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Basic morphological data of external genitals in 177 healthy central European men.

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Basic Morphological Data of External Genitals in
177 Healthy Central European Men
L. G. FARKAS
The Research Institute, The Hospital for Sick Childrerz, Toronto,
Ontario, Cnnadn
ABSTRACT
Five basic measurements were made of the penis, the scrotum
and the testicles of 177 healthy Bohemian (Czechoslovakian) men, 18-20 years
of age. The average length of the penis was 72.18 mm. The average circumference of the penis was 95.65 mm. The length of the right testicle was 47.37 mm,
the length of the left was 45.17 mm.
In 16.2% of those examined slight deformations of the urethral opening and
mild malformations of the prepuce and the frenum were found. These defects
did not disturb function. The method of measurement used has been described.
As a continuation of some recent studies (Trosev, '69; Farkas et al., '68) on the
postnatal development of the penis from
birth until the age of six or seven years
in members of two national populations,
I measured the male genitals in normal
adults. The information gained might be
useful to the surgeon and other specialists
dealing with congenital and acquired defects of the male genitalia.
MATERIAL
One hundred and seventy-seven healthy
men 18 to 20 years of age, selected at
random from among personnel of military units stationed in Prague (Czechoslovakia) were examined during the first
half of 1968.
METHOD
Five objective basic measurements of
the genitals obtained by anthropometry,
and three qualitative signs related to the
penis, assessed by anthroposcopy, were
recorded in each case. The subject was
recumbent during the examination.
Measurements were made with the penis
flaccid. The maximum-minimum measurements in millimeters were recorded
on coded charts and the mean and
standard deviations calculated. All measurements were performed by one person,
AM. J.
PHYS. ANTHROP.,
34: 325-328.
Measurements
1 . The total length of the penis: measured by sliding calipers on the dorsal
side of the penis between the root of the
penis and the tip of the glans (fig. 1).
2. The circumference of the penis:
measured by measuring tape in the mid
portion of the penile shaft (fig. 1).
3 . The circumference of the scrotum:
measured by measuring tape from the
right scrotal base along its circumference
to the left scrotal base (fig. 1).
4. The size of each testicle: (a) the
length: measured by sliding calipers
between the two most distant points of
its longitudinal axis (fig. 2), (b) the
width: measured by sliding calipers in
the mid portion of the testicle (fig. 2).
Qualitative signs
1. The site and the shape of the
urethral orifice.
2. The shape and the state of development of the frenum.
3. The prepuce: its size, configuration, the size of the opening of the preputial pouch.
RESULTS
The results are shown in table 1 and
table 2.
325
326
L. G . FARKAS
Fig. 1 Showing method of measuring penile
length (A) and circumference (B) in flaccid state
and circumference of the scrotum (C).
DISCUSSION AND CONCLUSIONS
The findings in both age groups (18
to 19 years and 19 to 20 years) were
analyzed in one group because in my
experience the size of the genitalia does
not change significantly between 18 and
20 years of age. Other authors' findings
support this suggestion (Schonfeld, '43;
Figalova et al., '68).
The men in this study group were
healthy adults, found fit for military service by a military medical committee and
were under constant medical supervision.
None of them had pathological body
configuration, abnormal body size, or
manifested endocrine disturbances.
Fig. 2.
Showing method of measuring testes.
No measurements other than those of
the genitalia were undertaken.
The surgeon repairing congenital or
acquired defects of the genitalia prefers
to use penile skin (or scrota1 skin) for
correction of the failure. The length and
circumference of the penis in the flaccid
state are of great value in the planning
TABLE 1
Metric data of external genitals in s t u d y g r o u p in millimeters
Region
Penis
Scrotum
Right
testicle
Left
testicle
Sign
N
Max-Min
Mean
SD
Length
Circumference
Circumference
Length
Width
Length
Width
177
176
177
176
176
176
176
110-45
72.18
95.65
195.14
47.37
28.02
45.17
27.42
11.24
8.31
22.43
4.71
3.44
4.78
3.22
120-77
250-105
65-34
42-17
62-34
36-15
TABLE 2
Qualitative signs oj'externnl genitals i n s t u d y group
Region
Urethral
orifice
Frenum
Prepuce
Total
Sign
N
%
Markedly elongated ventrally
Blind hole on the tip of glans and
the separated urethral meatus
situated ventrally
O n l v one of its root4 w a s
tlc~vcloprda n d placed o b l i q ~ e l v
Phimosis
17
10
9.6
5.6
1
0.5
1
0.5
29
16.2
NORMS OF ADULT MALE GENITALIA
of corrective surgery. The circumference
of the flaccid hypospadiac penis can be
decisive in choosing the method of the
urethroplasty (Farkas, '68). For these
practical reasons the penis was measured
in the flaccid state in all studies dealing
with boys with hypospadias and also in
controls (Farkas et al., '68; Farkas, '70).
The penis was measured between the
same landmarks used by Schonfeld ('43).
In only a few cases I found similar difficulties in the localization of the landmark at the penopubic junction as Schonfeld. I do not agree with Schonfeld that
assessment of the length of the stretched
penis is more precise than that of the
flaccid penis. Both methods are open to
inaccuracy. The error in measurement of
length of the penis was estimated by me
1-2 mm, established by repeated measurement in cases where the landmark
at the penopubic junction was not sufficiently visible.
The inaccuracies in measuring the
scrotal circumference are even greater
( * 2-3
mm) than in the length of the
penis because it is difficult to determine
the exact base of the scrotum.
The thickness of the scrotal skin makes
the measured length and width of the
testicles greater than they really are.
The average length of the penis (72.18
mm) in the study group is considerably
less than the 100-120 mm recorded in
some textbooks of anatomy (Borovansky,
cited by Hromada), but the method of
measuring is not known.
The length of the penis in this study
group cannot be compared directly with
the data in Schonfeld's paper because of
the difference in measurement techniques. In my experience a flaccid penis
72 mm in length can be extended by
approximately one-half of the original
length when stretched. Thus the length
of the penis of men in my study group
would be markedly shorter (about 118
mm) in comparison with the findings
given by Schonfeld (130 mm).
Hajnis and coworkers ('70) measuring
the length of the penis between the tip of
the glans and penoscrotal angle in normal
Czech boys, from birth to six years of
age, found the length of the erect penis
almost double the length of the flaccid
*
327
penis. However, the small number of the
observations makes a valid conclusion
impossible.
If Schonfeld's calculation is correct
stating that on an average there is about
20-30
m m difference between the circumference of a flaccid and erect penis,
then the circumference of the penis in
males of this study group, recorded in
flaccid state as 95.6 mm would be about
125 m m in state of erection which is
markedly more than the medium measurement of Schonfeld (90 mm). The
differences found between the Schonfeld
norms and the study group are not surprising. There are similar differences
between the size of the penis of normal
Czech and Bulgarian boys from birth up
to six years of age (Farkas et al., '68;
Trosev, '69) using the same method of
measurement.
The method of assessment of the size
of testicles I used differed from that used
by others (Albert, '53; Schonfeld, '43),
which excludes a comparison of the findings. The right testicle in men studied
was larger than the left, in accordance
with the observation of Trosev ('69) i n
normal Bulgarian boys, and of Hajnis
and coworkers ('70) in normal Czech
boys. Schonfeld ('43) found a larger right
testis in 23% of boys studied.
The relatively high frequency in my
study of slight morphological changes of
the urethral orifice and the shape of the
frenum is unusual but similar to those
found in slight degrees of hypospadias
(Farkas, '70). The question remains:
which anatomical changes of the urethral
opening should be considered as variations of normal state, and which should
be classified as microforms (forme frustes
or minor defects), of hypospadias or epispadias? A larger sample of the general
population would yield more reliable
results.
Precise measurements of male genitals
would be helpful for evaluating the effect
of treatment on hypospadias, epispadias
and for establishing the growth potential
of the congenitally damaged penis (Figalova et al., '68).
The above mentioned findings in different populations and those observed
during my long clinical practice in Central Europe, support our belief that there
328
L. G. FARKAS
exists differences between populations
(of the same racial origin) in some anthropometric signs probably caused by
different ethnic, social, alimentary, geographical and other factors.
However, a man’s reticence to undergo
this type of examination limits the number of subjects and makes it difficult to
establish the reported or valid norms for
each population.
Although the sample studied cannot be
regarded as representative of the general
population, it offers some valuable information about the size and configuration
of the genitalia of adult males.
ACKNOWLEDGMENTS
I am especially indebted to Professor
D. R. Hughes and Mr. James Webb of the
Department of Anthropology, University
of Toronto, for the statistical evaluation
of data.
LITERATURE CITED
Albert, A. 1953 Male Hypogonadism: 1. The
Normal Testis. Proc. Staff Meetings Mayo Clin.,
28: 409.
Farkas, L. G. 1968 Experience with our urethroplasty after two years. Acta Orthoped.
Traumat. CSL, 35: 540 (in Slovak).
1970 Minor defects of the penis. Microforms or stigmata of hypospadias and
epispadias? Plast. Reconstr. Surg., 45. 1.
Farkas, L. G., K. Hajnis and M. Novakova 1968
Time of correction of chordee in hypospadias
as seen from the viewpoint of postnatal dwelopment. Rev. Lat. Am. Cir. Plast., 12: 215.
Farkas, L. G., and J. Hynie 1970 Aftereffects
of hypospadias; repair in childhood. Postgrad.
Med., 47: 103.
Figalova, P., L. G . Farkas, and K. Hajnis 1968
Eine Studie zur Erforschung somatischer
Merkmalebei Patienten mit Hypospadie. Z.
Urol., 61: 313.
Hajnis, K., V. Novakova, and L. G . Farkas 1970
Anthropometric parameters for operative practice of most frequent development defects of
organorum genitalium masculinum (Partes
Externae). Acta Univ. Carol. Biol., 1969: 421.
Hromada, J. 1969 Quoted from J. Borovansky,
Systemic Human Anatomy, Prague (in Czech).
Schonfeld, W. A. 1943 Primary and secondary
sexual characteristics. Am. J. Diseases in Children, 65: 535.
Trosev, K. 1969 Contribution to the anthropometric study of the penis in a group of Bulgarian boys from birth to the age of seven years,
Acta Chir. Plast. (Praha), 11: 140.
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