Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

IJIR publishes special/guest-edited issues and topical collections. The peer review process for articles included in topical collections/special issues is the same as the peer review process of the journal in general. Additionally, if the Guest Editors author an article in their topical collection/special issue, they will not handle the peer review process.​

Grower or shower? Predictors of change in penile length from the flaccid to erect state

International Journal of Impotence Research volume 30, pages 287–291 (2018)Cite this article

Subjects

Abstract

In colloquial English, a “grower” is a man whose phallus expands significantly in length from the flaccid  to the erect state; a “shower” is a man whose phallus does not demonstrate such expansion. We sought to investigate various factors that might predict a man being either a grower or a shower. A retrospective review of 274 patients who underwent penile duplex Doppler ultrasound (PDDU) for erectile dysfunction between 2011 and 2013 was performed. Penile length was measured, both in the flaccid state prior to intracavernosal injection (ICI) of a vasodilating agent (prostaglandin E1), and at peak erection during PDDU. The collected data included patient demographics, vascular, and anatomic parameters. The median change in penile length from flaccid to erect state was 4.0  cm (1.0–7.0), and was used as a cut-off value defining a grower (≥4.0 cm) or a shower (4.0 cm). A total of 73 men (26%) fit the definition of a grower (mean change in length of 5.3 cm [SD 0.5]) and 205 (74%) were showers (mean change in length of 3.1 cm [SD 0.9]). There were no differences between the groups with regards to race, smoking history, co-morbidities, erectile function, flaccid penile length, degree of penile rigidity after ICI, or PDDU findings. Growers were significantly younger (mean age 47.5 vs. 55.9 years, p  < 0.001), single (37% vs. 23%, p  =  0.031), received less vasodilator dose (10.3  mcg vs. 11.0  mcg, p  =  0.038) and had a larger erect phallus (15.5 cm vs. 13.1 cm, p <   0.001). On multivariate analysis, only younger age was significantly predictive of being a grower (p < 0.001). These results suggest that younger age and single status could be predictors of a man being a grower, rather than a shower. Larger, multicultural and multinational studies are needed to confirm these results.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

References

  1. Talalaj J, Talalaj S. The strangest human sex, ceremonies and customs. Melbourne: Hill of Content; 1994.

    Google Scholar 

  2. Burton R. The kama sutra of Vatsayana. New York: Penguin Books; 1962. p. 247–52.

    Google Scholar 

  3. Winter HC An examination of the relationships between penis size and body image, genital image, and perception of sexual competency in the male. DAI-A November 1989; 50/05: 1225.

  4. Masters WH, Johnson VE. Human sexual response. Boston: Little, Brown & Co; 1966.

    Google Scholar 

  5. Masters WH, Johnson VE. Human sexual inadequacy. Boston: Little, Brown; 1970.

    Google Scholar 

  6. Eisenman R. Penis size: survey of female perceptions of sexual satisfaction. BMC Women’s Health. 2001;1:1.

    Article  Google Scholar 

  7. Mautz BS, Wong BB, Peters RA, Jennions MD. Penis size interacts with body shape and height to influence male attractiveness. Proc Natl Acad Sci USA. 2013;110:6925–30.

    Article  CAS  Google Scholar 

  8. Kinsey AC, Pomeroy WB, Martin CE. Sexual behavior in the human male. Philadelphia: W.B. Saunders Co.; 1948.

    Google Scholar 

  9. Wessells H, Lue TF, McAninch JW. Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol. 1996;156(1):995–7.

    CAS  PubMed  Google Scholar 

  10. Sikka SC, Hellstrom WJ, Brock G, Morales AM. Standardization of vascular assessment of erectile dysfunction: standard operating procedures for duplex ultrasound. J Sex Med. 2013;10(1):120–9.

    Article  Google Scholar 

  11. Yafi FA, Libby RP, McCaslin IR, Sangkum P, Sikka SC, Hellstrom WJ. Failure to attain stretched penile length after intracavernosal injection of a vasodilator agent is predictive of veno-occlusive dysfunction on penile duplex Doppler ultrasonography. Andrology . 2015;3(5):919–23.

    Article  CAS  Google Scholar 

  12. Salama, N. Penile Dimensions of Diabetic and Nondiabetic Men With Erectile Dysfunction: A Case–Control Study. Am J Mens Health. 2018;12(3):514–523.

    Article  Google Scholar 

  13. Kamel I, Gadalla A, Ghanem H, Oraby M. Comparing penile measurements in normal and erectile dysfunction subjects. J Sex Med. 2009;6:2305–10.

    Article  Google Scholar 

  14. Awwad ZM, Abu-Hijleh MO, Basari SN, Shegam N, Murshidi M, Ajlouni K. Penile measurements in normal adult Jordanians and in patients with erectile dysfunction. Int J Impot Res. 2005;17:191–5.

    Article  CAS  Google Scholar 

  15. Khan S, Somani B, Law M, Donat R. Establishing a reference range for penile length in Caucasian British men: a prospective study of 609 men. BJU Int. 2012;109:740–4.

    Article  Google Scholar 

  16. Berookhim BM, Nelson CJ, Kunzel B, Mulhall JP, Narus JB. Prospective analysis of penile length changes after radical prostatectomy. BJU Int. 2014;113:E131–6.

    Article  Google Scholar 

  17. Moreira de Goes P, Wespes E, Schulman C. Penile extensibility: to what is it related? J Urol. 1992;148:1432–4.

    Article  CAS  Google Scholar 

  18. 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;21:284–6.

    Article  CAS  Google Scholar 

  19. Akkus E, Carrier S, Baba K, Hus GL, Padma-Nathan H, Nunes L, et al. Structural alterations in the tunica albuginea of the penis: impact of Peyronie’s disease, ageing and impotence. Br J Urol. 1997;79:47–53.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of California at Irvine, Orange, CA, USA

    Faysal A. Yafi

  2. Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA

    Laith Alzweri, Ian R. McCaslin, Russell P. Libby, Suresh C. Sikka & Wayne J. G. Hellstrom

  3. Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Premsant Sangkum

Authors
  1. Faysal A. Yafi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laith Alzweri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ian R. McCaslin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Russell P. Libby
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Premsant Sangkum
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Suresh C. Sikka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wayne J. G. Hellstrom
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wayne J. G. Hellstrom.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yafi, F.A., Alzweri, L., McCaslin, I.R. et al. Grower or shower? Predictors of change in penile length from the flaccid to erect state. Int J Impot Res 30, 287–291 (2018). https://doi.org/10.1038/s41443-018-0053-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-018-0053-3

This article is cited by

Search

Advanced search

Quick links