Penile extenders, not surgery, should be the first-line treatment for men seeking a penile lengthening procedure.
Surgeons are frequently approached by men who are concerned about the size of their penis, despite the fact that the majority of them are normal sized. There are, however, a number of medical and surgical conditions that can cause penile shortening, such as radical prostate surgery for men with prostate cancer, Peyronie's disease (abnormal bending of the penis), congenital abnormalities, 'hidden penis' caused by overlying abdominal fat and skin in obese men or a lack of skin because of chronic inflammation.
Concerned that patients were seeking out unproven and potentially dangerous ways of lengthening the penis, the researchers examined the medical literature to see whether popular non-surgical methods had any scientific basis.
In a review of five evidence-based surgical studies of 121 men and six non-surgical studies of 109 men published between 2000 and 2009, it was found that penile extenders - which stretch the organ over a period of months through traction - were the most effective among non-invasive methods that included vacuum devices, exercises and botox injections. Psychological satisfaction was often just as important as physical changes. The men studied ranged in age from 24 to 56 years and were followed between three and 16 months. More than 70 of them used penile extenders, with six experiencing minor problems such as bruising, pain and itching. These devices yielded average flaccid length increases of between 0.2 inches and 1 inch and men achieving better results noted their satisfaction.
A review of surgical techniques showed they increased phallus size an average of about a half-inch to 1 inch, but the researchers cautioned that the safest surgery - which cuts the suspensory ligament of the penis to lengthen it - often yields poor results. On the contrary, more complex lengthening procedures are to be considered experimental and potentially dangerous. Surgery is characterised by a risk of complications and unwanted outcomes and lack of consensus among the medical profession on the indications for surgery and the techniques used. That is why a non-invasive technique is preferable.
The analysis also revealed that there is no scientific evidence to show that penile lengthening exercises work. Despite this, it is very attractive to patients who like the idea of a non-invasive, low-cost method of penis enlargement and is widely discussed on the internet. The study concludes that many men feel that their penis is too small when, in fact, very few seeking help have a micropenis (small penis). This suggests that psychological therapy could play an important role in helping men to address their concerns.
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