Manhood: The Rise and Fall of the Penis (13 page)

Age

Average

Average

a
pprox. SD* cm

-2.5 SD cm

Infant 30 weeks

2.5 approx. 0.4

1.5 cm

Infant 40 weeks

3.0 approx. 0.4

2.0 cm

Infant full-term

3.5 approx. 0.4

2.4 cm

0–15 months

3.9 approx. 0.8

1.9 cm

6–12 months

4.3 approx. 0.8

2.3 cm

1–2 years

4.7 approx. 0.8

2.6 cm

2–3 years

5.1 approx. 0.9

2.9 cm

3–4 years

5.5 approx. 0.9

3.3 cm

4–5 years

5.7 approx. 0.9

3.5 cm

5–6 years

6.0 approx. 0.9

3.7 cm

6–7 years

6.1 approx. 0.9

3.8 cm

7–8 years

6.2 approx. 1.0

3.7 cm

8–9 years

6.3 approx. 1.0

3.8 cm

9–10 years

6.3 approx. 1.0

3.8 cm

10–11 years

6.4 approx. 1.1

3.7 cm

Adults

13.3 approx. 1.6

9.3 cm

Table: Penis Length in Normal Men.

*SD = standard deviation

Source: K. W. Feldman and D. W. Smith, ‘Fetal phallic growth and penile standards for new born male infants’,
Journal of Pediatrics
, 86 (1975), p. 395.

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With these rules in mind the great majority of men can overcome their worries about the length of their penis! Apart from that there are some practical tips one can give: don’t wear jeans or briefs – Bermudas or boxer shorts are better – and trim over-abundant pubic hair.

If the patient continues to fret, the results of the scientific research carried out by psychologist William A. Fisher should be discussed. He attempted to measure the effect of penis size on the degree of sexual arousal in both women and men (students). In stories about love -

making the penis either was not mentioned (control condition) or
was
mentioned (experimental condition). In the description of the penis the length was mentioned five times per story. The length varied from story to story as follows: small – 7.5 cm, average – 12.5 cm, large – 20 cm.

After reading a story the test subjects assessed their own level of arousal and had to indicate how aroused the man and woman in the story were.

When asked afterwards about their memory of the content of the story the control group quite rightly did not mention the length of the penis. The experimental group did, especially the group that read the des cription of the large penis. No difference was observed between men and women. So the test subjects had noticed the nature of the description. However, the test subjects could not afterwards indicate what the point of the research was. Yet the observed length of the penis turned out to contribute nothing to the subjects’ assessment of their own degree of arousal. ‘Variation in the length of the penis therefore does nor appear to be a precondition for arousal,’ the authors of the article conclude.

The American psychologist Bernie Zilbergeld has incidentally pointed out that men with a relatively large penis can become impotent because, for instance, of the fear that they will hurt their partner during intercourse, or the fact that they were rejected at some time in the past because of their large penis.

In a 1994 article in a gay newspaper entitled ‘Willies. On Genitalia’, Cees van der Pluijm cites a 1967 study by an interestingly named American scientist called Havelock Eliott. The latter’s
On Penises
(1967), purportedly includes numerous interesting facts about size and particularly about the correlation between size and other characteristics. It emerges that athletes had on average not only a longer, but also a significantly thicker penis. In over 80 per cent of swimmers the penis was shown to be small.

Eliott is also reported, somewhat less plausibly, as having investigated the relationship between penis length and political affiliation.

Republicans score significantly higher than Democrats, while the most conservative Republicans are in turn among the best-hung individuals in their party. The hypothesis that men with left-wing sympathies are 60

t h e p e n i s

often below par, we are told, proves in 69.8 per cent of cases to have a basis in truth, though the suggestion that changing one’s voting behaviour might affect the penis length is dismissed by the researcher.

If true, these would be sensational findings, but the absence of the book in question from every major library catalogue consulted confirms one’s growing suspicion that Van der Pluijm’s piece is a sophisticated spoof.

61

chapter three

The Prostate and Seminal

Glands

Some women have endless trouble with their womb: for decades they endure the discomfort of painful periods, and then, just as hormonal retirement beckons, on come the hot flushes, to say nothing of other afflictions. Women sometimes feel that life has been unfair to them in this respect; that isn’t so. Men have their own cross to bear, namely the prostate, a gland that only receives proper attention when it starts playing up. Then the prostrate becomes a bane, not only keeping a man awake at night, but also inconveniencing him in everyday activities like What is your range?

Men’s troubles.

t h e p ro s tat e a n d s e m i n a l g l a n d s going to meetings. Urinating becomes a depressing business. Men’s troubles! The prostate is thoroughly out of favour nowadays. Many women have children with the aid of test tubes, pipettes and incubators, and no longer have any need for it . . .

So is the prostate perhaps not that important after all? For example, there has never yet been a prostate transplant. There is no country on earth where the prostate is eaten, in contrast to testes (for example, in Spain) and penis (as blood sausage in Yemen). Odd, when one knows that in operations to resection the prostate via the urethra urologists fish out what look like strips of kebab.

Historically, the prostate came into its own at a quite late stage.

Prostate problems were unknown in Ancient Egypt, undoubtedly partly because people did not live as long as they do now. Similarly, Hippo -

crates (
c
. 460–
c
.370 bc) writes nothing about the subject. The term was first used by Herophilus, who several centuries before Christ founded the famous school of Alexandria. Even Rudolf Virchow, the founder of modern pathology, collected only a few prostates in formalin.

Anatomy and physiology

Only a small percentage of the total volume of an ejaculate is made up of sperm cells. In older medical literature, as previously mentioned, a distinction was made between the sperm-cell portion or ‘nobler part’,

‘the aqueous elements’ from the seminal glands and the ‘oleagenous’

portion from the prostate. The prostate is about the size of a chestnut.

The seminal glands are situated behind it and discharge into the urethra, which passes right through the prostate.

In animals the system is different. Dogs, like many other carnivores, have very small seminal glands. The reason why is a complete mystery.

In man the fluid produced by the seminal glands is important mainly for the mobility and the metabolism of sperm cells. In humans it can make up between 50 and 80 per cent of the total volume of ejaculate. The principal ingredients of seminal fluid are fructose, coagulating agents and the prostaglandins e, a, d and f.

The finger in the anus

For years the significance of the so-called rectal toucher (rt) in relation to urinary ailments has been controversial. In this procedure the doctor puts a finger up the anus and feels the prostate and the mucous membrane of the rectum. The gravity of urinary complaints is rarely if ever related to the size of the prostate, whether this is assessed with the finger or by using ultrasound. In fact the size of the prostate is only of 63

m a n h o o d

Anatomy of

the prostate and

the urethra.

Bladder

Prostate

Urethra

importance to the urologist in deciding on the type of operation recommended, via the urethra or via an incision in the abdomen.

Estimating the size of the prostate using rt depends undeniably on the experience of the person carrying out the examination. In general the size of a large prostate tends to be underestimated and that of a small one overestimated in rt. The assessment of consistency can provide an indication as to whether there is a benign enlargement, an inflammation or a cancer. The benign prostate has the consistency of the ball of a closed fist, cancer feels as hard as the joint between the metacarpals and the first phalanx bone in the hand, and in the case of inflammation the prostate feels as soft as the ball of the thumb with the fingers spread.

With rt the feelings of both the person examining and the patient are much more involved than in a general physical examination. It is not inconceivable that certain emotional reactions may lead to rt being skipped altogether. Research in the uk showed that with almost two-thirds of patients with urinary complaints gps omitted to carry out rt before referral. In addition it is well known that insufficient training of medical students leads to postponement and avoidance behaviour in later professional life. Nowadays, in many medical faculties there are systematic skills training courses in preparation for later practice. In a number of faculties specially trained instructors are used.

Benign prostate enlargement

A chronically enlarged prostate can lead to bladder stones, in the past much more frequently than now. The great religious reformer Calvin was a sufferer. ‘When he could no longer endure the pain,’ writes the 64

t h e p ro s tat e a n d s e m i n a l g l a n d s Italian essayist Guido Ceronetti, ‘the old Calvin [in 1563 he was 54, which in those days counted as old] mounted his horse on his doctors’

advice, and rode at the trot, in dreadful pain, until the jolting caused the stone to descend into the urethra.’ On returning home he urinated slimy blood and the following day the stone – as big as a hazelnut – was expelled with the aid of hot compresses. This was followed by a spurt of blood. ‘Thus God relieved Calvin of the stone and left the stone, with Calvin, to the inhabitants of Geneva,’ wrote Ceronetti.

Bladder stones and incontinence are only two in a whole spectrum of prostate ailments. Other problems caused by an obstructive prostate are urinary blockage, or the inability to urinate, renal pelvic inflammation and loss of the kidneys. Fortunately things rarely if ever reach that stage nowadays. More frequent urination, a less powerful stream of urine, dribbling and suchlike prompt men to consult their gp in good time. The taboo surrounding prostate ailments has gone. The worried well with minor problems often need no treatment, rather reassurance about the presence or otherwise of prostate cancer. With moderate symptoms it is preferable to start with medication. Only if that fails to solve the problem is there reason to consult a urologist, who may choose to operate in one of two ways: via the urethra or, if the prostate is very enlarged, via an abdominal incision. Complications include incontinence, in most cases temporary, narrowing of the urethra (5%

risk), and blood loss in the urine, sometimes continuing for a period of weeks. Up to now alternative treatments such as warming the prostate (‘microwave’ therapy) have proved less effective.

Blood in sperm

In order to understand the sexual experiences of his or her fellow -

humans a urologist must be a man or woman of the world: broad-minded and with sufficient powers of imagination. Even when you think you possess these qualities, you can occasionally come across a case like the following, which remains baffling.

A 50-year-old homosexual man comes to the outpatient clinic complaining that his sperm ‘is always coloured’. ‘Haemospermia’ is my immediate thought. He had been examined two days before and nothing abnormal had been found. ‘Reassured patient,’ said the notes, but had that really reassured him? ‘So all that time there was blood in your sperm?’ ‘Yes, every time, sometimes red, sometimes brown or yellow, sometimes with lumps or streaks, and sometimes watery.’ The patient tells me this with some distaste, but in great detail, which many men would find impossible. Repeated examinations reveal no abnormalities. ‘You’re not doing anything . . .’ I ask hesitantly. ‘Nothing special, 65