Penis Enlargement; Types, Technique, Treatment

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 surgery, supplements, ointments, patches, and physical methods like pumping, jelqing, and traction.

Inflatable penile prosthetic (IPP) devices have been available and used for more than four decades. Often times, medical conditions causing erectile dysfunction also cause penis shortening, causing the decreased patient quality of life. To identify and review all available penis lengthening procedures that can be performed at the time of IPP insertion. An extensive, systematic literature review was performed using PubMed searching for key terms penis lengthening, inflatable penis prosthesis, penile girth, clitoroplasty, glans augmentation, and penis enhancement; all articles with subjective or objective penis length outcomes were reviewed.

Anatomy of Penis Enlargement

Lateral cross-section of the penis.
Male Reproductive System Labeled and Label Male Reproductive System Reproductive System Of The Human Male – Human Diagram Chart

Parts

  • The root of the penis (radix): It is the attached part, consisting of the bulb of the penis in the middle and the crus of the penis, one on either side of the bulb. It lies within the superficial perineal pouch.
  • Body of the penis (corpus): It has two surfaces: dorsal (posterosuperior in the erect penis), and ventral or urethral (facing downwards and backward in the flaccid penis). The ventral surface is marked by a groove in a lateral direction.
  • Epithelium of the penis consists of the shaft skin, the foreskin, and the preputial mucosa on the inside of the foreskin and covering the glans penis. The epithelium is not attached to the underlying shaft so it is free to glide to and fro.[rx]

Structure

The human penis is made up of three columns of tissue –  two corpora cavernosa lie next to each other on the dorsal side and one corpus spongiosum lies between them on the ventral side.[rx]

The enlarged and bulbous-shaped end of the corpus spongiosum forms the glans penis with two specific types of sinusoids, which supports the foreskin, or prepuce, a loose fold of skin that in adults can retract to expose the glans.[rx] The area on the underside of the penis, where the foreskin is attached, is called the frenum, or frenulum. The rounded base of the glans is called the corona. The perineal raphe is the noticeable line along the underside of the penis.

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Comparison of mean body weight, mean testicular weight, mean plasma testosterone and mean IGF-1 among experimental groups.

C MP G Testosterone GT
Bodyweight (g, s.d.) 588 (34) 579 (28) 575 (39) 552 (44) 567 (45)
Testis volume (mL, s.d.) 1.36 (0.11) 0.97 (0.05)b 1.26 (0.08)a 0.83 (0.06)ab 1.10 (0.09)a,b
Tibial length (mm) 38.4 (2.6) 36.6 (3.1) 39.1 (2.2) 35.5 (3.3) 36.8 (2.9)
Plasma testosterone (ng/mL, s.d.) 3.72 (1.91)a 0.44 (0.05)b 2.08 (0.51)a 27.5a,b 29.2a,b
Plasma IGF-1 (ng/mL, s.d.) 1445 (155) 1432 (232) 1704 (116)a,b 628 (206)a,b 1197 (126)a,b

denotes statistical significance (P < 0.05) compared to MP; denotes statistical significance (P < 0.05) compared to C.

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Disorders of Penis Enlargement

Penis Enlargement

  • Paraphimosis – is an inability to move the foreskin forward over the glans. It can result from fluid trapped in a foreskin left retracted, perhaps following a medical procedure, or accumulation of fluid in the foreskin because of friction during vigorous sexual activity.
  • In Peyronie’s disease – anomalous scar tissue grows in the soft tissue of the penis, causing curvature. Severe cases can be improved by surgical correction.
  • A thrombosis can occur during periods of frequent and prolonged sexual activity – especially fellatio. It is usually harmless and self-corrects within a few weeks.
  • Infection with the herpes virus can occur after sexual contact with an infected carrier –  this may lead to the development of herpes sores.
  • Pudendal nerve entrapment – is a condition characterized by pain on sitting and the loss of penile sensation and orgasm. Occasionally there is a total loss of sensation and orgasm. The pudendal nerve can be damaged by narrow, hard bicycle seats and accidents. This can also occur in the clitoris of females.
  • Penile fracture – can occur if the erect penis is bent excessively. A popping or cracking sound and pain is normally associated with this event. Emergency medical assistance should be obtained as soon as possible. Prompt medical attention lowers the likelihood of permanent penile curvature.
  • In diabetes – peripheral neuropathy can cause tingling in the penile skin and possibly reduced or completely absent sensation. The reduced sensations can lead to injuries for either partner and their absence can make it impossible to have sexual pleasure through stimulation of the penis. Since the problems are caused by permanent nerve damage, preventive treatment through good control of diabetes is the primary treatment. Some limited recovery may be possible through improved diabetes control.
  • Erectile dysfunction is the inability to develop and maintain an erection sufficiently firm for satisfactory sexual performance. Diabetes is a leading cause, as is natural aging. A variety of treatments exist, most notably including the phosphodiesterase type 5 inhibitor drugs (such as sildenafil citrate, marketed as Viagra), which work by vasodilation.
  • Priapism – is a painful and potentially harmful medical condition in which the erect penis does not return to its flaccid state. Priapism lasting over four hours is a medical emergency. The causative mechanisms are poorly understood but involve complex neurological and vascular factors. Potential complications include ischemia, thrombosis, and impotence. In serious cases, the condition may result in gangrene, which may result in amputation. However, that is usually only the case if the organ is broke out and injured because of it. The condition has been associated with a variety of drugs including prostaglandin. Contrary to common knowledge, sildenafil (Viagra) will not cause it.[rx]
  • Lymphangiosclerosis – is a hardened lymph vessel, although it can feel like a hardened, almost calcified or fibrous, vein. It tends not to share the common blue tint with a vein, however. It can be felt as a hardened lump or “vein” even when the penis is flaccid and is even more prominent during an erection. It is considered a benign physical condition. It is fairly common and can follow a particularly vigorous sexual activity for men, and tends to go away if given rest and more gentle care, for example by use of lubricants.
  • Carcinoma of the penis – is rare with a reported rate of 1 person in 100,000 in developed countries. Some sources state that circumcision can protect against this disease, but this notion remains controversial among medical circles.[rx]

Developmental Disorders

Hypospadias
  • Hypospadias is a developmental disorder where the meatus is positioned wrongly at birth. Hypospadias can also occur iatrogenically by the downward pressure of an indwelling urethral catheter.[rx] It is usually corrected by surgery.
  • A micropenis is a very small penis caused by developmental or congenital problems.
  • Diphallia, or penile duplication (PD), is the condition of having two penises. However, this disorder is extremely rare.

Alleged and observed psychological disorders

  • Penis panic (koro in Malaysian/Indonesian) – delusion of shrinkage of the penis and retraction into the body. This appears to be culturally conditioned and largely limited to Ghana, Sudan, China, Japan, Southeast Asia, and West Africa.
  • In April 2008, the Kinshasa Democratic Republic of Congo, West Africa’s ‘Police arrested 14 suspected victims (of penis snatching) and sorcerers accused of using black magic or witchcraft to steal (make disappear) or shrink men’s penises to extort cash for cure, amid a wave of panic. Arrests were made in an effort to avoid bloodshed seen in Ghana a decade before when 12 penis snatchers were beaten to death by mobs.[rx]
  • Penis envy—the contested Freudian belief of all women inherently envying men for having penises.

The technique of Penis Enlargement


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.[rx][rx] 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.[rx]
  • 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.[rx] Although vacuum therapy can treat erectile dysfunction sufficiently to prevent penis deterioration and shrinkage,[rx] clinical trials have not found it effective for penis enlargement.[rx][rx]


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”,[rx] the technique has ancient Arab origins.[rx] Despite many anecdotal reports of success, medical evidence is absent.[rx]
  • Journalists have dismissed the method as biologically implausible,[rx] or even impossible, albeit unlikely to seriously damage the penis.[rx] Still, if done excessively or harshly, jelqing could conceivably cause ruptures, scarring, disfigurement, and desensitization.[rx][rx]

Traction

  • 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.[rx] Scientific evidence supports some elongation by prolonged traction.[rx]

Jelqing exercises

  • Jelqing is an exercise that some people use to try to naturally increase the size of their penis. It involves using a hand-over-hand rolling motion to move blood to the head of your penis and stretch it. It’s sometimes called “milking.”
  • There aren’t enough medical studies to suggest that jelqing can actually increase your penis size. It’s a fairly safe practice, but it may lead to pain, irritation, or scar tissue formation if you do it too often or aggressively.

Clamps and rings

  • Some people use a clamp or ring to try to stretch and elongate their penis. To use one of these devices, you place it around the base of your penis after you’ve developed an erection. It’s meant to prevent blood from flowing out of your penis.
  • Wearing one of these devices may temporarily enlarge your penis. But wearing it for more than 30 minutes can cut off blood flow and cause damage to your penile tissue.

Diet, Exercise, and Lifestyle

  • The sad truth is that in a significant number of cases, erectile dysfunction is a condition we bring upon ourselves. Even when these things aren’t the outright cause of ED, they’re almost certain to be contributing factors that make your condition worse. This is a big, expansive category that covers a lot of ground, but in a nutshell, here’s what you need to know.
  • Eating lots of leafy greens, whole grains, oysters, watermelon, and blueberries (most any fruit will work, really) will help you give your body all that it needs to improve the quality of your erections while cutting out processed foods, cigarettes and alcohol will provide further benefits. Add in a healthy dose of exercise at least three times per week, and you’re well on your way to better sexual health!

References

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Penis Enlargement

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