Trouser Talk Part 3: Augmentation Phalloplasties – Basic Anatomy relevant to Penoplasties

Basic Anatomy relevant to Penoplasties

The penis serves as a reproductive organ and external excretory organ, for males. It has several tissue layers, and its main anatomical areas are:

  • Shaft or body (cylindrical structure of up to 30° in curvature, which contains erectile columns)
  • Neck (between the body and glans)
  • Corona (the flared part of the penile glans, which is prominent at the base of head as a rim);
  • Glans Proper or head (the rounded, spongy tip of the penis);
  • External Urethral Meatus (opening of the urethra, for passage of urine and sperm)
  • Foreskin (loose fold of skin covering the glans)

Regarding the three erectile columns, two are known as corpora cavernosa and are formed of trabecular smooth muscle and erectile tissue, and one, known as the corpus spongiosum, contains the urethra. The major supporting ligament is known as the dorsal suspensory ligament, and there are two others called fungiform ligaments.

Girth has a greater sexual bearing than length, but many ‘men’ are obsessed with the length of their penis. This is not being driven by women. Measuring the length of a penis in its flaccid state is meaningless for a variety of reasons. Only erect length provides meaningful data, and even then, it is the ‘stretched penile length’ (SPL) which is actually useful. SPL measures the penis’ length from the tip of the glans to the penile base abutting the symphysis pubis, and whilst it is the only accepted metric, many people make errors when measuring this distance.

So, what is the average length of a penis?

Reports in medical literature appear to vary quite significantly depending on the number of people surveyed and how the survey was undertaken. Also, the country where the survey was performed has a significant bearing on this number. Regardless, it appears that the vast majority of penises are typically 3” long when flaccid (and just over 3” in girth) and around 5.5” long when erect (and just over 4.5” in girth), but with the range for the erect length typically being between 10 cM (4”) and 18 cM (7”).

Penile blood flow is better in younger men and in those who don’t have microvascular disease (e.g. due to smoking). Also, given that muscles atrophy (shrink) when not regularly useful, it is technically feasible to say that infrequent erections and/ or very short-lasting erections could lead to muscle loss and a lack of stretching of the overlying membrane (tunica albuginea).

To finish off, I’d like to highlight how scientific studies are frequently, but unsurprisingly, twisted by headline-hungry journalists. Even as recently as this month, worldwide media had a large role to play in propagating misinformation pertaining to a simple study on penis-length. Journalists misquoted the study which was presented at the annual congress convened by American Society for Reproductive Medicine, and proceeded to falsely publish that men with small penises are likely to be infertile. In fact, penile length has no bearing on the degree of fertility. The moral of this story is that people need to do their own homework, people need to critique the credentials of authors and speakers, and people need to apply a healthy dose of logic when assessing sensational stories, particularly those relating to human health and sex.

<h4>Dr. Niro Sivathasan</h4><p>BSc (Hons), MB, BS (Lond), DRCOG, AesthMed Board Cert. (AAAM), GradDipAesthMed (UK), PGCert BA, MRCS (Eng), AFACP, DU (Paris), FCPCA, FFMACCS, FACCS, FASCBS, FAACS​</p>

Dr. Niro Sivathasan

BSc (Hons), MB, BS (Lond), DRCOG, AesthMed Board Cert. (AAAM), GradDipAesthMed (UK), PGCert BA, MRCS (Eng), AFACP, DU (Paris), FCPCA, FFMACCS, FACCS, FASCBS, FAACS​

Multiple postgraduate qualifications in general surgery, cosmetic surgery, and aesthetic medicine, were gained in America, Australia, and Britain. Now, ‘Dr. Niro’ is exclusively in private clinical practice and is a senior trainer and K.O.L. (key opinion leader) for the pharmaceutical and medical devices industries (since 2014).

He has published over 35 medical articles, spoken at conferences around the world, written book chapters, and is reviewer and editorial committee-member for various medical journals in addition to being a recognised medical educator on the national and international stage.