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Penile growth and development is a complex process regulated by genes, hormones, and environmental factors.ÌýÌý

Penile size differs between men of different ethnic backgrounds, and large studies of penis girth and length have been conducted by condom manufacturers. What many men perceive as a short penis actually falls into normal range size. Based on many published charts, scientific articles and self reported web based surveys, 95% of Caucasian men will fall into one of the following categories of size:Ìý

Penis size is an important issue for many, and men of all ages are concerned about length and thickness of their penises. As with any health concern, men who are worried about their penis size should consult with a urologist trained in sexual medicine.Ìý

Risks & CausesÌý

Shortening of the penis can be a result of weight gain and the deposition of fat around the pubic area. This results in the visual shortening of penis. Obesity increases the risk of erectile dysfunction, and heavy men who complain of loss of length may simply have inadequate blood flow to achieve adequate rigidity.Ìý

Less common reasons for shortening of the penis are inborn defects in response to a male hormone (testosterone), congenital chordee (tethering of penis), chromosomal abnormalities (rare) or a scar fromÌýPeyronie's diseaseÌý(development of scars/plaques in the penis). Penile length may slightly decrease with age because of atrophy related to a decrease in testosterone level and the decreased frequency of erections. Prostate surgery may also damage the nerves and result in shortening of the penis. Thus, men who are concerned about penile size should be fully evaluated by a urologist specializing in sexual medicine, to exclude medical reasons for a change in penile size.Ìý

Symptoms & EvalutionÌý

A majority of men who are concerned about penile size are younger men in their late teens, 20s and early 30s, and men older than 60.Ìý

There is no standardized approach to evaluate and manage men concerned about penile size. Most important is to perform a full genital exam with specific attention paid to examining the penile shaft for fibrosis or plaques.Ìý

Treatment OptionsÌý

Surgical management of a short penis is limited to liposuction and transposition of scrotal skin in men with abnormal position of the penis. Cutting the suspensory ligament and subsequently applying a traction system has been used in some centers to elongate the penis, but this is not a commonly performed procedure. Its effectiveness is questionable in most cases, and the effects depend on accurate patient selection and lack of any postoperative scarring. Fat injection, fat flaps and silicon injections have all been tried to increase girth of penis. Fat injections last temporarily as most adipose (fat) cells dissolve. Fat flaps have been described as a successful method of increasing girth and is occasionally performed in reconstructive surgery. Injection of silicon has often been disastrous with an uneven, "bumpy" surface of the penis, erosion through skin and scarring of subcutaneous tissue.Ìý

Patients with a decrease in penile length and girth caused by Peyronie's disease can be successfully treated in specialized centers. A decrease in length of the penis after prostate surgery is managed by increasing the frequency of erections and sexual interactions.Ìý

Three common "home" methods are used to elongate the penis without medical supervision or proof of effectiveness: penile tape (also used in foreskin restoration), penile weight system and penile stretching using a controlled stretch device. All are based on the assumption that by applying a pulling force on the penis, the penile tissues extend and men can achieve a 0.25 to 0.75 cm increase in length. Penile stretching using adjustable devices like Fastsize has been used in the treatment of Peyronie's disease, and when supervised by a urologist, is safe. However, the unsupervised stretching treatment has resulted in bruising of the penis, vein thrombosis and damage to nerves of the penis, especially if weights are used.Ìý