Penis-Lengthening Surgery Questioned

Study: Average Length Gain Is Half an Inch, Satisfying Few Patients

By Miranda Hitti
WebMD Health News

Reviewed by Ann Edmundson, MD, PhD

Feb. 16, 2006 -- In a new study of men who got penis-lengthening surgery, most patients weren't satisfied with the results.

The surgery added half an inch, on average, to penis length. That's based on the length of the flaccid, stretched penis.

"Overall, only 35% of the patients were satisfied with the outcome of surgery," write urologist David Ralph, BSc, FRCS, and colleagues in European Urology.

The researchers work in London at St. Peter's Andrology Centre and Institute of Urology. They studied 42 men who got penis-lengthening surgery from September 1998 to January 2005.

The surgical technique used was division of the penile suspensory ligament. This is the most common penis-lengthening surgery and allows the penis to hang lower.

Some men also got a spacer inserted to prevent the ligament's reattachment. Three patients also had excess fat removed from the pubic area. The use of the spacer seemed to bring the best results, but didn't change the findings, the researchers note.

Unrealistic Expectations

Most of the men who were studied actually had normal-sized penises and were preoccupied with the idea that their penises should be longer, the researchers note. This preoccupation with an imagined problem in penile appearance is called penile dysmorphic disorder.

"The most common scenario in patients with penile dysmorphic disorder consisted of anxiety and embarrassment arising from changing in front of others, that is, the 'locker room' syndrome," Ralph's team writes.

Men with penile dysmorphic disorder were particularly likely to be dissatisfied with the surgery's results. The study shows that only 27% of those men reported being content with the surgery's outcome.

"Men with penile dysmorphic disorder often have unrealistic expectations regarding the outcome of surgical intervention and should be encouraged to seek psychological help primarily, with surgery reserved as the last resort," write Ralph and colleagues.

They add that before penis-lengthening surgery, "all patients should have a psychiatric assessment" and a clear understanding of the procedure's limits.

Second Opinion

A journal editorial praises the study, calling penile enlargement "a very controversial procedure" that needs more scientific study.

"The size of the male genitalia has been a source of anxiety among men throughout history," writes editorialist Yoram Vardi, MD, of Rambam Hospital in Haifa, Israel. "Men often feel a need to enlarge their penis in order to improve their self-esteem or to satisfy and impress their partners," he continues.

"My personal conviction, especially after reading this manuscript [Ralph's study], is that men who are dissatisfied with the appearance of their genital organ should think very carefully before requesting these procedures," Vardi writes.

"A better option may be to seek the counsel of psychologists; often men simply need to be reassured that they are 'normal' or need advice on how to better satisfy their partner without resorting to cosmetic surgery," he continues.

"Unfortunately, there will always be people willing to undergo 'beautifying' surgical procedures in an attempt to feel better ... self-confidence and beauty come from the inside and no surgery is deep enough to change that," Vardi writes.