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Penis enlargement

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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, or male enhancement, is any technique aimed to increase the size of a human penis. Some methods aim to increase total length, others the shaft's girth, and yet others the glans size. Techniques include pills, hormones, massage, stretching, inflation, incision, injections, and implants. While some techniques are hoaxes, others may be somewhat effective, perhaps at high risk of complications.

Some surgical methods have the most evidence of effectiveness, whereas others have fairly frequent complications, sometimes severe, including scarring that lead, ultimately, to penis shrinkage or erectile dysfunction.[1][2] Noninvasive methods have received little scientific study, and most lack scientific evidence of effectiveness, although scientific evidence supports some elongation by prolonged traction.[3] Some quack products may improve penis erection, mistaken by consumers for penis enlargement.

Because of great risk and uncertainty, medical professionals are generally skeptical of penile enlargement and avoid attempting it.[2][4] Medical doctors do treat micropenis as a medical condition, however, usually by surgery, which can be warranted to improve urinary or sexual function.[5] Most men seeking penis enlargement have normal-size penises, and many may experience penile dysmorphophobia by underestimating their own penis size while overestimating the average size.[5]

Surgical methods

Such advertisements are common in South Africa.

There are several surgical treatments, most of which carry a risk of significant complications.[6] Procedures by unlicensed surgeons can lead to serious complications.[7] Risky surgical treatments include subcutaneous fat injection, division of the suspensory ligament, and the injection of dermal fillers, silicone gel, or PMMA.[8][9] The American Urological Association (AUA) and the Urology Care Foundation "consider subcutaneous fat injection for increasing penile girth to be a procedure which has not been shown to be safe or efficacious. The AUA also considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious."[10] Dermal fillers are also not approved by the US Food and Drug Administration (FDA) for use in the penis.[11]

Supplements

Penis-enlargement pills, patches, and ointments are sold online. While some products contain ingredients generally recognized as safe, others contain questionable ingredients, sometimes undisclosed.[citation needed] Such products are generally considered ineffective.[12]

Physical techniques

Physical techniques involve extension devices, hanging weights, and vacuum pressure. There is also significant overlap between techniques intended to enlarge the penis and techniques intended to achieve other, related objectives, such as reversing impotence, extending the duration of erections, or enhancing sexual climax.

Pumping

Water-based vacuum pump

Commonly called a "penis pump", a vacuum erection device, or VED, creates negative pressure that expands and thereby draws blood into the penis.[13][14] Medically approved VEDs, which treat erectile dysfunction, limit maximum pressure, whereas the pumps commonly bought by consumers seeking penis enlargement can reach dangerous pressure, damaging penis tissue.[15] To retain tumescence after breaking the device's airtight seal, one must constrict the penis' base, but constriction worn over 30 minutes can permanently damage the penis and cause erectile dysfunction.[16] Although vacuum therapy can treat erectile dysfunction sufficiently to prevent penis deterioration and shrinkage,[14] clinical trials have not found it effective for penis enlargement.[17][18]

Jelqing

Performed on the halfway tumescent penis, jelqing is a manual manipulation of simultaneous squeezing and stroking the shaft from base to corona. Also called "milking",[19] the technique has ancient Arab origins.[20] Despite many anecdotal reports of success, medical evidence is absent.[21] Journalists have dismissed the method as biologically implausible,[22] or even impossible, albeit unlikely to seriously damage the penis.[23] Still, if done excessively or harshly, jelqing could conceivably cause ruptures, scarring, disfigurement, and desensitization.[21][22]

Traction

One type of traction device

Traction is a nonsurgical method to lengthen the penis by employing devices that pull at the glans of the penis for extended periods of time. As of 2013, the majority of research investigating the use of penile traction focuses on treating the curvature and shrinkage of the penis as a result of Peyronie's disease, although some literature exists on the impact on men with short penises.[24]

Society and culture

In 2013 in Vietnam, many Vietnamese men attempted self penis enlargement by injecting liquid silicone into their penises, and subsequently suffered from complications such as infections, necrosis, tumors, swelling, deformities, sexual dysfunction, and were hospitalized.[25]

See also

References

  1. ^ Nugteren HM, Balkema GT, Pascal AL, Schultz WC, Nijman JM & van Driel MF, "Penile enlargement: From medication to surgery", J Sex Marital Ther, 2010;36(2):118–23.
  2. ^ a b Vardi Y, "Is penile enlargement an ethical procedure for patients with a normal-sized penis?", Eur Urol, 2006 Apr;49(4):609-11.
  3. ^ Oderda M & Gontero P, "Non-invasive methods of penile lengthening: Fact or fiction?", BJU Int, 2011 Apr;107(8):1278––82.
  4. ^ R. Morgan Griffin (2010). "Penis enlargement: Does it work?". WebMD. Retrieved July 28, 2011.
  5. ^ a b Campbell J & Gillis J, "A review of penile elongation surgery", Transl Androl Urol, 2017 Feb;6(1):69–78.
  6. ^ Levine, LA; Becher, E; Bella, A; Brant, W; Kohler, T; Martinez-Salamanca, JI; Trost, L; Morey, A (April 2016). "Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine". The Journal of Sexual Medicine. 13 (4): 489–518. doi:10.1016/j.jsxm.2016.01.017. PMID 27045255.
  7. ^ Christie Blatchford (May 2, 2001). "The beauty butchers". National Post. Retrieved July 14, 2014.
  8. ^ Shamsodini, Ahmad; Al-Ansari, Abdulla A.; Talib, Raidh A.; Alkhafaji, Haidar M.; Shokeir, Ahmed A.; Toth, Csaba (December 2012). "Complications of penile augmentation by use of nonmedical industrial silicone". The Journal of Sexual Medicine. 9 (12): 3279–3283. doi:10.1111/j.1743-6109.2011.02563.x. ISSN 1743-6109. PMID 22145947.
  9. ^ Fukuda, Hidetsugu; Endo, Hiromi; Katsuzaki, Jyoji; Mukai, Hideki (2016-08-01). "Development of nodules on the glans penis due to hyaluronic acid filler injection". European journal of dermatology: EJD. 26 (4): 416–417. doi:10.1684/ejd.2015.2600. ISSN 1952-4013. PMID 26081014.
  10. ^ "American Urological Association - Penile Augmentation Surgery". www.auanet.org. Retrieved 2018-03-14.
  11. ^ Health, Center for Devices and Radiological. "Dermal Fillers (Soft Tissue Fillers)". www.fda.gov. Retrieved 2018-03-14.
  12. ^ Nugteren, Helena M.; Balkema, G. T.; Pascal, A. L.; Schultz, W. C. M. Weijmar; Nijman, J. M.; van Driel, M. F. (2010). "Penile enlargement: from medication to surgery". Journal of Sex & Marital Therapy. 36 (2): 118–123. doi:10.1080/00926230903554453. ISSN 1521-0715. PMID 20169492.
  13. ^ Stein MJ, Lin H & Wang R, "New advances in erectile technology", Ther Adv Urol, 2014 Feb;6(1):15–24.
  14. ^ a b Qian SQ, Gao L, Wei Q & Yuan J, "Vacuum therapy in penile rehabilitation after radical prostatectomy: Review of hemodynamic and antihypoxic evidence", Asian Journal of Andrology, 2016 May–Jun;18(3):446–51.
  15. ^ Daniel Engber, "Do penis pumps work?", Slate, 29 Jun 2006.
  16. ^ T Lehrfeld & D I Lee, "The role of vacuum erection devices in penile rehabilitation after radical prostatectomy", International Journal of Impotence Research, 2009;21:158–164.
  17. ^ Kweon Sik Min, ch 20 "Penile traction therapy (penile lengthening device)", in Nam Cheol Park, Sae Woong Kim & Du Geon Moon, eds, Penile Augmentation (Springer, 2016), p 162.
  18. ^ Sarah L Hecht & Jason C Hedges, ch 13 "Vacuum therapy for erectile dysfunction", in Tobias S Köhler & Kevin T McVary, eds, Contemporary Treatment of Erectile Dysfunction: A Clinical Guide, 2nd edn (Humana Press, 2016), p 181.
  19. ^ Salvini, Mike (12 April 2005). "Size matters". Salon. Retrieved 6 January 2013.
  20. ^ Wylie, Kevan R.; Eardley, Ian (1 June 2007). "Penile size and the ?small penis syndrome?". BJU International. 99 (6): 1449–1455. doi:10.1111/j.1464-410X.2007.06806.x. PMID 17355371.Open access icon
  21. ^ a b Mayo Clinic staff. "Penis-enlargement products". Mayo Clinic. Retrieved 6 January 2013.
  22. ^ a b Wanjek, Christopher (February 20, 2007). "Penis enlargement products come up short". livescience.com. Tech Media Network. Retrieved 6 January 2013.
  23. ^ Johanson, Sue (2011). "Jelqing". Talk Sex with Sue Johanson. Retrieved 14 June 2013.
  24. ^ Eric C, Geralb B (February 2013). "Penile traction therapy and Peyronie's disease: a state of art review of the current literature". Ther Adv Urol. 5 (2): 59–65. doi:10.1177/1756287212454932. PMC 3547530.
  25. ^ "More Vietnamese men using silicone to enlarge their penises". Thanh Nien News. August 31, 2013. Retrieved July 14, 2014.
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