Study says 'size really doesn't matter' when it come...

"Scientists claim they've worked out what makes the perfect penis," The Independent reports.

According to Swiss researchers, women value overall cosmetic appearance of a penis over length.

The actual point of the study was to assess women's perception of the penises of men who have had surgery for hypospadias, a condition where the hole through which urine passes (meatus) is not at the tip of the penis. The condition is typically corrected in childhood by surgery.

Researchers asked women to compare pictures of men who have been treated for hypospadias with men who had been circumcised.

Overall general penile appearance was found to be the most important aspect of a penis for women and the position and shape of the meatus to be the least important.

Out of a list of eight aspects, the length of a penis was actually rated as coming sixth out of eight. Research suggests a massive disconnect between what men think is important about their penis and what women actually think. One study found that 85% of women were satisfied with their partner's penis size, while only 55% of their corresponding partners felt the same.

Where did the story come from?

The study was carried out by researchers from University Children’s Hospital Zurich and the University of Zurich. The source of funding was not reported.

The study was published in the peer-reviewed Journal of Sexual Medicine on an open-access basis, so the study is available to read online or download as a PDF (as an advanced warning, the study does contain some graphic images of different types of penises).

This story has been reported accurately in the media with quotes from authors and a detailed report of study findings.

Much of the reporting on the study takes a lighthearted tone, but it is important not to discount the anxieties that many men, usually without justification, experience about penis size. Read more advice about penis size.

What kind of research was this?

This was a cross-sectional study that aimed to investigate the importance of single aspects of penile appearance for women, which is an appropriate design for this research question.

What did the research involve?

This cross-sectional study was part of a larger project on hypospadias.

The three aims of this study were:

to investigate which aspects of penile appearance are considered to be relevant by women
to know whether penises that have undergone surgery for hypospadia are perceived to be less normal looking than circumcised genitals
to identify the most relevant observer-related predictors for normal penile perception

Women of three age groups, 16 to 20, 25 to 30 and 40 to 45 years, were asked to rate photosets of men with hypospadias-affected surgically repaired genitals (HASRGs) and men with circumcised genitals. They then answered a questionnaire on the importance of different aspects of a penis in general. Age categories were meant to reflect different degrees of sexual experience.

The 20 photosets included 10 circumcised genitals and 10 HASRGs (various techniques represented), which were paired according to penile size, age and bodyweight. Each photoset was rated on a four-point scale, one being total disagreement and four being full agreement, to the statement "This is a normal (looking) penis". The women were unaware that half the photoset showed "normal" circumcised genitals.

Women were also questioned on the importance of eight different aspects of a penis. This used a five-point scale, one being very unimportant and five being very important.

Penile aspects investigated, chosen based on the Penile Perception Score, were:

length
girth
position and shape of meatus
shape of glans
appearance of scrotum
shape of penile skin
appearance of pubic hair
general cosmetic appearance

Women were also questioned on their own sexuality and sexual desire.

What were the basic results?

General cosmetic appearance was considered the most important aspect of penile appearance, with length being much further down the rankings at sixth place. The least important item was the position and shape of the meatus.

Rankings differed depending on whether the photographs of HASRGs were seen before or after the questionnaire. The differing items were importance of shape of glans, importance of appearance of scrotum, importance of penile skin, and importance of penile length.

The general cosmetic appearance and position and shape of the meatus were not considered more important by women before or after exposure to the photosets.

Statistical analyses found that the genital appearance of circumcised penises was significantly more normal looking than HASRGs, however distal hypospadias was perceived to appear as normal looking as circumcised penises. It was also found that the most relevant observer related predictors for penile perception were:

higher age of women
higher sexual interest of women
evaluating penile length as less important

How did the researchers interpret the results?

The researchers conclude "Overall, women were found to consider the 'position and shape of the meatus' as the least important penile aspect. These findings may stimulate reflections regarding the relevance of surgical correction of the meatus in minor forms of hypospadias. In addition, this study indicates that women perceived genitals of men with distal operated hypospadias (which represents the majority of hypospadias) to be as normal as non-affected, circumcised genitals."

Conclusion

This was a cross-sectional study assessing women's perception of single aspects of penile appearance and whether hypospadias-affected surgically repaired genitals (HASRGs) are seen to be as normal looking as circumcised.

The findings are that overall general penile appearance is the most important aspect of appearance, and the position and shape of the meatus to be the least important. And despite assumptions to the contrary, women in the survey rated penile size as being relatively unimportant.

There was some variation between the other aspects depending on whether women had seen the photosets before or after answering questions. HASRGs with distal hypospadias were seen to be as normal looking as circumcised genitals; however proximal hypospadias appeared significantly less normal. This may not be a clinically relevant finding as the effect size was small.

There are some limitations to the study:

The sample size was small, with only 105 out of a possible 911 women agreeing to participate. The reasons for non-participation were not included in the study, but it would have been interesting to further understand women's perceptions. Thus the sample is of a select group of women willing to participate and from a small local area in Switzerland, so these findings may not be generalisable to other populations or to perception of men.
The study did not include any photos of hypospadias that had not been surgically corrected, or of penises with intact foreskin.
There was a very low response rate from men invited to participate. It may be that men with less satisfactory surgical results did not wish to take part.

Overall, these findings will be of relief to men with surgically corrected hypospadias.