Habous Mohamad, Muir Gordon, Soliman Tarek, Farag Mohammed, Williamson Ben, Binsaleh Saleh, Elhadek Waleed, Mahmoud Saad, Ibrahim Hussein, Abdelwahab Osama, Abdelrahman Ziad, Abdelkader Mohamed, Jenkins Lawrence C, Mulhall John P
Urology and Andrology Department, Elaj Medical Centres, Jeddah, Saudi Arabia.
Urology Department, King's College, London, UK.
Int J Impot Res. 2018 Feb;30(1):21-26. doi: 10.1038/s41443-017-0013-3. Epub 2017 Nov 27.
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.
准确的阴茎勃起尺寸数据对于多个涉及男性患者的学科极为重要，但关于测量阴茎长度的最佳技术的数据却很少。虽然之前一些小型研究表明拉伸阴茎长度之间存在良好的相关性，但其他研究显示存在显著差异。阴茎周长的研究较少，关于不同观察者和不同技术可能导致的误差的数据也很少。大部分已发表的数据报告的阴茎长度是从阴茎耻骨皮肤交界处到龟头顶端（STT），而非耻骨到顶端（BTT）。我们希望评估多名观察者使用不同技术测量阴茎的准确性。使用动态阴茎多普勒超声诊断性功能障碍或希望进行客观阴茎测量且能达到完全勃起的男性被纳入研究。排除标准为阴茎瘢痕、弯曲或先天性异常。在每种情况下，阴茎由七名男科专家之一在私人空调环境（21°C）中进行测量。每位患者测量三个参数：阴茎体部的周长（ girth）、耻骨上皮肤到龟头远端的长度（STT）以及耻骨到龟头远端的长度（BTT）。这三项测量在阴茎松弛拉伸状态下记录，然后在海绵体内注射诱导完全勃起后，在完全勃起状态下重复进行相同的三项测量。我们以勃起测量值为参考，分析了总体患者群体以及每位观察者的每个松弛测量值的准确性。本研究共纳入201名成年男性（平均年龄49.4岁）。在阴茎松弛和拉伸状态下进行评估时，对勃起测量值的平均低估约为2%（STT长度23.39%，BTT长度19.86%，周长21.38%）。在这项关于阴茎尺寸的大型、多中心、多观察者研究中，松弛测量值在预测勃起尺寸方面仅具有中等准确性。它们也显著依赖于观察者。从耻骨到龟头顶端测量阴茎长度更准确可靠，这种差异在超重患者中最为明显。
