Introduction

Erectile dysfunction (ED) is a common condition that can impact a man’s confidence, relationships, and overall quality of life. While there are many treatments available, some men choose a penile implant as a long-term solution, especially when other options don’t work. However, one of the biggest concerns for patients considering this surgery is how their penile length will be affected.

This study aimed to determine whether the length of the penis when stretched before surgery can predict its length after the implant is placed. Previous research suggests that pre-surgery stretched length closely matches the post-surgery result. By confirming this, doctors can better counsel patients on what to expect, helping them set realistic expectations. The researchers analyzed data from multiple centers to ensure accuracy. Their findings could improve patient satisfaction by providing clearer information before surgery, reducing uncertainty, and helping men feel more confident in their decision.

Methods

For this study, researchers collected data from three medical centers in Belgium and Spain between November 2021 and February 2024. Ethical approval was obtained, and all patients gave informed consent. The study included only first-time penile implant patients, and measurements were taken in a standardized way to ensure accuracy.

Doctors measured penile length before surgery (both flaccid and stretched) and again after surgery, both deflated and inflated. To keep the measurements consistent, they were always taken by the surgeon or trained staff. Patient satisfaction was assessed 12 weeks after surgery.

Researchers analyzed the data using statistical tests to compare penile length before and after surgery and to check if different implant types affected the outcome. Again, the goal was to confirm that pre-surgery stretched penile length could reliably predict post-surgery length, helping doctors set clear expectations for patients considering an implant.

Results

During the study timeframe, 479 patients underwent first-time penile implant surgery across three European centers. After excluding 118 patients due to missing data, 361 patients were included in the analysis. The average age of the patients was 61, with an average BMI of 27.9. Four types of implants were used, and most patients had ED that was caused by factors like prostate surgery, vascular issues, or Peyronie’s disease.

Pre-surgery, the average flaccid penile length was 6.8 cm, and the stretched length was 9.9 cm. Post-surgery, the average deflated length was 9.0 cm, and inflated length was 9.7 cm. A strong correlation was found between pre-surgery stretched length and post-surgery inflated length. However, the length of the implanted cylinders did not predict the post-surgery inflated length.

Regarding patient satisfaction, 64.5% of patients were satisfied with their implant. No significant difference in satisfaction was found based on penile length changes after surgery. The study also showed that penile length varied slightly depending on the type of implant used, with the Coloplast Titan and Rigicon Infla10AX implants resulting in slightly longer post-surgery inflated lengths compared to others.

Discussion & Conclusion

The findings of this study suggest that pre-surgery measurements are reliable for predicting post-surgery penile length. In 33% of patients, the pre-surgery stretched length matched the post-surgery inflated length, with an average difference of only 1.1 cm. This small difference is unlikely to have a noticeable visual impact.

The study also found that the type of implant used did not significantly affect the final penile length, as all implants provided similar outcomes. This implies that penile size after surgery is more dependent on the elasticity of the penis than the type of implant. Additionally, patient satisfaction was not strongly linked to the difference in penile length before and after surgery.

In the end, this study highlights that pre-surgery measurements can help set realistic expectations for patients regarding their post-surgery results, enhancing satisfaction and counseling. However, the study did have some limitations, such as only measuring penile length immediately after surgery, not accounting for long-term changes, and using a simple satisfaction survey rather than a more detailed one. Future research could focus on long-term satisfaction and the impact of proper counseling.

References:

• van Renterghem, K., De Bruyn, H., Jorissen, C., Van Huele, A., D’Anna, M., Torremadé, J., Martinez-Salamanca, J. I., Prieto Matienzo, L., & Moncada, I. (2025). Penile length after penile implant surgery is determined by stretched penile length before surgery. The Journal of Sexual Medicine, 22(1), 165–169. https://doi.org/10.1093/jsxmed/qdae153