Impact of Penile Size on Male Sexual Function and Role of Penile Augmentation Surgery

Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases

Men's satisfaction and sexual function is influenced by discomfort over genital size which leads to seek surgical and non-surgical solutions for penis alteration. In this article we report the results of a retrospective study of 355 cases of cosmetic elongation, enlargement and combined elongation and enlargement phalloplasty. We found a significant improvement in length at rest, stretched length and circumference at rest at 2, 6 and 12 months post-surgical procedure (all p < 0.0001). 5-item International Index of Erectile Function (IIEF-5) was also increased at 12 months post-surgery compared to baseline (p < 0.0001). This was consistent with an IIEF-5 improvement of 6.74% compared to baseline. This study is clinically relevant due to the large cohort of patients included and because it is the first study to use an inverse periosteal-fascial suture not described previously as part of the surgical methodology.

[Urological and psychological approach of secondary complications to penile aesthetic modifications]

OBJECTIVES

Due to the scarcity of scientific articles that review the technical alternatives available for aesthetic modifications in the penis that are the cause of subsequent uro-andrological problems, the existing literature is reviewed after the assistance of a penile infection by injection of subcutaneous hyaluronic acid with aesthetic purposes.

MATERIAL AND METHODS

A 38-year-old male patient with no medical or psychiatric remarkable reports who came to the emergency room due to inflammation and abscess in penile skin after injection of hyaluronic acid. Surgical treatment was required and degloving and excision of affected skin was performed, with subsequent satisfactory evolution. The psychological analysis showed a narcissistic personality possibly secondary to traumas in childhood. We have reviewed the literature present in medical databases as well as information available on-line.

RESULTS

Enlargement of the penis is an important cultural and social concern, so that there are different devices in the market to meet this demand, among them: herbal medicine, stretching exercises, weights, vacuum pumps or extensor devices. Among the surgical techniques, there have been described the pubic liposuction, the section of the suspensory ligament of the penis or the injection of autologous material or synthetic substances among others. As for the aesthetic modifications of the penis, there is a wide variety of genital piercings, tattoos and subcutaneous implants also called "pocketing" or "3D implants". All of these techniques or modifications are described in this article along with their possible associated more frequent urological complications.

CONCLUSIONS

Aesthetic manipulations in the penis are becoming increasingly popular, and both its terminology and its medical implications should be known by urologists and andrologists. community.

Penile Girth Enhancement With Polymethylmethacrylate-Based Soft Tissue Fillers

INTRODUCTION

An unknown percentage of men will take every risk to develop a larger penis. Thus far, most injectables have caused serious problems. Polymethylmethacrylate (PMMA) microspheres have been injected as a wrinkle filler and volumizer with increasing safety since 1989.

AIM

To report on a safe and permanently effective method to enhance penile girth and length with an approved dermal filler (ie, PMMA).

METHODS

Since 2007, the senior author has performed penile augmentation in 752 men mainly with Metacrill, a suspension of PMMA microspheres in carboxymethyl-cellulose.

MAIN OUTCOME MEASURES

The data of 729 patients and 203 completed questionnaires were evaluated statistically.

RESULTS

The overall satisfaction rate was 8.7 on a scale of 1 to 10. After one to three injection sessions, average girth increased by 3.5 cm, or 134% (10.2 to 13.7 cm = 134.31%). Penile length also increased by weight and stretching force of the implant from an average of 9.8 to 10.5 cm. Approximately half the patients perceived some irregularities of the implant, which caused no problems. Complications occurred in 0.4%, when PMMA nodules had to be surgically removed in three of the 24% of patients who had a non-circumcised penis.

CONCLUSION

After 5 years of development, penile augmentation with PMMA microspheres appears to be a natural, safe, and permanently effective method. The only complication of nodule formation and other irregularities can be overcome by an improved injection technique and better postimplantation care.

Perceptions about penis size among supposedly healthy 40 to 60-year-old Brazilian men: a cross-sectional pilot study

CONTEXT AND OBJECTIVE

Many men seek medical treatments complaining that their penises are too small (short) when in fact they are not (they are not cases of micropenis). The objective of the present study was to evaluate men's satisfaction with their own bodies and sex life and the prevalence of erectile dysfunction, among men who were not seeking medical or psychological advice.

DESIGN AND SETTING

Cross-sectional study in a private, philanthropic hospital in São Paulo, Brazil.

METHODS

In this study, 300 male blood donors aged between 40 and 60 years old answered a questionnaire, in privacy, about their sex life and their satisfaction with their own bodies. They were also screened for erectile dysfunction by means of the International Index of Erectile Function questionnaire.

RESULTS

Seven men (2.3%) reported that they were dissatisfied with their penis size (they thought that it was small), and among these, one was found to have mild erectile dysfunction. However, none of them had sought medical attention. Among these seven, only two had normal body mass index; the other five were overweight (three) or obese (two).

CONCLUSION

The prevalence of dissatisfaction with penis size was low. Among the seven dissatisfied men, only one had erectile dysfunction, of mild type, and all of them felt potent.