Urologists and psychotherapists often encounter patients who complain about the length of their penis, but these patients are usually well within the typical range for penis size, though many are unaware of what actually represents ‘normal’ size.
A network of urology outpatient clinics in Saudi Arabia received 778 Middle-Eastern male patients presenting for a variety of reasons, though all requesting reassurance regarding penis size and function. In this demographic group a “pre-marital check” is frequently requested to be sure that penile size and function, as well as fertility, are normal.
The patients were examined in air-conditioned consulting rooms at a constant temperature (21°C). Intracavernosal Quadrimix (prostaglandin E1 5µg, papaverine 15mg, phentolamine 1mg, atropine 20mcg in 1ml of saline; 0.1ml given for patients without erectile dysfunction, and up to 1ml for patients with erectile dysfunction) injection was used to induce full erection in all patients. Anthropometric data was collected and recorded in centimetres to the nearest five millimetres by a small group of experienced urologists. Each patient had three parameters of the erect penis recorded: circumference of the penile shaft; penile length from the suprapubic skin to distal glans (skin-to-tip); and pubis to distal glans (bone-to-tip). Using a rigid plastic ruler,skin to tip measurement was conducted as follows: with the penis in full erection the base of the ruler was placed on the penopubic skin junction and the tip of the ruler was placed at the level of the tip of the glans penis. Bone to tip measurement was conducted as above except the base of the ruler was pushed firmly down to the pubic bone.
Statistical analysis was performed using SPSS software (IBM, SPSS Statistics 21). Descriptive statistics (mean, standard deviation, median and range) were performed for age, body mass index (BMI), and each of the three recorded measurements of the erect penis (skin-to-tip length, bone-to-tip length and circumference). Pearson correlation coefficients were calculated using SPSS for each of the five recorded variables. In light of a hypothesis of increasing BMI with increasing age, both of these variables were controlled for in turn.
Our study has several weaknesses: measurements were recorded at different sites and, whilst clinical equipment and protocols are standardised across the Elaj Medical Group’s sites, several urologists examined the patients, introducing a degree of observer bias; whilst a strength of our population is its heterogeneity with regards to age, it is markedly homogeneous population as regards ethnicity, and is therefore only appropriate for application within the same ethnic setting, at least until further inter-population comparison studies have been reported.
Our data show penile sizes in a large group of men, corrected for BMI and age. We have also been able to demonstrate the difference between stretched and erect length, which few large studies have done before. Also our data demonstrated the difference between measuring the length from bone to tip and skin to tip in erected penis in relatively large number of men and this is ,to our knowledge, not reported before.
Written by:
Dr. Mohamad Habous, MD,FEBU,FECSM
Medical Director Elaj Group
Consultant Urologist
Urology / Andrology Department
Elaj Medical Centers
www.mhabos.com