Why is my penis getting shorter?
But first let’s dig into a very popular question:
What is the average penis size?
According to a study published in the Journal of Urology, the average penis size in the flaccid state is 8.8 cm or 3.5 inches. During the erect state, the average size was found to be 12.9cm (or 5.1 inches). I would also like to highlight that the flaccid size, in most occasions, does not correlate with the size during the erect state. Penises tend to “grow” from the flaccid to the erect state.
Even though there are many men who are interested in obtaining a ‘larger or longer penis’, most just want to make sure they do not lose what they already have. I’ll explain…. The most common surgery that I perform is placement of an inflatable penile prosthesis (also known as a penile implant) and probably the most common question that men have when I talk about the procedure is “But doctor… will I keep my size? Will the implant make me lose length?”
But…. Why is my penis shrinking?
There are two well-known conditions that can get the penis shorter: Peyronie’s disease and erectile dysfunction.
Peyronie’s disease is a condition in which the body starts forming scar tissue, known as a plaque, in the lining surrounding the corpora cavernosa, known as the tunica albuginea. Your penis has two chambers (known as the ‘corporas’) that fill up with blood in order to give you an erection. Those two chambers are surrounded by an ELASTIC layer called the tunica albuginea. When that elastic tissue has an injury or a condition that develops a plaque (or scar tissue), it won’t be able to stretch out and this can lead to 3 things: pain, curvature and a… shorter penis. These men not only have distress because they notice that their penis is now bent or curved, but now they notice it’s getting smaller!
Erectile dysfunction can also cause the penis to lose size. Have you ever heard the expression: “if you don’t use it, you lose it”? Well, your erections work that way, in a sense. When our body stops having regular erections, the elastic tissue that stretches the penis from the flaccid state into the erect state can transform in a way that the penis loses its elasticity. If the penis is not elastic, it won’t stretch when you get an erection, and you will notice you lost length.
Radical prostatectomy (RP): Penile shortening is a common occurrence after surgical removal of the prostate in patients with prostate cancer. Research studies have reported that this can happen in 15-68% of patients after radical prostatectomy. You may wonder: but why would that happen? The real answer to that is: we don’t know yet, but we have theories. Some urologic scientists proposed one mechanism: the anatomy changes when the urethra is shortened. When the prostate gets removed, the urethra needs to be reconnected with the bladder and this makes the urethra shorter. However, one thing that we do know for sure is that after the prostate gets removed, the nerves that help men get erections are injured. This can lead to poor oxygenation of the smooth muscle inside the penis (cavernous body) which can lead to fibrosis (scar formation), erectile dysfunction, loss of elasticity and, a shorter penis.
Overweight: Weight gain can also give you the appearance of a shorter penis. Unlike women, who gain most of their weight in their thighs, men’s bodies mostly focus their weight gain in the lower abdomen (referred to as ‘panniculus’). Accumulation of fat in this area hinders the penis and limits its visibility, giving you the appearance of a shorter penis.
And what can I do to optimize my length?
Traction therapy: Research shows that some men with Peyronie’s disease respond to traction therapy. This can be used alone or in combination with surgical and nonsurgical treatments such as Xiaflex intralesional therapy. There are multiple types of traction devices available that can be used to restore length and correct penile curvature.
Vacuum therapy: A vacuum erection works by creating negative pressure inside the penis and “suctioning” venous blood into the penile shaft. While inside the vacuum pump, the penis will maintain the erection. I truly believe (and research has shown) vacuum therapy can help men keep their size and helps with penile rehabilitation. My recommendation for men who don’t get erections during the night or are planning to get a penile implant in the future is: GET A VACUUM DEVICE and use it to exercise your penis. It will keep the tissues elastic and healthy.
Surgery: There are surgical procedures that can give the appearance of a longer penis without actually affecting your true penile size. These include: ventral phalloplasty, dorsal phalloplasty, panniculectomy, among others. For men with Peyronie’s disease, there are procedures that can help restore their length, but we will focus on these in another episode.
A penile implant can help you keep your size…
Penile Implant: Yes. A penile implant can help you MAINTAIN your length. The inflatable penile prosthesis is a medical device that’s placed inside the penis. We offer it to men with ED . The implant occupies the inside of the penile shaft in its entirety (Want to see how? Watch a video here). Earlier I described how erectile dysfunction can lead to loss of length. If there is one thing that will “halt” that process, it would be the penile implant. By occupying the entire space inside of the penile shaft, the penis has nowhere to go. This is why I encourage men to consider this option when ED continues to progress and oral medications fail. Why? Because… when you have a penile prosthesis, your penis will be in the “long” state at all times. The penile implant transforms your penis from being a “grower” to a “shower”.
Let’s go back to that original question: Why is your penis “shrinking”? Your inability to have a strong erection, Peyronie’s disease, history of prostate cancer and weight gain may be factors you need to look into.
And for the second question: will I lose size with the penile implant? The answer is simple… No. The implant does not cause the penis to be shorter, erectile dysfunction does. When it comes to penile size, it is important to understand that there are many factors that can affect it. However, I am equipped with the tools to help maximize and restore length and function. Give us a call! We will be honored to help you.
This article was authored by Dr. Jonathan Clavell. Dr. Clavell is an urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.