Advertisement

Penile Size Dissatisfaction

  • Hester Pastoor
    Correspondence
    Corresponding Author: Hester Pastoor, MSc, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, dr. Molewaterplein 40, Rotterdam, The Netherlands. Tel: 0031-6-17048767; Fax: 0031-10-7031753
    Affiliations
    Registered Psychotherapist, Registered Sexologist, ECPS, PhD Student, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
    Search for articles by this author
  • Angela Gregory
    Affiliations
    COSRT Accredited Psychosexual Therapist, Division of Family Health, Department of Sexual Health, Chandos Clinic, Nottingham University Hospital Trust, Nottingham, United Kingdom
    Search for articles by this author

      Abstract

      Background

      Men concerned about their penis size often consult professionals working in urology, andrology, surgery, and sexual medicine.

      Aim

      To inform professionals in the sexual medicine field about small penis syndrome as a clinical syndrome and to provide recommendations for treatment.

      Methods

      This was an overview of the existing literature combined with our extensive clinical experience.

      Results

      Small penis syndrome is a syndrome with psychiatric comorbidities and social consequences that impair life. Men with these concerns tend to be susceptible for treatment that is not evidence based and potentially harmful.

      Clinical Implications

      Treatment of men with concerns about penis size should start with a thorough biopsychosocial assessment, followed by extensive psychoeducation, counselling, and psychological interventions, even if surgery is being considered.

      Strengths & Limitations

      The strength of this study is the concise overview of the existing literature combined with clinical experience which leads to important recommendations. Limitation is that this is not a systematic review.

      Conclusion

      Complaints about penis size should be taken seriously, and a thorough biopsychosocial and multidisciplinary assessment is required.

      Key Words

      To read this article in full you will need to make a payment
      ISSM Member Login
      Login with your ISSM username and password.
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Purchase one-time access:

      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Murtagh J.
        The 'small' penis syndrome.
        Aust Fam Physician. 1989; 18 (218, 20)
        • Wylie K.R.
        • Eardley I.
        Penile size and the “small penis syndrome”.
        BJU Int. 2007; 99: 1449-1455
        • Sanches B.C.
        • Laranja W.W.
        • Alonso J.C.
        • et al.
        Does underestimated penile size impact erectile function in healthy men?.
        Int J Impot Res. 2018; 30: 158-162
        • Mondaini N.
        • Ponchietti R.
        • Gontero P.
        • et al.
        Penile length is normal in most men seeking penile lengthening procedures.
        Int J Impot Res. 2002; 14: 283-286
        • Veale D.
        • Miles S.
        • Read J.
        • et al.
        Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder.
        Body Image. 2016; 17: 48-56
        • Lever J.
        • Frederick D.A.
        • Peplau L.A.
        Does size matter? Men's and women's views on penis size across the lifespan.
        Psychol Men Masculinity. 2006; 7: 129-143
        • Veale D.
        • Miles S.
        • Bramley S.
        • et al.
        Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men.
        BJU Int. 2015; 115: 978-986
        • Zachalski W.
        • Krajka K.
        • Matuszewski M.
        Evaluation of the Treatment of Congenital Penile Curvature Including Psychosexual Assessment.
        J Sex Med. 2015; 12: 1828-1835
        • Association AP
        Diagnostic and statistical manual of mental disorders, fifth edition.
        DSM-5. 2013;
        • Veale D.
        • Miles S.
        • Read J.
        • et al.
        Phenomenology of men with body dysmorphic disorder concerning penis size compared to men anxious about their penis size and to men without concerns: a cohort study.
        Body Image. 2015; 13: 53-61
        • Veale D.
        • Miles S.
        • Read J.
        • et al.
        Penile Dysmorphic Disorder: Development of a Screening Scale.
        Arch Sex Behav. 2015; 44: 2311-2321
        • Eisenman R.
        Penis size: Survey of female perceptions of sexual satisfaction.
        BMC Womens Health. 2001; 1: 1
        • Francken A.B.
        • van de Wiel H.B.M.
        • van Driel M.F.
        • et al.
        What importance do women attribute to the size of the penis?.
        Eur Urol. 2002; 42: 426-431
        • Stulhofer A.
        How (un)important is penis size for women with heterosexual experience?.
        Arch Sex Behav. 2006; 35: 5-6
        • Kayes O.
        • Shabbir M.
        • Ralph D.
        • et al.
        Therapeutic strategies for patients with micropenis or penile dysmorphic disorder.
        Nat Rev Urol. 2012; 9: 499-507
        • Hatipoglu N.
        • Kurtoglu S.
        Micropenis: etiology, diagnosis and treatment approaches.
        J Clin Res Pediatr Endocrinol. 2013; 5: 217-223
        • van den Brink F.
        • Vollmann M.
        • Sternheim L.C.
        • et al.
        Negative Body Attitudes and Sexual Dissatisfaction in Men: The Mediating Role of Body Self-Consciousness During Physical Intimacy.
        Arch Sex Behav. 2018; 47: 693-701
        • Veale D.
        • Miles S.
        • Read J.
        • et al.
        Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.
        Sex Med-Uk. 2015; 3: 147-155
        • Kayes O.
        • Chandra L.
        • Yates A.
        Micropenis and penile dysmorphobia: diagnosis, management, outcomes, and future developments.
        in: Minhas SM J.P. Male sexual dysfunction: a clinical guide. Wiley Blackwell, 2016: 236-245
        • Ghanem H.
        • Glina S.
        • Assalian P.
        • et al.
        Position paper: Management of men complaining of a small penis despite an actually normal size.
        J Sex Med. 2013; 10: 294-303
        • Ghanem H.
        • Shamloul R.
        • Khodeir F.
        • et al.
        Structured management and counseling for patients with a complaint of a small penis.
        J Sex Med. 2007; 4: 1322-1327
        • Interventions CfC
        (2018) Building Body Acceptance. [www document].
        (Available at:)
        • Marra G.
        • Drury A.
        • Tran L.
        • et al.
        Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size.
        Sex Med Rev. 2020; 8: 158-180
        • Nikoobakht M.
        • Shahnazari A.
        • Rezaeidanesh M.
        • et al.
        Effect of penile-extender device in increasing penile size in men with shortened penis: preliminary results.
        J Sex Med. 2011; 8: 3188-3192
        • Nowroozi M.R.
        • Amini E.
        • Ayati M.
        • et al.
        Applying extender devices in patients with penile dysmorphophobia: assessment of tolerability, efficacy, and impact on erectile function.
        J Sex Med. 2015; 12: 1242-1247
        • Moncada I.
        • Krishnappa P.
        • Romero J.
        • et al.
        Penile traction therapy with the new device 'Penimaster PRO' is effective and safe in the stable phase of Peyronie's disease: a controlled multicentre study.
        BJU Int. 2019; 123: 694-702
        • Ziegelmann M.
        • Savage J.
        • Toussi A.
        • et al.
        Outcomes of a Novel Penile Traction Device in Men with Peyronie's Disease: A Randomized, Single-Blind, Controlled Trial.
        J Urol. 2019; 202: 599-610
        • Furr J.
        • Hebert K.
        • Wisenbaugh E.
        • et al.
        Complications of Genital Enlargement Surgery.
        J Sex Med. 2018; 15: 1811-1817
        • Littara A.
        • Melone R.
        • Morales-Medina J.C.
        • et al.
        Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases.
        Sci Rep. 2019; 9: 6323
        • Elist J.J.
        • Levine L.
        • Wang R.
        • et al.
        Patient selection protocol for the Penuma(R) implant: suggested preoperative evaluation for aesthetic surgery of the penis.
        Int J Impot Res. 2020; 32: 149-152
        • Elist J.J.
        • Valenzuela R.
        • Hillelsohn J.
        • et al.
        A Single-Surgeon Retrospective and Preliminary Evaluation of the Safety and Effectiveness of the Penuma Silicone Sleeve Implant for Elective Cosmetic Correction of the Flaccid Penis.
        J Sex Med. 2018; 15: 1216-1223
        • Wessells H.
        • Lue T.F.
        • McAninch J.W.
        Penile length in the flaccid and erect states: guidelines for penile augmentation.
        J Urol. 1996; 156: 995-997