urology

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‘Am I Normal?’ Check Biggest Study Yet Of Penis Size, Among 15,000 Men

From the paper "Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men" in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

From the paper “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men” in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

In Dr. Abraham Morgentaler’s 26 years as a urologist who treats issues of male sexuality, he has seen thousands of patients, and “probably there hasn’t been a single one who hasn’t paid attention to his penis size on some level,” he says.

“Most men tend to believe they’re smaller than average, and there’s some distortion about what reality is,” says Morgentaler, director of Men’s Health Boston and author, most recently, of “The Truth About Men and Sex: Intimate Secrets From the Doctor’s Office.”

A new study could help combat some of that reality distortion.

Combining 17 previous published studies for a total of 15,521 men, it amounts to the biggest review to date of medically measured penis size, says its lead author, Dr. David Veale of King’s College London. It processed the data into “nomograms,” or graphical diagrams, like the one above, familiar to parents as the typical form for the growth charts that pediatricians use.

From the press release on the paper (metric conversions mine), which is titled “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men”:

The nomograms revealed that the average length of a flaccid penis was 9.16 cm [3.6 inches], the average length of a flaccid stretched penis was 13.24 cm [5.21 inches], and the average length of an erect penis was 13.12 cm [5.165 inches]. The average flaccid circumference was 9.31 cm [3.66 inches], and the average erect circumference was 11.66 cm [4.59 inches]. There was a small correlation between erect length and height.

So those are the averages, but the great beauty of a nomogram is that it can also give you a sense of the distribution of the variation, and you may have already noticed that the curve above looks strikingly flat. That is, there’s just not much difference, except at the extreme edges.

If your erect penis is 11 centimeters, that puts you down in the 10th percentile; if your erect penis is 15 centimeters, that puts you way up in the 85th percentile. Quite a jump, for a little over an inch.

“What’s interesting is, when you look at the curves, you see that most penises actually are fairly similar in size,” Dr. Morgentaler says. “You really have to go to the extremes — the top or bottom 5 or 10 percent — to really see some big differences. And truthfully, in my practice, I would say that’s exactly right. Most men have penises roughly the same size.”

But somehow, many men who are average think they’re below average. The study notes:

“Men may present to urologists or sexual medicine clinics with a concern with their penis size, despite their size falling within a normal range. This type of concern is commonly known as ‘small penis anxiety’ or ‘small penis syndrome.’ Continue reading

Pathologist’s View On Prostate Cancer Grey Zone: ‘What Do My Numbers Mean?’

Prostate cancer, circled. (Photo courtesy Dr. Michael Misialek)

Prostate cancer, circled. (Photo courtesy Dr. Michael Misialek)

By Dr. Michael Misialek
Guest Contributor

We don’t like to admit it but cancer is rarely black and white. Increasingly a cancer diagnosis means living in a murky morass of constantly reassessing risk.

Here’s one man’s story of living on that precarious line. His saga, seen through a pathologist’s filter, illustrates the uncertainties surrounding prostate cancer. And, as the number one cancer in men, it is increasingly becoming a familiar story for many. Questions like, ‘What do my numbers mean?’ ‘Should we treat or not?’ and if so, ‘Which treatment is best for me?’ inevitably arise.

Mr. B. is a 64-year-old man who was found to have an elevated PSA four years ago on his routine physical exam. Obviously, prostate cancer was the first thought that came to mind, particularly since his father had the disease. What he soon learned is that prostate cancer is a complex diagnosis — one that requires the careful integration of the physical exam, biopsy results, radiographic studies and lab results.

And, of course, it’s a diagnosis that comes with many decisions and choices; choices that depend upon understanding the grey zone of medicine. Prostate cancer is rarely clear cut. As much as numbers like the PSA and Gleason score (the sum of the two most predominant grades in a patient’s tumor) guide diagnosis and treatment, they also contribute to the uncertainties on the best course of action.

When Mr. B’s elevated PSA was first detected, his primary care physician referred him to a urologist at Newton-Wellesley Hospital. His prostate was normal on physical exam and they elected no biopsy at the time. Over the next couple of years the PSA slowly continued to rise, still with no change in his physical exam. Last year a biopsy was done and was negative. No cancer, a relief. What was found was some inflammation. Could this have contributed to the rise in PSA? It certainly could have, but a negative biopsy did not rule out cancer. The journey of watching numbers continued.

This year Mr. B.’s PSA rose yet again, and his urologist ordered an MRI which was negative. Mr. B. underwent another biopsy. (Not an easy process since he takes the blood thinner Coumadin and any invasive procedure needs to be carefully coordinated with stopping and restarting this medication.) The biopsy is also uncomfortable: his first biopsy involved six needles, but this time it was twelve.

The slides came to me. I put them on my microscope and carefully studied each of them. As I scanned at low magnification I found two tiny foci of abnormal glands which qualified for a diagnosis of cancer. Continue reading

Are Laptops Hurting Male Fertility?

Hey guys: Is the heat from your laptop killing your fertility?

Here’s the scary health story of the morning, from Reuters, headlined: “Is Your Laptap Cooking Your Testicles?

The new findings, published in the journal Fertility and Sterility, do not bode well for men who spend many hours with their laptops on their laps:

The researchers hooked thermometers to the scrotums of 29 young men who were balancing a laptop on their knees. They found that even with a lap pad under the computer, the men’s scrotums overheated quickly.

“Millions and millions of men are using laptops now, especially those in the reproductive age range,” said Dr. Yefim Sheynkin, a urologist at the State University of New York at Stony Brook, who led the new study.

“Within 10 or 15 minutes their scrotal temperature is already above what we consider safe, but they don’t feel it,” he added.

So far, no studies have actually tested how laptops impact men’s fertility, said Sheynkin, and there is no bulletproof evidence that it would. But earlier research has shown that warming the scrotum more than one degree Celsius (1.8 degrees Fahrenheit) is enough to damage sperm.