, 62% of them were thought that a larger penis is more necessary for female sexual satisfaction. However, it is shown that women do not necessarily believe that a larger penis is ‘better’.14 This data showed that not only patients with small penis syndrome, but also men who think his penis is normal want to enhance his penis in Turkey as a result of penis is a symbol of masculinity.

Although the desire for penile augmentation is increasing worldwide, indications of such have not yet been clearly established, and many complications have been reported.15 Surgical techniques for penile elongations offered to young men that think their penis is too small are limited, and the few described lack high numbers of patients and long-term follow-up.16 Liposuction can provide a ‘visual’ lengthening effect only. Suspensory ligament release followed by post-operative penile stretching provides some length gain (1–2 cm), associated with relatively rare complications such as penile shortening, decreased angle of elevation or penile instability.17, 18 Skin enhancement techniques can cause severe deformities, dehiscence, and in some cases, hypertrophic scarring.16 Thus, providing standardized data on penile dimensions seem necessary to make convenient decisions in the treatment of people with short-penis concerns.

The tissue quality of the penis has been found to decrease significantly with aging, and the biomechanical behavior of the flaccid penis during stretching is significantly different for young men than it is for old men.19 This reality is why we used young men for the study.

There has still not been enough study on the topic, and there is no standard technique for getting an accurate penile length measurement. Some of the authors measured penile length at the dorsum of the penis from the pubopenile junction to the tip of the glans.6, 20 However, others described a more accurate method to measure penile length.21, 22, 23 On the basis of this method, in this study, researchers preferred to push the caliper into the pubic bone at the dorsal aspect of the penis to eliminate the effect of the pubic fat pad.

Measurements of the penile length are generally made during flaccid, stretched and erect states. The first study about penile length was reported by Loeb24 in 1899, and the average flaccid penile length as he measured it was 9.41 cm. The average flaccid penile length, circumference and the mean stretched length obtained in the present study are similar to the other countries shown in Table 3. In the relevant literature, some general observations are possible about the penile length. First, the values for penile length show some consistency. Second, with a value of 8–10 cm, the flaccid length is usually 3–4 cm shorter than the stretched penile length and 5–6 cm shorter than the erect length. Third, there is a good correlation between stretched penile length and erect length.12, 20 It is generally accepted that a true micropenis is >2.5 s.d. below the mean length, and it was suggested that any penis with a stretched length of <7 cm is a true micropenis.20

Table 3 Previous reports on penile measurements in the current literature

The above-mentioned studies tried to determine the normal penile length. However, the variability among these values reflects the ethnic diversity of populations that were studied, as well as different measurement techniques. The differences in age characteristics and study samples of the patient groups used for the studies could also be contributing factors. To our knowledge, the current study is the third-largest series in the relevant literature, and the average penile length was found to be parallel to the other series, as shown in Table 3.

In the previous decades, numerous urological studies have focused on penile measurements in different populations, but few studies are available about the relationship between penile measurements and different explanatory variables, such as somatometric parameters. Shah and Christopher7 reported no correlation between shoe size and penile length. A study of 52 Greek males, aged 19–38, revealed that the glanular and total penile lengths are insignificantly inversely correlated to age, weight, BMI and height/weight ratio, and positively to height and (statistically significantly) with index finger length.8 In the largest study of literature, Ponchietti et al.,9 in a subgroup of 325 males, showed that penile measurements (length and circumference at the midshaft) are correlated to height, weight, and BMI. In a sample of 1500 young men, Mehraban et al.4 reported a significant correlation among age, height, index finger length and penile dimensions, but no significant effect of waist/hip ratio or weight. In the present study, weak positive correlations were found between penile measurements (circumference, flaccid and stretched lengths), and height and weight (the r-value varies from 0.076 to 0.205). Although weak positive correlations were found between the mean circumference length and BMI, there were no correlations between the flaccid and stretched lengths and BMI. To our knowledge, this is the largest study in the literature, until now, that investigated the relationship between penile size and somatometric parameters. Both the previous reports and our results demonstrate that there is no exact association between penile length and somatometric parameters. Therefore, this correlation is inadequate to make a clinical application in which penile length measurements are necessary. However, these results may demonstrate variability among different study samples, age groups and ethnic populations.

Circumcision is a very common procedure in the world, though this ratio may vary in different countries.25 In our study, 99.25% of those seen were circumcised in Turkey. There is no study that has addressed the impact of circumcision on penile measurements in adults. To the our best knowledge, only one report have demonstrated a statistically significant difference between circumcised and uncircumcised penises in Brazilian child.26 However, they report that the length of penile corporeal body evaluated by ultrasound are not significantly affected neither in circumcised, nor uncircumcised penises. We could not compare the circumcised with the uncircumcised men, as there were so few of the latter. To investigate the effects of circumcision on the penile measurement, further studies are needed.

Conclusion

To inform a man who perceives his penis as being inadequate, and before surgical planning for penis enlargement, urologists must know the normal penile length in their patients' specific population. In this study, the mean flaccid, stretched and circumferential lengths were found to be 8.95, 13.98 and 8.89 cm, respectively. Significant inter-correlations were observed between all measures of penile dimensions. Penile dimensions are found to be correlated with somatometric measures, such as height, weight and BMI. A significant difference was observed between the penile dimensions reported from different countries. The results demonstrate that, like other studies, penile lengths and circumference measurements are somatometric characteristics and, as such, are related to somatometric parameters, even if this relationship is not of clinical significance. To gain more insight into the morphological aspects of penile dimensions, a multi-centered, multi-ethnic study is needed.

References

  1. 1

    Diseth TH, Bjordal R, Schultz A, Stange M, Emblem R . Somatic function, mental health and psychosocial functioning in 22 adolescents with bladder exstrophy and epispadias. J Urol 1998; 159: 1684–1689; discussion 1689–1690.

    CAS  Article  Google Scholar 

  2. 2

    Mondaini N, Ponchietti R, Gontero P, Muir GH, Natali A, Caldarera E et al. Penile length is normal in most men seeking penile lengthening procedures. Int J Impot Res 2002; 14: 283–286.

    CAS  Article  Google Scholar 

  3. 3

    Sengezer M, Ozturk S, Deveci M . Accurate method for determining functional penile length in Turkish young men. Ann Plast Surg 2002; 48: 381–385.

    Article  Google Scholar 

  4. 4

    Mehraban D, Salehi M, Zayeri F . Penile size and somatometric parameters among Iranian normal adult men. Int J Impot Res 2007; 19: 303–309.

    CAS  Article  Google Scholar 

  5. 5

    Schneider T, Sperling H, Lummen G, Syllwasschy J, Rubben H . Does penile size in younger men cause problems in condom use? a prospective measurement of penile dimensions in 111 young and 32 older men. Urology 2001; 57: 314–318.

    CAS  Article  Google Scholar 

  6. 6

    Aslan Y, Atan A, Omur Aydin A, Nalcacioglu V, Tuncel A, Kadioglu A . Penile length and somatometric parameters: a study in healthy young Turkish men. Asian J Androl 2010; 13: 339–341.

    Article  Google Scholar 

  7. 7

    Shah J, Christopher N . Can shoe size predict penile length? BJU Int 2002; 90: 586–587.

    CAS  Article  Google Scholar 

  8. 8

    Spyropoulos E, Borousas D, Mavrikos S, Dellis A, Bourounis M, Athanasiadis S . Size of external genital organs and somatometric parameters among physically normal men younger than 40 years old. Urology 2002; 60: 485–489; discussion 490–481.

    Article  Google Scholar 

  9. 9

    Ponchietti R, Mondaini N, Bonafe M, Di Loro F, Biscioni S, Masieri L . Penile length and circumference: a study on 3,300 young Italian males. Eur Urol 2001; 39: 183–186.

    CAS  Article  Google Scholar 

  10. 10

    Ghanem H, Shamloul R, Khodeir F, ElShafie H, Kaddah A, Ismail I . Structured management and counseling for patients with a complaint of a small penis. J Sex Med 2007; 4: 1322–1327.

    Article  Google Scholar 

  11. 11

    Alter GJ . Augmentation phalloplasty. Urol Clin North Am 1995; 22: 887–902.

    CAS  PubMed  Google Scholar 

  12. 12

    Wylie KR, Eardley I . Penile size and the ‘small penis syndrome’. BJU Int 2007; 99: 1449–1455.

    Article  Google Scholar 

  13. 13

    Kuzgunbay B, Turunç T, Güvel S, Özkardeş H . The average penile size of the Turkish men and their opinions about the penile size. Turk J Urol 2007; 33: 290–293.

    Google Scholar 

  14. 14

    Francken AB, van de Wiel HB, van Driel MF, Weijmar Schultz WC . What importance do women attribute to the size of the penis? Eur Urol 2002; 42: 426–431.

    CAS  Article  Google Scholar 

  15. 15

    Son H, Lee H, Huh JS, Kim SW, Paick JS . Studies on self-esteem of penile size in young Korean military men. Asian J Androl 2003; 5: 185–189.

    PubMed  Google Scholar 

  16. 16

    Vardi Y, Gruenwald I . The status of penile enhancement procedures. Curr Opin Urol 2009; 19: 601–605.

    Article  Google Scholar 

  17. 17

    Murtagh J . The ‘small’ penis syndrome. Aust Fam Physician 1989; 18: 218, 220.

    CAS  PubMed  Google Scholar 

  18. 18

    Li CY, Kayes O, Kell PD, Christopher N, Minhas S, Ralph DJ . Penile suspensory ligament division for penile augmentation: indications and results. Eur Urol 2006; 49: 729–733.

    Article  Google Scholar 

  19. 19

    Bondil P, Costa P, Daures JP, Louis JF, Navratil H . Clinical study of the longitudinal deformation of the flaccid penis and of its variations with aging. Eur Urol 1992; 21: 284–286.

    CAS  Article  Google Scholar 

  20. 20

    Wessells H, Lue TF, McAninch JW . Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol 1996; 156: 995–997.

    CAS  Article  Google Scholar 

  21. 21

    Ting TH, Wu LL . Penile length of term newborn infants in multiracial Malaysia. Singapore Med J 2009; 50: 817–821.

    CAS  PubMed  Google Scholar 

  22. 22

    Gabrich PN, Vasconcelos JS, Damiao R, Silva EA . Penile anthropometry in Brazilian children and adolescents. J Pediatr (Rio J) 2007; 83: 441–446.

    Article  Google Scholar 

  23. 23

    Chen J, Gefen A, Greenstein A, Matzkin H, Elad D . Predicting penile size during erection. Int J Impot Res 2000; 12: 328–333.

    CAS  Article  Google Scholar 

  24. 24

    Loeb H . Harnrohrencapacitat und Tripperspritzen. Munch Med Wochenschr 1899; 46: 17.

    Google Scholar 

  25. 25

    Burgu B, Aydogdu O, Tangal S, Soygur T . Circumcision: Pros and cons. Indian J Urol 2010; 26: 12–15.

    Article  Google Scholar 

  26. 26

    Smith DP, Rickman C, Jerkins GR . Ultrasound evaluation of normal penile (corporeal) length in children. J Urol 1995; 154 (2 Part 2): 822–824.

    CAS  Article  Google Scholar 

  27. 27

    Kinsey A, Pomeroy W, Martin C . Sexual Behaviour in the Human Male. WB Saunders Co.: Philadelphia, PA, 1948.

    Google Scholar 

  28. 28

    Ajmani ML, Jain SP, Saxena SK . Anthropometric study of male external genitalia of 320 healthy Nigerian adults. Anthropol Anz 1985; 43: 179–186.

    CAS  PubMed  Google Scholar 

  29. 29

    Awwad Z, Abu-Hijleh M, Basri S, Shegam N, Murshidi M, Ajlouni K . Penile measurements in normal adult Jordanians and in patients with erectile dysfunction. Int J Impot Res 2005; 17: 191–195.

    CAS  Article  Google Scholar 

  30. 30

    Promodu K, Shanmughadas KV, Bhat S, Nair KR . Penile length and circumference: an Indian study. Int J Impot Res 2007; 19: 558–563.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to H Söylemez.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Söylemez, H., Atar, M., Sancaktutar, A. et al. Relationship between penile size and somatometric parameters in 2276 healthy young men. Int J Impot Res 24, 126–129 (2012). https://doi.org/10.1038/ijir.2011.53

Download citation

Keywords

  • penile size
  • somatometric parameters
  • young men

Further reading