Men who want surgery to increase the length of their penis should try non-invasive methods like penile traction devices or
extenders first, and in some cases, even try therapy to make them feel more confident about their bodies, said Italian urologists in
a paper published in the April print issue of the British Journal of Urology International.
Marco Orderda and Paolo Gontero of the University of Turin carried out a research review and concluded that penile extenders
were more effective than other non-invasive methods like vacuum devices, exercises and botox injections.
They also noted that surgery was not necessarily the perfect solution that some might assume it to be.
Gontero, an Associate urology Professor, told the media:
“Based on current evidence, we suggest that penile extenders, not surgery, should be the first-line treatment for men seeking a
penile lengthening procedure.”
“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,” said
In some cases, psychological satisfaction is often just as important as physical changes, Orderda and Gontero noted.
Gontero said urologists are often approached by men worried about the size of their penis, even though in most cases, the penis is
of normal size.
But there are some conditions such as Peyronie’s disease and congenital abnormalities that can leave a man with a shorter than
normal penis, as can surgical procedures like radical prostatectomy for men with prostate cancer. Lack of skin due to chronic
inflammation or aggressive circumcision can also make the penis appear smaller.
And another condition is “hidden penis”, often seen in obese older men whose belly fat and skin overlies the penis.
According to most of the studies that they reviewed, a penis was considered normal if its length when flaccid was more than 4
cm, and when erect, was more than 7.5 cm, but this also depended on height and BMI. The length was measured along the dorsal
or upper side.
Gontero said that no studies have yet compared surgical and non-invasive methods of increasing penis length.
“However our review suggests that penile extenders represent an effective and durable method of penile lengthening, capable of
elongating the penis by an average of 1.8cm with minimal side effects. This compares favourably with surgery, which is much
more invasive for the patient,” he added.
Gontero and Oderda reviewed five evidence-based studies of penile surgery on a total of 121 men,
and six evidence-based studies of non-surgical interventions covering a total of 109 men, 72 of whom used the penile extenders.
All the studies were published between 2000 and 2009.
They found that surgical procedures resulted in average flaccid length increases of 1.3 to 2.5 cm, while studies of three types of
penile extenders resulted in average flaccid length increases of 0.5 to 2.3 cm.
Penile extenders usually require the penis being in traction for several hours a day for several months, and the researchers wondered whether the gains were worth it.
A small number of the men who used penile extenders reported experiencing bruising, temporary discoloration, pain and
One study that looked at the long term effects of repeated vacuum treatment in 37 men found no significant change in penis
length after six months, although it reported a degree of psychological satisfaction for some men. One man reported experiencing
numbness, and another man had a haematoma (blood under the tissue).
Another study they reviewed showed that botox may have a temporary effect in increasing flaccid length and decreasing penile
retraction, while a further study suggested that using penoscrotal rings with an erectile dysfunction drug could help anxious men
maintain an erection, but the reviewers could only find two case reports that measured how effective these devices
Ordeda and Gontero noted that despite the fact the idea appeals to a lot of men, and that it is widely discussed on the internet,
probably because it is cheap and involves no invasive procedures, there is no evidence that exercises can help a man lengthen his
Many men who feel their penis is too small are often surprised to discover that it is in the normal size range. This means there is a
role for therapy in helping these patients, said the reviewers, who recommended they try cognitive behavioral therapy to improve
their perception of their body image.
Written by: Catharine Paddock, PhD