Modified penile augmentation by dermal-fat graft in post-operative hypospadias adults / 中华整形外科杂志

Objecive@#To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting.@*Methods@#From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied.@*Results@#In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001).@*Conclusions@#This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.

Male external genitalia growth curves and charts for children and adolescents aged 0 to 17 years in Chongqing, China / 亚洲男科学杂志(英文版)

Genital size is a crucial index for the assessment of male sexual development, as abnormal penile or testicular size may be the earliest visible clinical manifestation of some diseases. However, there is a lack of data regarding penile and testicular size measurements for Chinese boys at all stages of childhood and puberty. This cross-sectional study aimed to develop appropriate growth curves and charts for male external genitalia among children and adolescents aged 0-17 years in Chongqing, China. A total of 2974 boys were enrolled in the present study. Penile length was measured using a rigid ruler, penile diameter was measured using a pachymeter, and testicular volume was determined using a Prader orchidometer. Age-specific percentile curves for penile length, penile diameter, and testicular volume were drawn using the generalized additive models for location, scale, and shape. Very similar growth curves were found for both penile length and penile diameter. Both of them gradually rose to 10 years of age and then sharply increased from 11 to 15 years of age. However, testicular volume changed little before the age of 10 years. This study contributes to the literature covering age-specific growth curve and charts about male external genitalia in Chinese children and adolescents. These age-related values are valuable in evaluating the growth and development status of male external genitalia and could be helpful in diagnosing genital disorders.

Correlation between the Penile Size and Prostatic Volume / 대한남성과학회지

PURPOSE: To evaluate the clinical correlation between penile size and prostatic volume. MATERIALS AND METHODS: A total of 196 men were included in this study, 96 patients diagnosed as benign prostataic hyperpalsia(BPH, mean age: 67.2+/-18.8) by transurethral ultrasonography(TRUS), and 100 healthy volunteers(mean age: 48+/-16.2). The stretched penile length and penile circumference were measured by one examiner. We compared penile size with prostatic volume. BPH patients were classified as group I(30~39 ml), group II(40~49 ml) and group III(above 50 ml) by prostatic volume. RESULTS: For penile length and penile circumference, the mean values were 12.3+/-2.0 cm and 9.1+/-1.1 cm in group I, 12.6+/-2.2 cm and 9.2+/-1.0 cm in group II, 13.9+/-2.7 cm and 9.8+/-1.2 cm in group III, and 12.3+/-1.3 cm and 9.0+/-1.2 cm in control group, respectively. Compared to the control group, penile size was significantly higher in group III(p <0.05). CONCLUSIONS: Larger prostatic volume, especially above 50 ml, is associated with a significant increase in penile size.

The Psychologic Study on the Self Esteem about Penile Size of the Third Decade Men in Korea / 대한남성과학회지

PURPOSE: The penile augmentation operation is becoming popular in Korea, but there is not enough data about psychologic aspects of Korean male's thoughts about their penile size. We investigated the flaccid and stretched penile sizes of young Korean males and their penile size complex or pride. We performed Minnesota Multiphasic Personality Inventory (MMPI) test. This study may be used for better patient consultation in penile augumentation. MATERIALS AND METHODS: After explanation and agreement to the purpose and methods of this study, 123 Korean male in early 20's who visit our institution were studied. We measured their pre-pubic bone fat pad depth, flaccid penile length, flaccid mid-shaft circumferences and stretched length under warm and comfortable private environment. Because the stretched penile length closely correlated with the erect length, we did not measure the erect length. Then they were asked to answer questions of MMPI and other questions including, 'how do you think about your penile size?'. We used the student t-test to analyze our data statistically. RESULTS: In 123 subjects, mean flaccid length, flaccid circumference, stretched length and fat pad depth were 6.9 0.8cm, 8.5+/-1.1cm, 9.6+/-0.8cm and 1.1+/-0.4cm respectively (Table 1). In 123 subjects, the distribution of the answer about penile size was 1 (0.8%) 'very small', 29 (23.6%) 'small', 86 (69.9%) 'normal', 6 (4.9%) 'large', and 1 (0.8%) 'very large'. Compared to the subjects who thought their penis was normal, the subjects who thought their penile size was small, showed high hypochondriasis and psychasthenia scale and the subjects who thought their penile size was large, showed high hysteria scale in MMPI test. Subjects who underestimated their penile size, showed high depression, psychasthenia scale in MMPI test CONCLUSIONS: In consultation of the patient who want penile augmentation, urologist should consider psychologic tendency of the patients about their penile size.

Body Predictive Index of Penile Size / 대한남성과학회지

PURPOSE: Penile size has been a focus of interest in the life and the culture throughout human history. It has been a longstanding question whether there is any relation between penile size and the dimensions of body extremities. We measured the standard length of the penis and investigate whether any body extremity is a predictive index of penile size in Korea men. PATIENTS AND METHODS: A series of 655 males above 17 years of age were examined during a 4-month period. Stretched penile length, penile circumference, and length and characteristics of various body parts and features (1st finger, 2nd finger, 3rd finger, 1st toe, 2nd toe, 3rd toe, ear, mouth, nose, height, weight, and baldness) were investigated by one examiner. To see the relation among the penile length and circumference and various body dimensions, univariate and multivariate statistical methods such as correlation analysis and multiple linear regression were applied. RESULTS: The mean values standard deviations were 46.6 +/- 18.4 for age, 10.0 +/- 2.0 cm for the length of the penis, and 8.5 +/- 1.0 cm for the circumference of the penis. In a correlation coefficient analysis, the length of the penis was slightly correlated with penile circumference. Additionally, the circumference of the penis was slightly correlated with penile length, patient height, weight, and 3rd toe and 1st toe length, in decreasing order. In a multivariate analysis, the coefficients of determination from multiple linear regression were 13% and 15% for the length and the circumferences of the penis, respectively. CONCLUSIONS: Human body index including the size or characteristics of body extremities is not enough to predict the penile size.

Normal Penile Size and Self Esteem about Penile Size of the Third Decade Men in Korea / 대한비뇨기과학회지

PURPOSE: The penile augmentation operation is getting popular in Korea, but we don`t have enough data about normal penile length distribution of Korean male and their self-esteem about their penile size. So I investigated the flaccid and erect penile sizes of young Korean males and their penile size complex or pride if any. This study data could be a step stone to establish better operation indication and patient consultation. MATERIALS AND METHODS: After explanation and agreement to the purpose and methods of this study, 171 Korean male in early 20`s who visit our institution were take part in. I measured their pre-pubic bone fat pad depth, flaccid penile length, flaccid mid-shaft circumferences and stretched length under warm and comfortable private environment. Then erect penile lengths and mid-shaft circumferences were measured after self-stimulation which was tried two times if needed. I used rigid ruler except the measuring of penile circumference to avoid measurement bias originated from penile skin curvature. Then they were asked to answer several questions including, `How do you think about your penile size?`, `Why do you think so?'. I used the correlation analysis and the student t-test to analyze our data statistically. RESULTS: Total number of study subject who can get sufficient erection is 156 among 171 subjects. In 156 subjects, mean flaccid length, flaccid circumference, erect length and erect circumference were 6.1+/-1.3cm, 8.9+/-0.8cm, 10.8+/-1.3cm and 11.3+/-1.2cm(Table 1). Mean stretched length was 9.6+/-1.2cm and the stretched length most closely correlated with the erect length(r=0.81)(Table 2). Mean fat pad depth was 1.1+/-0.4cm and mean functional penile length, the sum of erect length and fat pad depth, was 11.9+/-1.3cm. In 156 subjects, the answer about penile size were 7(4.5%) `very small`, 32(20.5%) `small`, 110(70.5%) `normal`, 7(4.5%) `large`, and no `very large`(Table 3). And most of them compared their penile size with others at rest room or rocker room. CONCLUSIONS: This study demonstrated that more Korean young males think their penile size is small rather than large. And their penile self-esteem is based on their flaccid length mostly. To define the length guideline of penile augmentation, I used flaccid length 3.5cm and erect length 8.2cm as reference values which are 2 standard deviation below from the average among normal distribution. In consultation of the patient who want penile augmentation, urologist should consider the tendency of low self-esteem about penile size and the distribution of flaccid and erect penile size of young Korean male.

The Relationship between Height and Body Weight and Penile Size in University Students / 대한비뇨기과학회지

PURPOSE: Is there any relationship between penile size and physical stature? This study was performed to answer this question and provide guidelines of penile size to assist in counseling patients for penile augmentation. MATERIALS AND METHOD: Penile size, body weight and height were measured in 150 young healthy men, and the body mass index(BMI) was calculated in weight(kg)/height(m)2. The penile length and circumference were measured with tape in flaccid and erect states. The 'lengthening ratio' was calculated by 'erect length/flaccid length', and 'tumescent ratio' was calculated by 'erect circumference/flaccid circumference'. All the data was statistically evaluated and the following results were obtained. Result : The average length and circumference were 8.26+/-1.07cm and 8.34+/-1.03cm respectively in the flaccid state, and 13.42+/-1.38cm and 11.17+/-1.05cm in the erect state. The average lengthening and tumescent ratios were 1.64+/-0.22 and 1.35+/-0.08, and were negatively correlated to the flaccid penile length and circumference. Height was positively correlated to erect penile length and lengthening ratio. There was a relationship between body weight and erect penile length in a positive direction, but with other penile parameters there were none. There was no relationship between BMI and any parameters of penile size. However, the erect penile length of the normal BMI group was longer than that of the lower BMI group. CONCLUSIONS: The results show that the flaccid penile size is related to the erect penile size and there is some relation between penile size and physical stature. We believe these results will be applicable to the penile augmentation.

Comparison of Penile Size and Satisfaction between One Stage and Two Stage Urethroplasty for Hypospadias / 대한비뇨기과학회지

PURPOSE: We studied penile size of children who underwent hypospadias repair. Also we surveyed the degree of satisfaction with, as judged by patient's parents and urologist. MATERIALS AND METHODS: We measured the relaxed and erected penile size of children who underwent hypospadias repair and followed more than one year (28 cases of one stage repair and 20 cases of two stage repair). All of them had no complication. We used age adjusted ANOVA test for penile size, and Wilcoxon matched pairs signed rank test for comparison of satisfaction with penile appearance between one stage group and two stage group. RESULTS: Significant difference was noted between one stage group and two stage group for relaxed and erected penile length (p0.05). Two stage group showed statistically significant larger value than one stage group for glandular size, glandular shape, position of meatus, general appearance, and genital perception score as judged by patient's parents (p<0.05). And two stage group showed statistically larger value than one stage group for genital perception score judged by urologist (p<0.05). CONCLUSIONS: Our study demonstrated that two stage operation met with better penile size and satisfaction judged by patient's parents and urologist than one stage operation for middle and posterior penile hypospadias.

Clinical Correlation between the Penile Size and Benign Prostatic Hyperplasia / 대한비뇨기과학회지

To evaluate the clinical correlation between the penile size and benign prostatic hyperplasia (BPH) we measured the penile circumference(PC) and length(PL) as the flaccid state in 416 male cases more than 50 old years. PC was measured on the penile groove and PL from upper margin of symphysis pubis to the tip of penile glans. We compared PC and PL with prostatic volume, IPSS symptom score, uroflow and BPH defined by Garraway (1993)(BPH-G). All cases were classified as group I(below 9.0cm : 231 cases), II(above 9.0cm : 185 cases) in PC and A(below 8.0cm . 206 cases), B(above 8.0cm 210 cases) in PL. The ranges of PC and PL value were 6.0- 13.0cm(ave. 9.2) and 5.0-13.0cm(ave. 8.2), respectively. PC and PL values according to presence and absence of BPH-G were 9.3+/-0.8cm, 8.4+/-2.6cm and 8.6+/-1.5cm, 7.6+/-2.6cm, respectively (P<0.05), and PC values in prostatic volume below 30gm and more than 30gm, 8.8+/-l.0cm, 9.5+/-0.7cm, respectively (p<0.05). Among BPH associated factors, only prostatic volume has a correlation with penile size according to regression analysis(<0.05). Prevalence of BPH in group I, II and A, B was 10.4%, 27.09& and 0.49&, 31.4%, respectively(p<0.05). As higher PL or PC, as higher prevalence of BPH. We suggest that prominently large penile size, especially PC may be a possible sign of BPH.

A Study on the Penile Size of Korea men / 대한비뇨기과학회지

A study on the penile size was made on 702 Korean male of In-patients and Out-patients to the department of Urology, Capital Military Hospital, during the period from May 1, to July 31, 1971. The patient's ages were ranged from 21 to 31. The length of the penis was measured from the symphysis pubis to the apex of the penis with a tape measure and following results were obtained. 1. The mean length of the penis in a non-erected state was 8.0cm., and in a erected state was 12.7 cm. The average ratios erected length/non-erected length of the penis were 1.9 in a small sized group and 1.4 in a large sized group. 2. The mean circumference of the penis in a non-erected state was 8. 1 cm., and in a erected state was 11.0 cm. The average ratios erected circumference/non-erected circumference of the penis were 1.5 in a small sized group and 1.2 in a large sized group. 3. A slight correlation can be seen between the mean length and circumference of the penis. In a non-erected state, the mean of length and circumference of the penis were equaled and in an erected state, the mean of length of the penis was slightly large than the mean of circumference of the penis.