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11 February 2008
Penile Augmentation Study Laments "Unconvincing Results"
by George Atkinson

Penile augmentation, a surgical procedure aimed at lengthening and/or broadening the penis, suffers a "serious lack of standardization that has led to a wide variety of poorly documented surgical techniques with unconvincing results," suggests an academic review in the Indian Journal of Urology.

The study notes that most men complaining of a small sized penis have normal sized genitals and while some are simply misinformed, others suffer from what is known as penile dysmorphophobia. Penile dysmorphophobia is a sub-type of body dysmorphic disorder which is defined as a condition marked by excessive preoccupation with an imaginary or minor defect in a facial feature or localized part of the body. In studying patients complaining of a small penis, the researchers noted that all the men were misinformed regarding the actual normal penile size.

In assessing whether a patient should opt for penile augmentation surgery, the study authors suggest that only men with a flaccid length of less than 4 cm (1.6 inches) or a stretched or erect length of less than 7.5 cm (3 inches) should be considered candidates for penile lengthening.

Techniques employed to increase penile length include severing the suspensory ligament, possibly with fat, dermis or a synthetic material graft to prevent reattachment of the suspensory ligament. Surgery to enhance penile girth includes lipoinjection, dermal free or pedicle grafts and venous grafting for the corpora cavernosa. Success following these procedures is minimal, say the researchers. Usually one to two cm extra length is considered to be a success and sometimes there is no actual gain at all.

What is actually created after such surgery, say the researchers, is a "pseudo-longer" penis and the lack of standardized measurement methods makes any claims of extraordinary length highly questionable. They add that the unavailability of any measurements of post-augmentation erect penis together with the denial of most patients in noticing any change in their erect penis size adds more uncertainty towards the whole procedure. Because no standard method of measurement exists, claims of extraordinary length gains remain unfounded, the study warns.

Apart from the questionable level of success, a variety of complications can ensue after the procedure. The researchers cite "scrotalization" (where the penis is covered by scrotal corrugated skin rather than by its natural smooth skin); "dog-ears"; skin sloughing; hypertrophic and/or wide scars; a proximal penile hump; penile lumps and shaft deformities.

Interestingly, a small review conducted by the researchers into the complications arising from penile augmentation in 12 men found that only 1 patient reported a subjective increase in penile length. All other patients reported poor cosmetic appearance. Four patients complained of sexual dysfunction and six patients needed a re-do of the procedure (due to penile shortening after releasing the ligaments). In a larger study that is cited in the review, reports on patient satisfaction following penile augmentation are not encouraging. European Urology reported that only 27 percent of men with penile dysmorphophobia were satisfied with the results.

The review closes by noting that most members of the International Society of Sexual Medicine advised against surgical augmentation due to frequent complications and lack of significant results with surgery. The members generally advised patient education and counseling although it should be noted that currently there are no studies that compare the psychological outcome of patients suffering from penile dysmorphophobia treated surgically to those managed by education and psychotherapy.

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Information On Augmentation Surgery

Source: Indian Journal of Urology

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