Grower or Shower: Is It Even a Thing? Penile Growth Patterns and Erectile Dysfunction Aetiology in Growers and...

Penile elongation patterns lack objective scientific validation, and their association with vascular mechanisms of erectile dysfunction (ED) remains unclear. The objective is to define objective grower and shower profiles using data-driven methods, and evaluate their association with ED aetiology.

Retrospective, observational study, including men who underwent penile Doppler ultrasound. Patients with Peyronie's disease or Erection Hardness Score (EHS) <3 were excluded. Penile morphometric and hemodynamic parameters were recorded. Penile growth was measured from flaccid to erect. Associations between growth patterns, tunica albuginea compression, and ED aetiology were assessed using comparative statistics and logistic regression.

A total of 420 men were included. k-Means clustering identified three growth profiles: growers (>71.7% growth, n = 31), showers (<39.4%, n = 140), and intermediate (n = 133). Growers exhibited significantly greater reduction in tunica albuginea thickness during erection compared with showers (27.0% vs. 14.1%; p < 0.001). Reduced tunica compression was significantly associated with venous leak on logistic regression (p = 0.011). Growth profiles were not significantly associated with ED aetiology (χ², p = 0.084).

These findings suggest that penile growth patterns reflect distinct morphometric and hemodynamic characteristics, particularly in relation to tunica albuginea compression during erection. While cluster-defined grower and shower profiles were not independently associated with specific erectile dysfunction aetiologies, the observed trends support a potential link with vascular mechanisms. This objective, data-driven classification may therefore contribute to a refined morphometric framework for understanding erectile dysfunction.

An objective classification of grower and shower profiles was shown. Growth patterns are significantly associated with tunica albuginea compression, and reduced compression is independently associated with venous leak. The association between growth categories and ED aetiology did not reach statistical significance; the study was underpowered for this outcome. These hypothesis-generating findings warrant validation in larger, prospective multicenter studies.