Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement

Abstract

Accurate data regarding the size of the erect penis is of great importance to several disciplines working with male patients, but little data exists on the best technique to measure penile length. While some previous small studies have suggested good correlation between stretched penile length, others have shown significant variability. Penile girth has been less well studied, and little data exist on the possible errors induced by differing observers and different techniques. Much of the published data report penile length measured from the penopubic skin junction-to-glans tip (STT) rather than pubic bone-to-tip (BTT). We wished to assess the accuracy of different techniques of penile measurements with multiple observers. Men who achieved full erection using dynamic penile Doppler ultrasound for the diagnosis of sexual dysfunction or a desire for objective penile measurement were included in the study. Exclusion criteria were penile scarring, curvature, or congenital abnormality. In each case, the penis was measured by one of the seven andrology specialists in a private air-conditioned (21 °C) environment. Each patient had three parameters measured: circumference (girth) of the penile shaft, length from suprapubic skin-to-distal glans (STT), and pubis-to-distal glans (BTT). The three measurements were recorded in the stretched flaccid state, and the same three measurements were then repeated in the fully erect state, following induction of full erection with intracavernosal injection. We analyzed the accuracy of each flaccid measurement using the erect measurements as a reference, for the overall patient population and for each observer. In total, 201 adult men (mean age 49.4 years) were included in this study. Assessing the penis in the stretched and flaccid state gave a mean underestimate of the erect measurement of ~20% (STT length 23.39%, BTT length 19.86%, and circumference 21.38%). In this large, multicenter, multi-observer study of penis size, flaccid measurements were only moderately accurate in predicting erect size. They were also significantly observer dependent. Measuring penile length from pubic bone to tip of glans is more accurate and reliable, the discrepancy being most notable in overweight patients.

Long-Term Results after Surgical Treatment of Congenital Penile Curvature Using a Modified Nesbit Technique

“…Erect penile length and curvature was measured pre-and postoperatively during artificial erection. Length's measurement was done from the pubic bone to the tip of the glans [13]. As adequate length measurement in case of severe curvature is difficult, the concave side of curvature was measured in these cases (from point of maximum curvature to pubic bone and to tip of glans).…”

Editorial Comment to Penile size and stretched rate in a Japanese male population: A cross‐sectional cadaveric study

“…Among them, Habous et al . reported that PFL is the only accurate parameter to predict erect size . We also note that penile size is influenced by anthropometric measurements, such as height, weight and, especially, body mass index.…”

Negative Self-Perception and Self-Attitude of Sexuality Is a Risk Factor for Patient Dissatisfaction Following Penile Surgery with Small Intestinal Submucosa Grafting for the Treatment of Severe Peyronie’s Disease

“…Physical examination and penile ultra-sonography determined location, number, and size of plaques of the tunica albuginea of the penis. Penile length was measured from suprapubic skin to distal glans in the stretched flaccid penis, as described previously [18]. Color duplex Doppler ultra-sonography (CDDU) of the penis combined with intracavernous injection of 20 µg Prostavasin was performed preoperatively according to established standard operating procedures [19].…”