Injection methods of penis enlargement

Authors

DOI:

https://doi.org/10.18370/2309-4117.2021.59.110-115

Keywords:

penis enlargement, penis plastic surgery, fillers, micropenis, small penis syndrome

Abstract

Review objective: to evaluate the current scientific evidence of all available injectable methods of penis enlargement, to evaluate their effectiveness.
Materials and methods. A systematic search of scientific medical information include databases MEDLINE, Embase, AMED and HMIC. A manual web search of relevant links in the found texts was performed.
Results. Conditions in which phallus thickening is used: concern with penis size or small penis syndrome, penile dysmorphophobia, penis reduction (radical prostatectomy for prostate cancer, Peyronie's disease, congenital anomalies, erectile dysfunction).
Injectable thickening of penis started using in the in the early XX century, paraffin and mineral oils were introduced. In the 1940s, safer liquid silicone and polymethyl methacrylate were used. Gel-like biodegradable materials are currently popular because they lack most of the disadvantages of permanent substances: hyaluronic acid, polylactic acid, dextran gel and mixtures of these substances. Thickening of the penis depends on the volume inserted filler and averages + 2–4 cm in circumference.
In 2003, Moon et al. for the first time proposed a method of enlarging the penis head with hyaluronic acid. Other drugs were also used: hydrogel, polyacrylamide and dextran gel. Hyaluronic acid is the most commonly used drug. Promising filler is polylactic acid, which stimulates the fibroblasts development at the injection site and is relatively safe to use. The circumference length of the penis head can be increased by an average of 1.5 cm.
Conclusion. Penis enlargement procedures are gaining popularity among men. However, there are a limited number of scientific papers that would describe the results and complications of these procedures. Further research is needed to study the impact of penis enlargement techniques on men's sex life and well-being, because it is the key motivating factor in turning to experts on this issue.

Author Biographies

M.I. Boiko, SSI “Scientific and Practical Center for Preventive and Clinical Medicine” of the State Management of Affairs, Kyiv

MD, professor, chief researcher, Department of Minimally Invasive Surgery;

President of Ukrainian Association for Andrology and Sexual Medicine

M.S. Notsek, SSI “Scientific and Practical Center for Preventive and Clinical Medicine” of the State Management of Affairs, Kyiv

Postgraduate student, Department of Minimally Invasive Surgery

References

Dillon, B.E., Chama, N.B., Honig, S.C. “Penile size and penile enlargement surgery: A review.” Int J Impot Res 20 (2008): 519–29. DOI: 10.1038/ijir.2008.14

Friedman, D.M. A Mind of Its Own: A Cultural History of the Penis. Robert Hale (2009); 2001. DOI: 10.5860/choice.39-5875

Roos, H., Lissoos, I. “Penis lengthening.” Int J AesthRestor Surg 2 (1994): 89–96.

Hehemann, M.C., Towe, M., Huynh, L.M., et al. “Penile Girth Enlargement Strategies: What’s the Evidence?” Sex Med Rev 7 (2019): 535–47. DOI: 10.1016/j.sxmr.2018.11.003

Boiko, M.I., Chornokulskyi, I.S., Boiko, O.M. “Elongation of human penis. New method of skin plasty.” Urology and reproductive medicine 82 (2019): 36–46.

Boiko, M.I., Chornokulskyi, I.S., Boiko, O.M. “New method of skin plasty during penile elongation.” Plastic, Reconstructive and Estetic Surgery (2019): 47–57.

Kelley, J.H., Eraklis, A.J. “A procedure for lengthening the phallus in boys with exstrophy of the bladder.” J Pediatr Surg 6 (1971): 645–9. DOI: 10.1016/0022-3468(71)90391-5

Lever, J., Frederick, D.A., Peplau, L.A. “Does size matter? Men’s and women’s views on penis size across the lifespan.” Psychol Men Masculinity 7 (2006): 129–43. DOI: 10.1037/1524-9220.7.3.129

Francken, A.B., Van de Wiel, H.B.M., Van Driel, M.F., Weijmar Schultz, W.C.M. “What importance do women attribute to the size of the penis?” Eur Urol 42 (2002): 426–31. DOI: 10.1016/S0302-2838(02)00396-2

Davoudzadeh, E.P., Davoudzadeh, N.P., Margolin, E., et al. “Penile Length: Measurement Technique and Applications.” Sex Med Rev (2017). DOI: 10.1016/j.sxmr.2017.10.002

Tran, H., Goldfarb, R., Ackerman, A., Valenzuela, R.J. “Penile Lengthening, Girth, and Size Preservation at the Time of Penile Prosthesis Insertion.” Sex Med Rev 5 (2017): 403–12. DOI: 10.1016/j.sxmr.2016.11.005

Marra, G., Drury, A., Tran, L., et al. “Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size.” Sex Med Rev (2019). DOI: 10.1016/j.sxmr.2019.01.004

Mondaini, N., Ponchietti, R., Gontero, P., et al. “Penile length is normal in most men seeking penile lengthening procedures.” Int J Impot Res 14 (2002): 283–6. DOI: 10.1038/sj.ijir.3900887

Campbell, J., Gillis, J. A review of penile elongation surgery. Vol. 6. AME Publishing Company (2017). DOI: 10.21037/tau.2016.11.19

Patent for useful model No. 117128 Ukraine, IPC (2017.01) A61B 17/00. Method for surgically increasing penis length / Boiko M.I., Chornokulsky I.S., Boiko O.M.; applicant and patentee SSI “Research and Practical Center of Preventive and Clinical Medicine” State Management of Affairs, No. u 2017 01242; appl. 10.02.2017; publ. 12.06.2017, Bull. Number 11.

Patent for useful model No. 117889 Ukraine, IPC (2006) A61B 17/00. Method of surgical penile elongation / Boiko M.I., Chornokulsky I.S., Boiko O.M.; applicant and patentee SSI “Research and Practical Center of Preventive and Clinical Medicine” State Management of Affairs, No. u 2017 01244; appl. 10.07.2017; publ. 10.07.2017, Bull. Number 13.

Patent for useful model No. 119081 Ukraine, IPC (2006) A61B 17/00. Method for surgical correction of penis length / Boiko M.I., Chornokulsky I.S., Boiko O.M.; applicant and patentee SSI “Research and Practical Center of Preventive and Clinical Medicine” State Management of Affairs, No. u 2017 02939; appl. 28.03.2017; publ. 11.09.2017, Bull. Number 17.

Patent for useful model No. 118697 Ukraine, IPC (2006) A61B 17/00. Method for surgical elongation of penile length / Boiko M.I., Chornokulsky I.S.; applicant and patentee SSI “Research and Practical Center of Preventive and Clinical Medicine” State Management of Affairs, No. u 2017 01200; appl. 28.03.2017; publ. 28.08.2017, Bull. Number 16.

Boiko, M. “P-01-043 Penile elongation: A new surgery plastic skin procedure in patients with penile dysmorphophobia.” J Sex Med 14 (2017): e173. DOI: 10.1016/j.jsxm.2017.03.175

Ghanem, H., Glina, S., Assalian, P., Buvat, J. “Position Paper: Management of Men Complaining of a Small Penis Despite an Actually Normal Size.” J Sex Med 10 (2013): 294–303. DOI: 10.1111/j.1743-6109.2012.02725.x

American Psychiatric Association. Diagnostic and statistical mental disorders manual of fifth edition (DSM-5). Vol. 17. 5th ed. Arlington, VA. American Psychiatric Publishing (2013).

Oates, J., Sharp, G. “Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.” Aesthetic Surg J 37 (2017): 1032–8. DOI: 10.1093/asj/sjx068

Sarwer, D.B., Spitzer, J.C. “Body image dysmorphic disorder in persons who undergo aesthetic medical treatments.” Aesthetic Surg J 32 (2012): 999–1009. DOI: 10.1177/1090820X12462715

Wylie, K.R., Eardley, I. “Penile size and the ‘small penis syndrome’.” BJU Int 99 (2007): 1449–55. DOI: 10.1111/j.1464-410X.2007.06806.x

Veale, D., Miles, S., Read, J., et al. “Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.” Sex Med 3 (2015): 147–55. DOI: 10.1002/sm2.63

Phillips, K.A., Coles, M.E., Menard, W., et al. “Suicidal Ideation and Suicide Attempts in Body Dysmorphic Disorder.” J Clin Phsychiatry 66.6 (2005): 717–25. DOI: 10.4088/jcp.v66n0607

Veale, D., Anson, M., Miles, S., et al. “Efficacy of cognitive behaviour therapy versus anxiety management for body dysmorphic disorder: A randomised controlled trial.” Psychother Psychosom 83 (2014): 341–53. DOI: 10.1159/000360740

Veale, D., Gournay, K., Dryden, W., et al. “Body dysmorphic disorder: A cognitive behavioural model and pilot randomised controlled trial.” Behav Res Ther 34 (1996): 717–29. DOI: 10.1016/0005-7967(96)00025-3

Wilhelm, S., Phillips, K.A., Didie, E., et al. “Modular cognitive-behavioral therapy for body dysmorphic disorder: A randomized controlled trial.” Behav Ther 45 (2014): 314–27. DOI: 10.1016/j.beth.2013.12.007

Phillips, K.A., Albertini, R.S., Rasmussen, S.A. “A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder.” Arch Gen Psychiatry 59 (2002): 381–8. DOI: 10.1001/archpsyc.59.4.381

Veale, D., Miles, S., Read, J., et al. “Penile Dysmorphic Disorder: Development of a Screening Scale.” Arch Sex Behav 44 (2015): 2311–21. DOI: 10.1007/s10508-015-0484-6

Moon, D.G., Kwak, T.I., Cho, H.Y., et al. “Augmentation of glans penis using injectable hyaluronic acid gel.” Int J Impot Res 15 (2003): 456–60. DOI: 10.1038/sj.ijir.3901058

Moon, D.G., Kwak, T.l., Kim, J.J. “Glans Penis Augmentation Using Hyaluronic Acid Gel as an Injectable Filler.” World J Mens Health 33 (2015): 50. DOI: 10.5534/wjmh.2015.33.2.50

Ahn, S.T., Kwak, T.l., Park, K.S., et al. “Complications of glans penis augmentation.” Int J Impot Res 31 (2019): 245–55. DOI: 10.1038/s41443-018-0097-4

Kwak, T.I., Jin, M.H., Kim, J.J., Moon, D.G. “Long-term effects of glans penis augmentation using injectable hyaluronic acid gel for premature ejaculation.” Int J Impot Res 20 (2008): 425–8. DOI: 10.1038/ijir.2008.26

Kim, J.J., Kwak, T.I., Jeon, B.G., et al. “Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation.” Int J Impot Res 16 (2004): 547–51. DOI: 10.1038/sj.ijir.3901226

Perovic, S.V., Radojicic, Z.I., Djordjevic, M.L., Vukadinovic, V.V. “Enlargement and sculpturing of a small and deformed glans.” J Urol 170 (2003): 1686–90. DOI: 10.1097/01.ju.0000084431.99013.13

Shaeer, O. “Supersizing the Penis Following Penile Prosthesis Implantation.” J Sex Med 7 (2010): 2608–16. DOI: 10.1111/j.1743-6109.2010.01723.x

Yang, D.Y., Ko, K., Lee, S.H., et al. “Efficacy and safety of newly developed cross-linked dextran gel injection for glans penis augmentation with a novel technique.” Asian J Androl 20 (2018): 80–4. DOI: 10.4103/aja.aja_1_17

Abdallah, H., Abdelnasser, T., Hosny, H., et al. “Treatment of premature ejaculation by glans penis augmentation using hyaluronic acid gel: A pilot study.” Andrologia 44 (2012): 650–3. DOI: 10.1111/j.1439-0272.2011.01244.x

Kim, J.J., Kwak, T.I., Jeon, B.G., et al. “Human glans penis augmentation using injectable hyaluronic acid gel.” Int J Impot Res 15 (2003): 439–43. DOI: 10.1038/sj.ijir.3901044

Vardi, Y., Harshai, Y., Gil, T., et al. “A Critical Analysis of Penile Enhancement Procedures for Patients with Normal Penile Size: Surgical Techniques, Success, and Complications.” Eur Urol 54 (2008): 1042–50. DOI: 10.1016/j.eururo.2008.07.080

Bizic, M.R., Djordjevic, M.L. “Penile Enhancement Surgery: an Overview.” Cit EMJ Urol 4 (2016): 94–100. DOI: 10.1111/j.1610-0387.2010.07518.x

Eandi, J.A., Yao, A.P., Javidan, J. “Penile paraffinoma: The delayed presentation.” Int Urol Nephrol 39 (2007): 553–5. DOI: 10.1007/s11255-006-9058-9

Orentreich, D.S. “Liquid injectable silicone: techniques for soft tissue augmentation.” Clin Plast Surg 27 (2000): 595–612.

Silberstein, J., Downs, T., Goldstein, I. “Penile injection with silicone: Case report and review of the literature.” J Sex Med 5 (2008): 2231–7. DOI: 10.1111/j.1743-6109.2008.00911.x

Yacobi, Y., Tsivian, A., Grinberg, R., Kessler, O. “Short-term results of incremental penile girth enhancement using liquid injectable silicone: Words of praise for a change.” Asian J Androl 9 (2007): 408–13. DOI: 10.1111/j.1745-7262.2007.00262.x

Sasidaran, R., Mat Zain, M.A., Basiron, N.H. “Low-grade liquid silicone injections as a penile enhancement procedure: Is bigger better.” Urol Ann 4 (2012): 181–6. DOI: 10.4103/0974-7796.102672

Casavantes, L., Lemperle, G., Morales, P. “Penile Girth Enhancement With Polymethylmethacrylate-Based Soft Tissue Fillers.” J Sex Med 13 (2016): 1414–22. DOI: 10.1016/j.jsxm.2016.06.008

Kwak, T.l., Oh, M., Kim, J.J., Moon, D.G. “The Effects of Penile Girth Enhancement using Injectable Hyaluronic Acid Gel, a Filler.” J Sex Med 8 (2011): 3407–13. DOI: 10.1111/j.1743-6109.2010.01748.x

Yang, D.Y., Jeong, H.C., Ahn, S.T., et al. “A Comparison Between Hyaluronic Acid and Polylactic Acid Filler Injections for Temporary Penile Augmentation in Patients with Small Penis Syndrome: A Multicenter, Patient/Evaluator-Blind, Comparative, Randomized Trial.” J Sex Med 17 (2020): 133–41. DOI: 10.1016/j.jsxm.2019.10.006

Yang, D.Y., Ko, K., Lee, S.H., Lee, W.K. “A Comparison of the Efficacy and Safety Between Hyaluronic Acid and Polylactic Acid Filler Injection in Penile Augmentation: A Multicenter, Patient/Evaluator-Blinded, Randomized Trial.” J Sex Med 16 (2019): 577–85. DOI: 10.1016/j.jsxm.2019.01.310

Bartus, C., William Hanke, C., Daro-Kaftan, E. “A decade of experience with injectable poly-l-lactic acid: A focus on safety.” Dermatologic Surg 39 (2013): 698–705. DOI: 10.1111/dsu.12128

Yang, D.Y., Lee, W.K., Kim, S.C. “Tolerability and efficacy of newly developed penile injection of cross-linked dextran and polymethylmethacrylate mixture on penile enhancement: 6 months follow-up.” Int J Impot Res 25 (2013): 99–103. DOI: 10.1038/ijir.2012.41

Patent for useful model No. 147422 Ukraine, IPC (2021.01) AA61B 17/00 A61M 1/00. Test system for determining the circumference length of the penile shaft when injecting the filler / Boiko M.I., Notsek M.S.; applicant and patentee SSI “Research and Practical Center of Preventive and Clinical Medicine” State Management of Affairs, No. u 2020 07951; appl. 14.12.2020; publ. 05.05.2021, Bull. Number 18.

Published

2021-07-22

Issue

Section

Andrology