Penis enlargement

Penile enlargement procedures are designed to increase the size of the cavernous cylinders of the penis or to stimulate blood flow to increase hardness.

Penis enlargement, sometimes euphemistically called male enhancement, are techniques alleged to increase the girth, length, or hardness of the human penis. Often, in the advertising of fraudulent products, the distinction between temporary enlargement, i.e. erection, and permanent enlargement, is deliberately muddied.

Procedures range from manual exercises to stretching devices and surgical procedures, with reports of successes and failures around the world. While some of these are known to be outright hoaxes, other techniques can produce some measure of success.

Little legitimate scientific research has been done specifically on penile enlargement, so any claims of significant and permanent enlargement can be biased or anecdotal. General research has been done regarding the efficacy (or lack thereof) of the contents of the pills; otherwise, one assumes, mainstream medicine would have made use of them if they indeed worked in any setting. There are also risks inherent to some of the more invasive procedures, with negative outcomes ranging from the tearing of skin and scarring, to permanent loss of sexual function. Due to the speculative nature of any hope for "improvement" and the many known cases of permanent injury involved in this endeavor, many medical professionals are sceptical of the subject.

At present, there is no proof of any non-surgical technique that permanently increases either the thickness or length of a normal penis.

Much of the marketing of pills and potions appears based on the unproven premise that women require men to have large penises and that the size of one's penis may be (in extreme cases) a psychological/psychiatric condition best dealt with by qualified medical practitioners.

Enlargement of a normal penis is distinguished from seeking relief from the recognized medical condition of micropenis, where surgery to increase the organ's size is sometimes needed for urinary or sexual purposes.

Surgery

There are several surgical treatments, all carrying a risk of significant complications. The Second International Consultation on Sexual Dysfunctions concluded most men will not wish to proceed to surgery when properly informed of the likely outcome and risks of complications.

The most common procedure is division of the suspensory ligament. Those who advocate this procedure say that, at best, the unerect penis length increases by 2cm. One series of procedures showed that "of men with body dysmorphic syndrome who had this surgery, despite a mean increase in length of 1 cm, only 27% were satisfied and 54% requested further surgery."

Cosmetic

Rather than attempting to change the actual size of the penis, one may make it appear bigger by trimming pubic hair or losing weight.

Pills and supplements

Penis enlargement pills, patches, and ointments are commonly offered over the Internet. While some products contain harmless ingredients, many are entirely untested for safety and side effects.

Medication

Selective serotonin reuptake inhibitor (SSRI) antidepressants might be indicated for use in men with small penis syndrome or body dysmorphic disorder.

Penis pump

A penis pump is a cylinder that is fitted over the penis, with a manual or motorized pump to create suction. The apparatus creates a partial vacuum around the penis, engorging it as blood is drawn in. As vacuum increases, the difference between the inner blood pressure and the pump pressure increases as well; excessive vacuum causes vascular damage.

Penis pumps can be used to temporarily overcome symptoms of impotence, but do not cure the condition: a ring must be applied to maintain the erection which will otherwise immediately subside. Pumps may work even if there is nerve or vascular damage preventing a natural erection.

A flexible compression ring (or sometimes more than one), commonly called cock rings when used recreationally, must be used. It is fitted on the open end of the cylinder, then an erection is created by pumping. Then the ring is pushed by hand onto the base of the erect penis before releasing the vacuum. This restricts blood flow out of the now erect penis, enabling the erection to be held even in the presence of problems of the vascular or nervous system which would otherwise lead to immediate loss of erection. In the best circumstances erections can be maintained for a considerable time, but manufacturers' literature recommends that, for safety, rings should be removed after no more than 30 minutes. Very prolonged use (hours) will cause permanent harm.

A personal lubricant of a type not harmful to the ring material is used, primarily to make a good seal at the base of the pump to prevent air leakage, in the same way that vacuum grease is used with a laboratory vacuum pump. It also makes it easier to slide the ring off the cylinder, and later to remove the ring.

Pumping must be done very carefully to avoid serious injury: over-enthusiastic pumping can burst blood vessels and form blisters. In some cases the testicles can be unexpectedly pulled into the cylinder, causing discomfort, pain, and possibly injury. It is also believed that the rim of the cylinder can cut into the skin and over time cause damage to the ligaments surrounding the penis. Impatiently pumping without reading explanatory material can produce too much suction (any pressure lower than 10 torr/1,333 Pa) and cause permanent and irreparable injury. Attempts at using vacuum cleaner units for this purpose have resulted in extremely severe injuries because the suction is far too powerful.

Pumps used with rings are virtually always effective, as they operate by a simple mechanical process, in cases of ED, even when pharmaceutical methods fail. They may nonetheless be found unsatisfactory due to the inconvenience and similar factors.

The effectiveness of penis pumps for permanent penis enlargement was examined by Kazem, Hosseini and Alizadeh. They studied 37 men with penis length less than 10 cm and found no significant change in penile length after using pumps for six months, although the follow-up have found 30% satisfaction with the method. The conclusion of the paper stated that vacuum treatment of the penis is not an effective method for penile elongation, but provides psychological satisfaction for some men.

A 31-patient study conducted by the Department of Urology at St Peter's Hospitals and the Institute of Urology in London investigating the usefulness of pumps to correct the penile curvature associated with Peyronie's disease found that "There was a clinically and statistically significant improvement in penile length, angle of curvature and pain after 12 weeks of using the vacuum pump". In this study, subjects with Peyronie's undertook two ten-minute pumping sessions per day for twelve weeks. The additional penis length of 0.5 cm average was an unexpected side effect found in approximately one third of the subjects and not an intended aim of the study.

In the US, Penis pumps may be funded by Medicare, where a patient's erectile dysfunction is deemed to necessitate this.

Clamping

Clamping is a risky and dangerous technique. The goal of clamping is to increase the growth of the penis. This enlargement technique uses a constricting device, such as a shoe string, cable clamp, or a tight cock ring. The device is firmly tied, clamped, or put, respectively, on the base of the erect penis while "edging" (extended masturbation) with a firmly erect penis. Use of a metal cock ring is not advised because trapped blood engorging the penis can make it impossible to remove without amputation or emergency intervention such as sawing the ring off. Clamping is considered extremely dangerous by both practitioners and the medical community as it can cause permanent catastrophic damage to the penis.

Hanging

Weight hanging consists of attaching a weighteddevice (usually a rope or a strap) that grips the glans or just behind the glans and allows a weight to be suspended for a specific amount of time. Then a conscious effort is made to exercise the penis by raising the weight in repetitions (lasting no more than 5 to 10 minutes at a time) starting with the smallest and lightest weight 1/16 pound to the heaviest usually 1/4 pound or more.

Weight hanging, however, can also carry serious risks, which include nerve damage, chronic pain, scarring and impotence. The idea behind weight hanging is to stretch the tunica albuginea and other various tissues of the penis.

Hanging carries additional health risks due to the restriction of blood flow to the glans, including testicular cancer.

Jelqing

Jelqing “is an ancient Arab technique whereby the hand pulls on the penis causing stretching (and effectively self-focus work encouraging psychological acceptance of the penis, which will change in size and shape during the process) and is recommended on many websites.”