Skip to main content

A Review on Penile Length and Girth Issues in Penile Prosthetic Surgery

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.


Purpose of Review

The goal of this paper is to understand the reasons behind penile length and girth issues after penile prosthesis surgery and review the literature for current strategies employed to decrease these issues.

Recent Findings

Measurement inconsistencies triggering further studies have shown there is a real loss of penile length and girth after prosthesis surgery. There have been varying hypotheses of why this happens, and numerous approaches have been proposed to help combat this in the preoperative, intraoperative, and postoperative settings.


Erectile dysfunction prevalence is expected to increase; therefore it is important for urologists to understand the treatment options, including prosthesis surgery. Numerous techniques have been hypothesized and studied in smaller settings in the preoperative, intraoperative, and postoperative settings with regard to prosthetics surgery. However, larger studies are still needed to confirm these findings in order to help to counsel and educate patients preoperatively in addition to employing tactics to help minimize penile shortening.

This is a preview of subscription content, access via your institution.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Welliver C. Erectile dysfunction: patient evaluation, investigations. AUA Core Curriculum. 2020.

  2. Mulhall JP, Luo X, Zou K, Stecher V, Galaznik A. Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA. Int J Clin Pract. 2016;70:1012–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Goldstein I, Goren A, Li VW, Tang WY, Hassan TA. Epidemiology update of erectile dysfunction in eight countries with high burden. Sex Med Rev. 2020;8:48–58.

    Article  PubMed  Google Scholar 

  4. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. AUA guidelines: Erectile Dysfunction. 2018.

    Google Scholar 

  5. Osterberg EC, Maganty A, Ramasamy R, Eid JF. Pharmacologically induced erect penile length and stretched penile length are both good predictors of post-inflatable prosthesis penile length. Int J Impot Res. 2014;26:128–31.

  6. Deveci S, Martin D, Parker M, Mulhall JP. Penile length alterations following penile prosthesis surgery. Eur Urol. 2007;51:1128–31.

    Article  PubMed  Google Scholar 

  7. Habous M, Giona S, Tealab A, Aziz M, Sherif H, Abdelwahab O, et al. Penile length is preserved after implant surgery. BJU Int. 2019;123:885–90.

    Article  PubMed  Google Scholar 

  8. Habous M, Muir G, Soliman T, Farag M, Williamson B, Binsaleh S, et al. Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement. Int J Impot Res. 2017;30:21–6.

    Article  PubMed  Google Scholar 

  9. Xie D, Nicholas M, Gheiler V, Perito D, Siano L, Kislinger I, et al. A Prospective Evaluation of Penile Measures and Glans Penis Sensory Changes after Penile Prosthetic Surgery. Transl Androl Urol. 2017;6:529–33.

    Article  PubMed  PubMed Central  Google Scholar 

  10. • Wang R, Howard GE, Hoang A, Yuan JH, Lin HC, Dai YT. Prospective and Long-Term Evaluation of Erect Penile Length Obtained with Inflatable Penile Prosthesis to That Induced by Intracavernosal Injection. Asian J Androl. 2009;11:411–5. was one of the first papers to show an overall decrease in penile length post operatively after 3-piece IPP placement.

    Article  PubMed  PubMed Central  Google Scholar 

  11. • Saavedra-Belaunde JA, Clavell-Hernandez J, Wang R. Epidemiology regarding penile prosthetic surgery. Asian J Androl. 2020;22:2–7. is an up to date review of the epidemiology of men undergoing penile prosthetic surgery and common conditions today that lead to the development of ED.

    Article  PubMed  Google Scholar 

  12. Munding MD, Wessells HB, Dalkin BL. Pilot study of changes in stretched penile length 3 months after radical Retropubic prostatectomy. Urology. 2001;58:567–9.

    Article  CAS  PubMed  Google Scholar 

  13. Kim KS, Bae WJ, Kim SW, Lee MY. Experience with AMS 700 LGX Penile Prostheses for Preserving Penile Length in Korea. BMC Urol. 2019.

  14. Lee KCJ, Brock GB. Strategies for maintaining penile size following penile implant. Strategies for Maintaining Penile Size Following Penile Implant. 2013;2:67–73.

    Article  Google Scholar 

  15. Wallen JJ, Madiraju SK, Wang R, Henry GD. Implementation of length expanding inflatable penile prosthesis is not sufficient to prevent postsurgical penile shortening. Asian Journal of Andrology. 2018;21:98–100.

    Article  PubMed Central  Google Scholar 

  16. Wilson SK, Levin L, Wang R. Make It as Long as You Can, Doc. Concomitant Surgical Treatments with Penile Implant to Enhance Penile Size. International Journal of Impotence Research. 2020.

  17. Canguven O, Talib RA, Campbell J, Young LD, El Ansari W, Al-Ansaria A. Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology. 2016;5:103–6.

    Article  PubMed  Google Scholar 

  18. Köhler TS, Pedro R, Hendlin K, Utz W, Ugarte R, Reddy P, et al. A pilot study on the early use of the vacuum erection device after radical Retropubic prostatectomy. BJU Int. 2007;100:858–62.

    Article  PubMed  Google Scholar 

  19. Gontero P, Di Marco M, Giubilei G, Bartoletti R, Pappagallo G, Tizzani A, et al. A pilot phase-II prospective study to test the ‘efficacy’ and tolerability of a penile-extender device in the treatment of ‘short penis’. BJU Int. 2009;103:793–7.

    Article  PubMed  Google Scholar 

  20. Levine LA, Rybak J. Traction therapy for men with shortened penis prior to penile prosthesis implantation: a pilot study. J Sex Med. 2011;8:2112–7.

    Article  PubMed  Google Scholar 

  21. Welliver C, Kottwitz M, Ahmad AE, Wilson SK, Köhler TS. Manufacturers’ data show increasing implanted cylinder sizes and measured corporal lengths in inflatable penile implants. World J Urol. 2015;34:993–8.

    Article  PubMed  Google Scholar 

  22. Chung PH, Siegel JA, Tausch TJ, Klein AK, Scott JM, Morey AF. Inflatable penile prosthesis as tissue expander: what is the evidence? Int Braz J Urol. 2017;43:911–6.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Negro CLA, Paradiso M, Rocca A, Bardari F. Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures. Asian Journal of Andrology. 2015;18:114–7.

    Article  Google Scholar 

  24. Caso JR, Myers MD, Wiegand L, Rodriguez A, Hann S, Carrion R. Phalloplasty and penile implant surgery. Current Urology Reports. 2009;10:475–7.

    Article  PubMed  Google Scholar 

  25. Hakky TS, Suber J, Henry G, Smith D, Bradely P, Martinez D, et al. Penile Enhancement Procedures with Simultaneous Penile Prosthesis Placement. Adv Urol. 2012.

  26. Miranda-Sousa A, Keating M, Moreira S, Baker M, Carrion R. ORIGINAL RESEARCH—SURGERY: concomitant ventral Phalloplasty during penile implant surgery: a novel procedure that optimizes patient satisfaction and their perception of phallic length after penile implant surgery. J Sex Med. 2007;4:1494–9.

    Article  PubMed  Google Scholar 

  27. Gupta NK, Sulaver R, Welliver C, Kottwitz M, Frederick L, Dynda D, et al. Scrotoplasty at time of penile implant is at high risk for dehiscence in diabetics. J Sex Med. 2019;16:602–8.

    Article  PubMed  Google Scholar 

  28. Baumgarten AS, Beilan JA, Shah BB, Loeb A, Bickell M, Parker J, et al. Suprapubic fat pad excision with simultaneous placement of inflatable penile prosthesis. J Sex Med. 2019;16:333–7.

    Article  PubMed  Google Scholar 

  29. Borges F, Hakim L, Kline C. ORIGINAL RESEARCH-SURGERY: surgical technique to maintain penile length after insertion of an inflatable penile prosthesis via Infrapubic approach. J Sex Med. 2006;3:550–3.

    Article  PubMed  Google Scholar 

  30. Shaeer O, Shaeer K, El-Sebaie A. ORIGINAL RESEARCH-SURGERY: minimizing the losses in penile lengthening: ‘V-Y half-skin half-fat advancement flap’ and ‘T-closure’ combined with severing the suspensory ligament. J Sex Med. 2006;3:155–60.

    Article  PubMed  Google Scholar 

  31. • Rolle L, Ceruti C, Timpano M, Sedigh O, Destefanis P, Galletto E, et al. A New, Innovative, Lengthening Surgical Procedure for Peyronie’s Disease by Penile Prosthesis Implantation with Double Dorsal-Ventral Patch Graft: The ‘Sliding Technique’. The Journal of Sexual Medicine. 2012;9:2389–95. reviews a novel “Sliding technique” for prosthesis placement in Peyronie’s disease.

    Article  PubMed  Google Scholar 

  32. Egydio PH, Kuehhas FE. The multiple-slit technique (MUST) for penile length and girth restoration. J Sex Med. 2018;15:261–9.

    Article  PubMed  Google Scholar 

  33. Wilson SK, Mora-Estaves C, Egyido P, Ralph D, Habous M, Love C, et al. Glans necrosis following penile prosthesis implantation: prevention and treatment suggestions. Urology. 2017;107:144–8.

    Article  PubMed  Google Scholar 

  34. Fang A, Wang R. Nondegloving technique for Peyronie′s disease with penile prosthesis implantation and double dorsal-ventral patch graft. Asian Journal of Andrology. 2018;20:90–2.

    Article  PubMed  Google Scholar 

  35. • Clavell-Hernández J, Wang R. Penile Size Restoration With Nondegloving Approach for Peyronie’s Disease: Initial Experience. The Journal of Sexual Medicine. 2018;15:1506–13. reviews a novel non- degloving surgical method for penile prothesis placement with graft in Peyronie’s disease.

    Article  PubMed  Google Scholar 

  36. Henry GD, Carrion R, Jennermann C, Wang R. Prospective evaluation of postoperative penile rehabilitation: penile length/girth maintenance 1 year following Coloplast titan inflatable penile prosthesis. J Sex Med. 2015;12:1298–304.

    Article  PubMed  Google Scholar 

  37. Pryor MB, Carrion R, Wang R, Henry G. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast titan prosthesis. Asian Journal of Andrology. 2016;18:754–8.

    Article  PubMed  Google Scholar 

  38. Benevides MD, Carson CC. Intraurethral application of Alprostadil in patients with failed inflatable penile prosthesis. J Urol. 2000;163:785–7.

    Article  CAS  PubMed  Google Scholar 

  39. Mulhall JP, Jahoda A, Aviv N, Valenzuela R, Parker M. The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ. BJU Int. 2004;93:97–9.

    Article  CAS  PubMed  Google Scholar 

Download references


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Run Wang.

Ethics declarations

Declaration of Interest


Conflict of Interest

Run Wang, MD, FACS – Consultant for Boston Scientific, Coloplast, and Teleflex.

Ethical Approval


Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Men’s Health

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chang, C., Wang, R. A Review on Penile Length and Girth Issues in Penile Prosthetic Surgery. Curr Urol Rep 22, 16 (2021).

Download citation

  • Accepted:

  • Published:

  • DOI:


  • Erectile dysfunction
  • Penile shortening
  • Penile length
  • Penile girth
  • Penile prosthesis