Mean Stretched Penile Length Research Articles

Penile Length and Circumference among Adult Egyptians

Abstract Background accurate measurement of penile length is important for both clinical and academic purposes. For this reason, a standard practice for measurement has been defined to maintain consistency. Rather than measuring a flaccid penis, which offers limited clinical significance, stretched penile length (SPL) measurement is considered best practice for adult men as it most closely replicates normal erect penile length. Aim of the Work to assess the stretched penile length and penile circumference in a sample of physically normal Egyptian men and to determine the penile anthropometry-somatometric parameters relationship. Patients and Methods The current study demonstrated that the mean stretched penile length of this sample of Egyptian men was 13.0 ±1.9 cm and the flaccid penile circumference was 9.3±1.1; which are consistent with the results of previous studies done in Egypt and with studies done within the same geographical region. There were significant positive correlations between penile measures and height, weight, and BMI with no significant correlations between penile measures and age. Our study results revealed as well that there was no significant difference between age grades regarding penis length and penis circumference. The previous correlations agree with most of the studies except for BMI which remains controversial whether it has positive or negative correlation with the penile anthropometry. Results revealed that alcohol use and smoking were significant factors that decrease penis length and circumference. This could be attributed to the associated erectile dysfunctions revealed in previous studies to be found in smokers and alcohol drinkers, in addition to the findings that postulate that erectile dysfunction could shorten the penile measurements. Nonetheless, further studies are needed to clarify these associations. Conclusion Concern over penile size is not uncommon. The results of this study help to establish a reference range for male genital size among adult Egyptian men, which should be helpful for andrologists in counselling patients. As evident from the current study, the mean stretched penile length of Egyptian men was 13.0 ±1.9 cm and the flaccid penile circumference was 9.3±1.1 with significant positive correlations between penile measures and height, weight, and BMI. Moreover, penile anthropometry was significantly lower in smokers and alcohol users.

Behandeling van acute fase M. Peyronie met tamoxifen en tadalafil off label

AbstractPeyronie’s Disease (PD) causes penile curvature and pain in acute phase. In two preclinical studies, tamoxifen and vardenafil (T&T) together showed to be effective in the acute phase. The aim of this study was to describe the clinical results of the off-label treatment of PD patients with T&T in combination with vacuum erection device (VED) in St Antonius hospital, urology outpatient clinic. Baseline descriptive Statistics, Fisher Exact and Chi-Square Test were used. 48 Men were included, mean age 53.0 years (SD 9.5), baseline curvature 46.7° (SD 18.8), median duration four months, 70.8% (n = 48) painful erections. Dorsal curvature is found in 27 (56.3%) men, mean stretched penile length 13.4 cm. Mean use of T&T was 13 weeks (1–52 weeks). Curvature improvement in 27.7% men, pain reduction in 48.5% men, sexual intercourse/coitus improvement in 34.2% men, erection improvement in 14.6% men. Adverse reactions of T&T in 39.6% (n = 19). This was the first study investigating the use of T&T in acute phase PD patients. 27.7% of patients reported improvement in curvature with T&T.

Pediatric penile biometry guides the surgical outcome following tubularised incised plate urethroplasty for hypospadias: a single centre study

Background: In hypospadias urethral meatus opens onto the ventral surface of the penis proximal to tip of glans and its surgery is challenging. Recent focus of hypospadias surgery is on reduction of postoperative complications and objective assessment of penile anthropometry which can affect outcome. Aim of study was to assess the surgical outcome of tubularised incised plate urethroplasty on penile biometric parameters among children with coronal, distal penile and mid penile hypospadias. Methods: Study was conducted in the department of pediatric surgery in IPGMER and SSKM Hospital in Kolkata during November 2019 to October 2021. Results: Among 42 boys mean urethral plate length is 4.286 (coronal), 7.643 (distal penile) and 8.846 (mid penile), mean urethral plate width is 3.321 (coronal), 5.786 (distal penile) and 5.923 (mid penile), mean diameter at mid glans level is 4 (coronal), 5.071 (distal penile) and 5.923 (mid penile), mean diameter at coronal level is 5.75 (coronal), 6.429 (distal penile) and 6.769 (mid penile), mean stretched penile length is 39.2143 (coronal), 41.857 (distal penile) and 40.308 (mid penile) hypospadias respectively. P value is less than 0.05 for all except urethral plate depth which has a non-significant p value. Conclusions: Urethral plate length, urethral plate width, mid glans diameter, glans diameter at coronal sulcus level and stretched penile length affect the outcome of the surgical process TIP urethroplasty in coronal, distal penile and mid penile type hypospadias but urethral plate depth does not.

A comparative study of distal hypospadias repair combined with preputioplasty vs repair using conventional circumcision technique

Background: Hypospadias is one of the most common congenital anomalies characterised by underdevelopment of the ventral anatomical structures of the penis including skin, urethra, corpora spongiosum and prepuce and urethral opening can occur anywhere from the perineum to the ventral aspect of penis. This study evaluated and compared short-term cosmetic and functional outcomes and complications of distal hypospadias repair combined with preputioplasty with the repair using circumcision. Materials & Methods: Patients were divided in two groups with 25 patients in either group. Group A patients underwent urethroplasty with circumcision whereas Group B patients were offered preputioplasty as an additional procedure. Clinical examination included location of the urethral meatus on the ventral aspect of the penis, presence or absence of associated chordee, stretched penile length, penile circumference, glans girth, depth of the navicular fossa or glans groove, urethral plate width, status of the preputial hood and testicular examination. Post-operatively, penis was examined for the location and shape of the neo-meatus, any complications in the form of meatal stenosis, urethrocutaneous fistula, preputial dehiscence and phimosis. Results: Both the groups were comparable with respect to the age at presentation and status of the urinary stream. Distal penile hypospadias predominated in both the groups and it was present in 21 patients in group A and 24 patients in group B. Rest of the babies had sub-coronal hypospadias. Preputial hood and navicular fossa/glans groove were good in either group. Mean stretched penile length in group A was 5.14 cm and it was 4.78 cm in group B children (p value- 0.141). Mean penile circumference of group A and group B patients ware 3.88 cm and 3.68 cm respectively (p value- 0.139). Girth of the glans and mean urethral plate width were also comparable (p values- 0.258 and 0.621 respectively). Final meatal appearance was slit shaped and wide in 22 patients in group A and 21 patients in group B. Urethro-cutaneous fistula was observed in two babies in group A and a single child in group B. One of the children was noted to have preputial dehiscence after two weeks. Prepuce was retracting well in 24 children during the 3rd follow up whereas one patient developed phimosis and thus results of the preputioplasty as an adjunct procedure were found to be satisfactory. Conclusion: Preputioplasty is a safe procedure and should be offered to all children undergoing single-stage distal penile hypospadias repair as it provides a near normal penile appearance at the cost of additional approximately 8% foreskin related complication rate.

Penile size in term newborns in Addis Ababa, Ethiopia.

To determine the normative value of stretched penile length (SPL) for Ethiopian newborns and to set a cut-off point for micropenis. A total of 221 term newborns were included in the study. Stretched penile length was measured in the first 72h of postnatal age in neonates with a gestational age of 37-42 completed weeks. SPL < -2 SD was taken as micropenis in this study. The minimum and maximum penile length were 2.5cm and 5cm, respectively, with a mean ± SD of 3.28 ± 0.42. SPL at -2 SD and +2 SD were 2.43 and 4.12 cm respectively. A significant correlation was observed between penile length and body length (p= 0.005). Neonates born via instrumental delivery had larger SPL compared to those who were delivered by caesarean section (p= 0.01) or by vaginal delivery (p= 0.006). The mean stretched penile length in our study mirrors findings from other African studies. SPL < 2.43 cm can be considered as micropenis in our setting. Therefore, routine genital examination and interpretation at birth is crucial to identify micropenis which might herald a serious underlying condition that needs further investigation.

Penile Modeling in Peyronie's Disease: A Systematic Review of the Literature.

Penile modeling to correct the penile curvature in Peyronie's disease (PD) may be achieved manually (intra-operatively or post-injection) or by using assisted devices (penile traction, vacuum device, or penile prosthesis). To evaluate the efficacy, safety, and satisfaction associated with penile modeling in patients with PD. A PROSPERO registered (CRD42021241729) systematic search in MEDLINE and Cochrane Library was done following PRISMA. PICO: Studies were deemed eligible if they assessed patients with PD (P) undergoing modeling procedures (I) with or without a comparative group(C) evaluating the efficacy, safety, or patient satisfaction (O). Retrospective and prospective primary studies were included. The primary outcome measure is the change in penile curvature after modeling. The secondary outcome measures are the change in stretched penile length, adverse events, and patient satisfaction after modeling. A total of 23 studies, involving 1,238 patients were included. Most studies (13, 56.5%) evaluated penile traction therapy. The studies were of low and intermediate quality (mean Newcastle-Ottawa Scale score of 5.7 and mean Jadad score of 3.3) with a mean level of evidence of 3.4. The mean penile curvature at baseline was between 31 and 80.8 degrees. Nine (39.1%) studies found a significant improvement (P < .05) of penile curvature after penile modeling, ranging between 11.7, and 37.2 degrees. An increase in mean stretched penile length was reported in 7 (30.4%) articles, varying between 0.4, and 1.8 cm. Serious complications such as penile prosthesis malfunctions (3.3-11.1%) and urethral injuries (2.9%) were only reported for intra-operative manual modeling. Although individual studies have noted improvement in penile curvature and stretched penile length, specific recommendations regarding penile modeling in PD cannot be provided due to limited evidence available. Further RCTs with adequate sample size, validated assessment tools, and longer follow-up are needed. Krishnappa P, Manfredi C, Sinha M etal. Penile Modeling in Peyronie's Disease: A Systematic Review of the Literature. Sex Med Rev 2022;10:427-443.

A systematic review of modeling in Peyronie's Disease

ABSTRACT Introduction Penile modeling to correct the penile curvature in Peyronie's disease (PD) may be achieved manually (intra-operatively or post-injection) or by using assisted devices (penile traction, vacuum device or penile prosthesis). To the best of our knowledge this is the first systematic review of the literature comprehensively evaluating penile modeling procedures. Objective To evaluate the efficacy, safety and satisfaction associated with penile modeling in patients with PD. Methods A PROSPERO registered (CRD42021241729) systematic search in MEDLINE and Cochrane Library was done in accordance with PRISMA. PICO: Studies were deemed eligible if they assessed patients with PD (P) undergoing modeling procedures (I) with or without comparative group(C) evaluating the efficacy, safety or patient satisfaction (O). Results A total of 23 studies, involving 1,238 patients were included in the systematic review. The majority (n=13) studied penile traction therapy and the least being manual modeling at home and manual modeling after collagenase injection (1 each). The studies were of low and intermediate quality (mean Newcastle-Ottawa Scale score of 5.7 and mean Jadad score of 3.3) with a mean level of evidence of 3.4. The mean penile curvature at baseline was between 31 and 80.8 degrees. Nine (39.1%) studies found a significant improvement (p&amp;lt;0.05) of penile curvature after penile modeling, ranging between 11.7 and 37.2 degrees. A increase in mean stretched penile length was reported in 7 (30.4%) articles, varying between 0.4 and 1.8 cm. Serious complications such as penile prosthesis malfunctions (3.3%-11.1%) and urethral injuries (2.9%) were only reported for intra-operative manual modeling. Conclusion Although individual studies have noted improvement in penile curvature and stretched penile length, specific recommendations regarding penile modeling in PD cannot be provided due to the inability to perform a pooled analysis of the included studies with significant heterogeneity and the absence of standardized methods to report complications and patient satisfaction. Further RCTs with adequate sample size, validated assessment tools and longer follow-up are needed. Disclosure Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Boston Scientific).

Measurement of Stretched Penile Length in Term Neonates at a Single Tertiary Care Centre of South India

Evidence from several studies has shown that the penile length varies among different populations of different racial/ethnic groups. Size abnormalities of the newborn external genitalia may be a pointer to some endocrine and genetic disorders. In this study we have prospectively measured the stretched penile length of all newborns at our hospital in an attempt to define normative data for full term neonates of our region. All live male neonates born at our hospital were enrolled into the study. Stretched penile length was measured from the pubic ramus to the tip of the glans penis using a digital Vernier Calliper. The measurements were taken within 48 hours of birth. Two consecutive measurements were taken and the average was recorded as the final measurement. The mean stretched penile length was 2.63±0.35 mm and the mean diameter of glans was 1.04±0.09 mm respectively. The penile length significantly varied with the length (height) of the neonate as expressed in cms. The taller the neonate, longer was the penis. Similarly, the mean penile length and the diameter of the glans was significantly different (p<0.05) for different gestational age. The stretched penile length of neonates significantly correlates with the gestational age and the length of the neonate.

Early Penile Rehabilitation with a Vacuum Erectile Device in Patients Undergoing Robotic-Assisted Radical Prostatectomy

Purpose: This aim was to study the efficacy of a vacuum erectile device (VED) in rehabilitating the erectile function of patients undergoing nerve-sparing robotic-assisted radical prostatectomy. Materials and Methods: This prospective randomized study enrolled 35 prostate cancer patients from Thailand who had intact baseline erectile function and underwent nerve-sparing robotic-assisted radical prostatectomy. These patients were randomly assigned into either a study group which applied the VED for 10 min daily for 6 months or a control group which received no additional interventions. A 5-item version of the International Index of Erectile Function (IIEF-5) score, stretched penile length, and midshaft circumference were measured at 1, 3, and 7 months after surgery, respectively. Results: The mean patient age was 65.6 years, and the mean baseline IIEF-5 score was 22.91, which were comparable between the two groups. Three patients in the study group did not follow the VED protocol due to postoperative urinary incontinence. A per-protocol analysis revealed that the mean IIEF-5 score at 7 months was significantly higher in the study group compared to the control group (11.29 ± 7.47 vs. 6.61 ± 5.33, P = 0.047). The mean midshaft circumference was also higher in the study group (9.24 ± 1.43 cm vs. 7.91 ± 0.37 cm, P = 0.002). No statistically significant difference in the mean stretched penile length between the two groups was found. Conclusion: Early VED usage for penile rehabilitation following radical prostatectomy significantly improves IIEF-5 score and better preserves penile circumference but not penile length. A larger-scale multi-institutional study is required to validate these findings.

Stretched penile length and total serum testosterone in term male neonates

Introductionthe reference values of stretched penile length vary with different ethnic group. There is paucity of data on the reference range of total serum testosterone in neonates especially in Africa. This study therefore was to determine the normal stretched penile length, total serum testosterone levels in term male newborns and to correlate them with anthropometric parameters.Methodsthis was a prospective cross-sectional study. One hundred and twenty-four consecutive healthy term male neonates were recruited in the first 72 hours of postnatal life. The stretched penile length (SPL) was measured with a rigid metric ruler. Weight, length and occipitofrontal circumference were also measured. Total serum testosterone level was determined using Enzyme Linked Immunoassay. Data were analysed using the Statistical Package for Social Sciences for Windows version 20.Resultsa total of 124 term male neonates were recruited. The postnatal age of recruited neonates was one to 70 hours with a mean of 22.8 ± 17.6 hours and the mean of estimated gestation age was 38.5 ± 1.3 weeks. The range of stretched penile length was from 2.1 to 3.9 cm with a mean of 3.2 ± 0.4 cm and SPL less than 2.2 cm was considered as micropenis. The mean total serum testosterone level was 357.4 ± 241.7 ng/dl. The SPL had a positive correlation with the birth weight, length and total serum testosterone. The total serum testosterone and birth length were predictors of stretched penile length.Conclusionamong the studied population the mean stretched penile length was 3.2 cm and mean total serum testosterone was 357.4 ng/dL.

Fate of the micropenis and constitutional small penis: do they grow to normalcy in puberty?

Penile length is an important indicator of male sexual development. Scarce data were reported on penile length measurements in children comparing changes between prepuberty and puberty for the small penile issue with long-term follow-up. The purpose of this study was to investigate the possibility of catch-up growth of the penile length of boys with a small penis in the long-term follow-up. From April 2001 to December 2016, 27 boys who visited the outpatient clinic owing to a small penis, without any chromosomal anomalies and other genital disorder, were investigated retrospectively. Micropenis is defined as 2.5 standard deviations less than the mean stretched penile length (SPL) of age. Periodic penile length, testicular volume, hormonal levels (serum testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH)), and bone age were measured. Pubertal development was recorded by using the Tanner scale. The effect of hormonal therapy and the factors attributable to the increment of the penile length were evaluated. The mean age at the first visit was 9.8 years (5-12 years) and that at puberty was 12.6 years (10-16 years). The length of the penis at the initial visit was 4.0±0.8cm (2.5-6.0) and at puberty, 7.3±1.8cm (4.0-12.0). Nine patients diagnosed with micropenis no longer had a micropenis in puberty. The less the age-matched SPL, the more the increment of SPL that was observed (rho=- 0.548, P=0.003). The mean increment of SPL in the hormonal therapy group (11 boys) and the non-hormonal therapy group (16 boys) was not statistically different (43.5±22. 9% vs 41.5±21.6%, respectively, P=0.497). This study explains how much the growth of a small penis catches up in puberty. From the point of view of the increment of SPL, the increment was higher in boys who belonged to the smaller penis group. Hormonal therapy does not attribute to an increase in the length after long-term follow-up. Limitations of this study were its retrospective origin with a small number of patients in a single center. Catch-up growth of the small penis at puberty was accomplished in most children with a small penis before puberty. Hormonal treatment was not significantly correlated with the penile length increment in the long-term follow-up.

Normative data on penile and anogenital measurements of term male infants in Sagamu, Nigeria.

To document normative data on penile size and anogenital distances of apparently normal term male infants in Sagamu, Nigeria. This cross-sectional study was carried out on 303 term male infants within the first 72hours of life. Stretched penile length, penile width and three measures of anogenital distances were recorded: anogenital distance-1, anogenital distance-2 and anoscrotal distance. The mean (±SD) stretched penile length and penile width were 39.4±4.2mm and 11.0±1.0mm, respectively. The mean values for anogenital distance-1, anogenital distance-2 and the anoscrotal distance were 48.7±3.9mm, 42.8±4.6mm and 25.5±3.9mm, respectively. Only penile width and anogenital distance-1 significantly correlated with all the anthropometric parameters but anogenital distance-1 had the strongest correlation (p<0.01 for all). The observed mean stretched penile length was greater than previously reported. Local references are preferable in interpreting anogenital measurements in newborns to avoid diagnostic errors. There is need for a consensus on the definition of micropenis.

Establishment of normative data for stretched penile length in Turkish preterm and term newborns.

Halil H, Oğuz ŞS. Establishment of normative data for stretched penile length in Turkish preterm and term newborns. Turk J Pediatr 2017; 59: 269-273. The aim of this study was to establish a normal range of preterm and term stretched penile length based on their gestational age and anthropometric parameters at birth. A total of 585 infants; 336 (57.43%) preterm and 249 (42.57%) term male infants born between August 2015 and September 2016 with gestational age between 26 and 41 weeks were included in our study. Stretched penile length was measured from the pubic ramus to the tip of the glans. Gestational age, stretched penile length and anthropometric parameters at birth (weight, length and head circumference) were recorded within the first three days of life. Variations of stretched penile length in relation to gestational age and anthropometric parameters were evaluated using multiple linear regression models. The mean stretched penile length ± SD of preterm and term neonates were 2.5±0.565 cm and 3.2±0.551cm, respectively. In all infants, stretched penile length was significantly affected by gestational age and birth length (OR: 0.079, 95% CI 0.059-0.098, p=0.0001, OR:0.022, 95% CI 0.007-0.037, p=0.005, respectively). In term infants, stretched penile length was significantly affected by gestational age (OR: 0.139, 95% CI 0.082-0.196, p=0.0001) and in preterm infants, gestational age and birth length significantly infleuenced the stretched penile length (OR: 0.090, 95% CI 0.065-0.0115, p=0.0001, OR:0.024, 95% CI 0.009-0.039, p=0.002, respectively). This study provides reference values of stretched penile length for term and viable preterm Turkish infants.

236 Penile Suspensory Ligament Weakness and its Repair – Myth or Truth?

The Suspensory ligament of the penis are important for maintaining a stabilized penile position during erection and preventing its slippage from the vagina during intercourse. It also gives an angle to the erect penis for comfortable penetration. To evaluate men presenting with Penile Suspensory Ligament (PSL) weakness , its surgical correction and its outcomes This is a retrospective study of 43 patients presenting with PSL Weakness from Jan 2010 to Dec 2015. The diagnosis was done by History, Physical Examination-Pubic Gap sign and Straightening sign, Autophotography and Penile Doppler. The surgical repair was corporopexy which was performed with nonabsorbable sutures placed between tunica albuginea of the penis and the periostium of the symphysis pubis. The success was analysed using International Index of Erectile Dysfunction-5 ( IIEF-5 ) questionnaire. The mean age of the patients was 40.7 years. The most common etiology was congenital weakness of PSL. The mean pre-operative IIEF-5 score was 7.1.The mean stretched penile length was 15.03 cms. The average operative time was 1 hour and 40 mins. The usual period of hospitalization was 2 days. Patients were followed up for an average of 16.7 months. The mean post-operative IIEF-5 score was 18.8. There was significant improvement in IIEF score ( P = 0.04 ). The patient satisfaction was 88% and the partner satisfaction was 81%. There were no significant complications and none of our patients had to undergo repeat procedure.

Topical treatment for acute phase Peyronie's disease utilizing a new gel, H-100: a randomized, prospective, placebo-controlled pilot study.

Safety and efficacy of topically applied gel H-100 composed of Nicardipine, superoxide dismutase and emu oil for treatment of acute phase Peyronie's disease (PD) was evaluated. Twenty-two patients (PD <12 months duration) were studied in a prospective, randomized, double-blind, placebo-controlled study. Eleven patients received H-100 and 11 patients received placebo for 3 months. All 22 patients then received H-100 for the final 3 months. Flaccid-stretched penile length, degree of penile curvature, pain level and side effects were assessed monthly. H-100 showed significant improvement in all PD parameters at 6 months: mean stretched penile length increase (22.6%, P=0.0002), mean curvature reduction (40.8%, P=0.0014), and mean pain level reduction (85.7%, P=0.004). Placebo group showed no significant improvement except for mean stretched penile length increase (6.8%, P=0.009). Crossover patients from placebo to H-100 showed significant improvement in all parameters: mean stretched penile length increase (17.5%, P=0.000007), mean curvature reduction (37.1%, P=0.006), and mean pain level reduction (40%, P=0.17). Treatment was well tolerated. A self-limited rash was the only side effect in three patients. Statistically significant improvements in flaccid-stretched penile length, curvature and pain suggest that H-100 is a safe and possibly effective non-invasive, topically applied treatment for acute phase Peyronie's Disease.

RETRACTED: The effect of parenteral testosterone administration prior to hypospadias surgery: A prospective, randomized and controlled study

The goal of hypospadias surgery is to provide a functionally and cosmetically normal penis. Whether this goal will be to the patient's satisfaction depends largely on the original anatomy, surgical technique and surgeon's experience. It has been suggested that androgen administration is associated with better outcomes in hypospadias repair; however, few studies have included control groups and the issue is still controversial. To evaluate the effects of parenteral testosterone administration on the results of hypospadias repair in children with untreated hypospadias. A total of 182 children with midshaft or distal hypospadias and a mean age of 30 months (range 18-52 months) were enrolled in this study. Consecutive children were randomly allocated to the study group (testosterone administration) (Group 1, n = 91) or control group (Group 2, n = 91). Only children with a flat urethral plate were included in this study. The control group did not receive any pre-operative treatment. Children with a previous history of hypospadias repair and any proven endocrine disorder were excluded. The study children received 2 mg/kg testosterone enanthate monthly for two months before surgery. Tubularized incised plate (TIP) urethroplasty, with or without chordee correction, was performed for all children in both groups by the same urologist. Hypospadias repair was performed 4 weeks after the second dose of testosterone administration. Postoperative complications were recorded, including: urethrocutaneous fistulas, urethral diverticula, meatal stenosis, and glanular dehiscence. The mean stretched penile length and circumference were measured at baseline and at 1 month and 2 months post operation. All children were examined every month for any adverse affects to testosterone treatment, like pubic and axillary hair, and height acceleration, up to 3 months post operation. An increase in penile length (from 28.1 ± 2.2 mm to 38.5 ± 2.6 mm) (P = 0.001) and penile circumference (from 35.1 ± 1.6 mm to 45.5 ± 2.2 mm) (P = 0.001) were noticed in all but four children in Group 1. The actual values for increase in penile length in the study group were, 22.0%, 35.0% and 36.0%, at postinjection months 1, 2 and 3, respectively (P = 0.01, P = 0.001 and P = 0.001, respectively) (Figure). The actual values for increase in penile circumference in the study group were, 16.0%, 27.0% and 29.0%, at postinjection months 1, 2 and 3, respectively (P=0.01, P=0.001 and P =0.001, respectively). The overall complication rates were significantly higher in Group 2 [12 children, 13.18%) compared to Group 1 (five children, 5.45%) (P=0.03). Urethrocutaneous fistula was the most common complication in both groups (four children [4.39%] in Group 1 and seven children [7.69%] in Group 2) (P=0.02), followed by meatal stenosis (one child [1.09%] in Group 1 and three children [3.29%] in Group 2) (P=0.03). All children in Group 1 developed pigmentation of the genitalia, and scant pubic hair appeared in 14 of them. These side effects disappeared by the 3 months postoperation follow-up visit. Tubularized incised plate urethroplasty is a popular reconstructive method for hypospadias repair and is widely accepted by pediatric urologists. It is a reliable and simple technique with low complication rates. Testosterone administration before hypospadias repair decreases complication rates, reduces the need for reoperation and results in better cosmetic outcomes. Some studies have demonstrated temporary side effects like pubic hair growth and aggressive behavior, which gradually became normalized after treatment cessation. Nowadays, many pediatric urologists administer testosterone prior to hypospadias surgery; however, this can be variable. Parenteral testosterone administration before hypospadias repair is beneficial in decreasing complication rates.

Stretched penile length of healthy term neonates: normative values among Igbo babies in southeastern Nigeria.

To determine the normative values of stretched penile length in apparently healthy term Igbo newborn males in South eastern Nigeria and its relationship with gestational age, birth weight and birth length. Eight hundred and eleven apparently healthy term male neonates within the first 72 h of life were studied. Enrolled subjects were consecutively delivered babies of Igbo extraction from three hospitals. The stretched penile length was measured using Schonfeld method, and the smoothed centiles (3 rd to 97th percentile values) for stretched penile length by gestational age were determined. The mean stretched penile length of term newborns was 3.46 ± 0.44 cm. The lower and upper limits (±2.5 SD) were 2.36-4.56 cm. Stretched penile length correlated positively with birth length and birth weight (r = 0.343, p = 0.001; r = 0.229, p = 0.001). This study has created the first smoothed percentile values for stretched penile length by gestational age for Igbo babies.

Penile length-somatometric parameters relationship in healthy Egyptian men

This study aimed to assess the penile length-somatometric parameters relationship in healthy Egyptian men. Two thousand physically normal men (22-40years) were subjected to measurement of stretched penile length, glans penis, testis size, index finger, weight, height, span, body mass index (BMI), waist circumference, hip circumference and waist/hip ratio. The mean stretched penile length of the studied subjects was 13.84±1.35cm (range 12-19cm), and the mean glans penis length was 2.6±0.4cm (range 1.7-3.8cm). Penile length demonstrated positive significant correlation with glans penis length, index finger length, BMI and significant negative correlation with waist/hip ratio. On the other hand, penile length demonstrated nonsignificant correlation with age, weight, height, waist circumference, span or testicular size. It is concluded that the penile length-somatometric parameters relationship in healthy Egyptian men is mostly related to glans penis and index finger lengths.

Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants.

The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.

The Peyronie's Plaque “Scratch”: An Adjunct to Modeling

Penile modeling to correct the penile curvature in Peyronie's disease (PD) may be achieved manually (intra-operatively or post-injection) or by using assisted devices (penile traction, vacuum device, or penile prosthesis).To evaluate the efficacy, safety, and satisfaction associated with penile modeling in patients with PD.A PROSPERO registered (CRD42021241729) systematic search in MEDLINE and Cochrane Library was done following PRISMA. PICO: Studies were deemed eligible if they assessed patients with PD (P) undergoing modeling procedures (I) with or without a comparative group(C) evaluating the efficacy, safety, or patient satisfaction (O). Retrospective and prospective primary studies were included. The primary outcome measure is the change in penile curvature after modeling. The secondary outcome measures are the change in stretched penile length, adverse events, and patient satisfaction after modeling.A total of 23 studies, involving 1,238 patients were included. Most studies (13, 56.5%) evaluated penile traction therapy. The studies were of low and intermediate quality (mean Newcastle-Ottawa Scale score of 5.7 and mean Jadad score of 3.3) with a mean level of evidence of 3.4. The mean penile curvature at baseline was between 31 and 80.8 degrees. Nine (39.1%) studies found a significant improvement (P < .05) of penile curvature after penile modeling, ranging between 11.7, and 37.2 degrees. An increase in mean stretched penile length was reported in 7 (30.4%) articles, varying between 0.4, and 1.8 cm. Serious complications such as penile prosthesis malfunctions (3.3–11.1%) and urethral injuries (2.9%) were only reported for intra-operative manual modeling.Although individual studies have noted improvement in penile curvature and stretched penile length, specific recommendations regarding penile modeling in PD cannot be provided due to limited evidence available. Further RCTs with adequate sample size, validated assessment tools, and longer follow-up are needed.Krishnappa P, Manfredi C, Sinha M et al. Penile Modeling in Peyronie's Disease: A Systematic Review of the Literature. Sex Med Rev 2022;10:427–443.