MALE GENITAL SIZE AND CLINICALLY SIGNIFICANT PROSTATE CANCER: COULD THERE BE AN ASSOCIATION?

Testosterone plays a significant role in the development of male genitals during puberty. In addition, African Americans have on average larger genital size and a higher risk of prostate cancer (PCa) than Caucasians. Both of these phenomena could be explained by higher testosterone levels at a younger age. The aim was to evaluate an association between male genital size and PCa in Caucasian men.

We designed an observational cross-sectional pilot study. Consecutive Caucasian patients undergoing systematic and cognitive-targeted prostate biopsy for suspected PCa were enrolled. Subjects with hypogonadism, previous prostate biopsy, history of BPH surgery, clinically significant varicocele, or previous varicocelectomy were excluded. CsPCa was chosen as primary outcome and defined as any PCa with Gleason Score (GS) > 6 and/or volume > 0.5 cc and/or extraprostatic extension. PCa without these features and negative biopsies were considered non-csPCa.

Length of the penis was measured with the stretched penile test, while testicular volume was measured using the ultrasonography. Chi-square test and Mann–Whitney U test were used to compare categorical and continuous variables between csPCa and non-csPCa patients.

A total of 107 patients (50 csPCa and 57 non-csPCa) were enrolled. Median (IQR) age was significantly different between the groups (csPCa 73 [69.8-77.0] vs. non-csPCa 63 [59.0-69.5] years, p < 0.001). Median (IQR) stretched penile length was 15 (14.0-16.3) cm in csPCa group and 15 (13-15) cm in non-csPCa group (p = 0.287). Median (IQR) right testicular volume was 12(12-14) cc in both groups (p = 0.756). Median (IQR) left testicular volume was 10 (7-13) cc in csPCa group and 12 (10-14) cc in non-csPCa group (p = 0.186). Comparison between patients with GS 8-9 vs. GS 6-7 revealed median (IQR) stretched penis length 16 (15-17) vs. 14 (14-15) cm (p = 0.011), median (IQR) right testicular volume 14(11.5-15) vs. 10(8-12.5) cc (p = 0.028), and median (IQR) left testicular volume 12(9-13) vs. 11(6-13) cc (p = 0.229).

Male genital sizes do not seem to be associated with diagnosis of csPCa in Caucasian men; however, higher grade prostate tumors may be associated with larger genital size.

The authors have no conflicts of interest to declare.