Presentation Authors: Evangelos Spyropoulos*, Katherine Spyropoulos, Paleo Faliro, Greece, Dimitrios Kotsiris, Athens, Greece
Introduction: In both genders, self-perceptions of external genitalia appearance (genital self-image) are associated with variations in sexual self-esteem that potentially, may lead to disturbances in sexual functioning and performance. Aim of this study, conducted by using a novel questionnaire, was to investigate the perceptions of adult men regarding morphological characteristics of their external genitalia (self-perceived genital image) as well as of related sexual competency feelings and determine possible interactions of these parameters with overall sexual health and function.
Methods: A cross-sectional observational survey was conducted in a cohort of 125 adult males (age range: 19-85 y.o) who presented to two outpatient urology clinics in the region of Athens, Greece, complaining of symptoms unrelated to genital area pathology. It was based on a novel questionnaire developed by our department including sixteen demographics and ten main outcome questions (answer scale range:1-5), the latter aiming to investigate adult male perceptions of external genitalia self-image, as well as, by being used as dependent variables, to test for correlations with sexual functioning. Statistical analysis was performed using SPSS-22Â© & MedCalcÂ© softwares (p < 0,05).
Results: Overall, nine out of ten men (86,4%) were adequately satisfied with the morphology of their genitalia and only one in ten (13,6%) complained of poor genital self-image. Most common afflictions referred to small penile size in the flaccid state (51,1%) and small erect penis (20%). Inadequate sex image impression was attributed to self-assessment in 49,3%, to sexual partners comments (27,5%) and in only 5,8% of cases, to expert medical diagnosis. Nine out of ten men (89,4%) considered external genitalia morphological appearance a highly significant determinant of sexual self-esteem with 75,7% claiming they meet this requirement while, most of them (71,3%) were also highly satisfied with their body image. However, in only 1 out of 10 men (12,1%) sexual performance and attractiveness was significantly affected by sexual partners impression of their genitalia morphology. Seven out of ten (68,2%) men argued against resorting to surgical procedures to improve their sex image, 1 in 4 (25,8%) would think of surgery if a spectacular cosmetic result was guaranteed and only a small minority (6%) considered this option imperative for their well-being. Statistically significant associations between various genital self-image correlates and sexual functioning, were recorded in 12 questionnaire domains.
Conclusions: The majority of adult men feel satisfied with their external genitalia morphology, complaints of genital image inadequacy are mainly attributed to perceptions of small penile size (mostly in the flaccid state), most commonly this impression originates from self-assessment and unfavorable sexual partners comments whereas, most men consider genital appearance a strong determining factor of sexual functioning although, very few experience sexual relationships difficulties due to feelings of genital inadequacy. A small minority strongly require surgical treatment to improve genital aesthetics, considering it imperative for their sexual and overall well-being.