What can be done about a small penis?

MEN'S HEALTH MATTERS: I am 26 years of age and am very embarrassed and conscious about the length of my penis

MEN'S HEALTH MATTERS:I am 26 years of age and am very embarrassed and conscious about the length of my penis. It is very short and I read in a magazine recently about different procedures to have it lengthened. Can anything be done about it?

AA penis enlargement procedures (sometimes euphemistically referred to as male enhancement procedures) are techniques alleged to make the human penis larger. These procedures range from surgery to manual exercises to devices and medical interventions, with mixed reports of successes and failures from around the world. While some are known to be hoaxes, there is no strong scientific proof about their effectiveness in general.

Surgical techniques used for penis lengthening (enhancement phalloplasty) and penis widening (girth enhancement) have been described in the surgical literature for many years. We know from experience that most patients who undergo penis-lengthening surgery are dissatisfied with the results.

Approximately one-third to one-half of the penis is inside the body, and is internally attached to the undersurface of the pubic bone. Penis lengthening involves the release of the suspensory ligament that attaches the two erectile bodies to the pubic bone. Once these ligaments have been cut, part of the penile shaft (usually held within the body) drops forward and extends out enlarging it by about 20-30 mm (0.78-1.18 in.) and giving a longer physical appearance.

Real penile lengthening (ie lengthening of corporal bodies vs division of ligaments) is not a routine and safe procedure because of the high risk of losing the ability to have an erection. Rather than attempt to change the actual size of the penis, one may make it appear bigger, by trimming the pubic hair, having liposuction of the pubic area or by losing weight, which may be of particular use if one is overweight.

Another method employed to enlarge the penis is to replace the two corpora cavernosa(the erectile tissue in the penis) with inflatable penile implants. This is performed primarily as a therapeutic surgery for men suffering from complete impotence but can also be performed to enlarge the penis.

The experience from centres that perform a lot of this surgery is that “the dissatisfaction rate is in excess of 70 per cent”. As a result penile surgery is strongly discouraged in all patients with normal, functional penises and should be reserved only for men born with a congenital abnormality, who have suffered an injury, or who have severe erectile dysfunction.

“Penis enlargement pills” (for example Enzyte and ExtenZe) or ointments and patches are commonly offered over the internet. There is no scientific evidence that any of these preparations actually work. There may, however, be a placebo effect ie a psychological effect of making the user think he has a larger penis, and increasing his confidence, when there is no actual change to his penis size.

A penis pump is another method employed. This consists of a cylinder with a pump to create suction which is placed over the penis.

Other methods such as stretching of the penis have been practiced by certain African tribes as long as 2,000 years ago. Stretching consists of attaching a penis stretcher or “extender” device to the penis for set periods of time. This, in theory, lengthens and widens the penis. This efficacy of this constant traction on the penis is subject to debate – much like all methods of penis enlargement.

No scientific research supports the use of any nonsurgical method to enlarge the penis, and no reputable medical society endorses penis-enlargement surgery performed for purely cosmetic reasons.

  • This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Dr Patrick Ormond, Consultant Dermatologist and Dermatological Surgeon, St James's Hospital, Dublin