Penis enlargement#Jelqing

{{Short description|Technique aimed to increase the size of a human penis}}

Penis enlargement, or male enhancement, is any technique aimed to increase the size of a human penis. Some methods aim to increase total length, others the shaft's girth, and yet others the glans and foreskin size.{{cite journal |last1=Li |first1=MK |last2=Shahinyan |first2=G |last3=Sigalos |first3=JT |last4=Mills |first4=JN |last5=Eleswarapu |first5=SV |date=May 2023 |title=Penile and Foreskin Stretching Practices Through Time and Culture |journal=Urology |publisher=Elsevier |volume=175 |pages=2–5 |doi=10.1016/j.urology.2023.02.018 |doi-access=free |pmid=36868413 |issn=0090-4295 |s2cid=257305118}} Techniques include surgery, supplements, ointments, patches, and physical methods like pumping, jelqing, and traction.

Surgical penis enlargement methods can be effective; however, such methods carry risks of complications and are not medically indicated except in cases involving a micropenis. Non-invasive methods have received little scientific study, and most lack scientific evidence of effectiveness. However, limited scientific evidence supports some elongation by prolonged traction.{{cite journal | vauthors = Oderda M, Gontero P | title = Non-invasive methods of penile lengthening: fact or fiction? | journal = BJU International | volume = 107 | issue = 8 | pages = 1278–1282 | date = April 2011 | pmid = 20868389 | doi = 10.1111/j.1464-410X.2010.09647.x | doi-access = free }} Some quack products may improve penis erection, mistaken by consumers for penis enlargement.

Surgical methods

File:Penis Enlargement Sign in Johannesburg.jpg.]]

There are several surgical penis enlargement treatments, most of which carry a risk of significant complications.{{cite journal | vauthors = Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, Trost L, Morey AF | display-authors = 6 | title = Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine | journal = The Journal of Sexual Medicine | volume = 13 | issue = 4 | pages = 489–518 | date = April 2016 | pmid = 27045255 | doi = 10.1016/j.jsxm.2016.01.017 }} Procedures by unlicensed surgeons can lead to serious complications.{{cite news|url=http://www.psurg.com/nationalpost-2001-05-02.html|title=The beauty butchers| vauthors = Blatchford C |author-link=Christie Blatchford |date=May 2, 2001|newspaper=National Post|access-date=July 14, 2014}}

Surgical penis enlargement methods include penile augmentation and suspensory ligament release. Penile augmentation involves injecting fat cells into the penis or grafting fat cells onto the penis. Injecting fat cells into the penis can cause swelling and deformity; in some instances, removal of the penis may be necessary. Grafting fat cells onto the penis can be effective; however, the increase in size may disappear over time. Suspensory ligament release increases flaccid penis length, but does not increase the length of an erect penis{{cite book|url=https://books.google.com/books?id=H4tiyNn2B9EC&pg=RA1-PA657|page=657|title=Plastic Surgery|volume=6|edition=3d| veditors = Neligan PC |publisher=Elsevier Health Sciences|year=2013|isbn=978-1-4377-1733-4}} and can create problems with sexual function.{{Cite web|url=https://www.medicalnewstoday.com/articles/323688.php|title=Does penis enlargement work? Methods and effectiveness| vauthors = Barrell A |website=Medical News Today|date=12 January 2020|access-date=1 March 2020}}

The American Urological Association (AUA) and the Urology Care Foundation "consider subcutaneous fat injection for increasing penile girth to be a procedure which has not been shown to be safe or efficacious. The AUA also considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious."{{Cite web|url=https://www.auanet.org/guidelines/penile-augmentation-surgery|title=Penile Augmentation Surgery|website=American Urological Association|language=en|access-date=1 March 2020

}} Both statements were first published in January 1994 and re-affirmed ever since. Complications from penis enlargement procedures include scarring that may lead, ultimately, to penis shrinkage or erectile dysfunction.{{cite journal | vauthors = Nugteren HM, Balkema GT, Pascal AL, Schultz WC, Nijman JM, van Driel MF | title = Penile enlargement: from medication to surgery | journal = Journal of Sex & Marital Therapy | volume = 36 | issue = 2 | pages = 118–123 | year = 2010 | pmid = 20169492 | doi = 10.1080/00926230903554453 | s2cid = 39984361 }}{{cite journal | vauthors = Vardi Y | title = Is penile enlargement an ethical procedure for patients with a normal-sized penis? | journal = European Urology | volume = 49 | issue = 4 | pages = 609–611 | date = April 2006 | pmid = 16439051 | doi = 10.1016/j.eururo.2005.12.053 }}

Other surgical treatments include the injection of dermal fillers, silicone gel, or PMMA.{{cite journal | vauthors = Shamsodini A, Al-Ansari AA, Talib RA, Alkhafaji HM, Shokeir AA, Toth C | title = Complications of penile augmentation by use of nonmedical industrial silicone | journal = The Journal of Sexual Medicine | volume = 9 | issue = 12 | pages = 3279–3283 | date = December 2012 | pmid = 22145947 | doi = 10.1111/j.1743-6109.2011.02563.x }}{{cite journal | vauthors = Fukuda H, Endo H, Katsuzaki J, Mukai H | title = Development of nodules on the glans penis due to hyaluronic acid filler injection | journal = European Journal of Dermatology | volume = 26 | issue = 4 | pages = 416–417 | date = August 2016 | pmid = 26081014 | doi = 10.1684/ejd.2015.2600 | s2cid = 41634996 }} Dermal fillers are also not approved by the US Food and Drug Administration (FDA) for use in the penis.{{Cite web|url=https://www.fda.gov/medicaldevices/productsandmedicalprocedures/cosmeticdevices/wrinklefillers/default.htm|title=Dermal Fillers (Soft Tissue Fillers) | author = Center for Devices and Radiological Health|website=www.fda.gov|language=en|access-date=2018-03-14}} Injectables such as hyaluronic acid and polyactic acid have shown some limited efficacy, however the Sexual Medicine Society of North America (SMSNA) "strongly recommends against" permanent fillers such as paraffins and silicone.{{cite journal |last1=Trost |first1=Landon |last2=Watter |first2=Daniel |last3=Carrier |first3=Serge |last4=Khera |first4=Mohit |last5=Yafi |first5=Faysal |last6=Bernie |first6=Helen |last7=Ziegelmann |first7=Matthew |last8=Köhler |first8=Tobias |title=Cosmetic penile enhancement procedures: an SMSNA position statement |journal=The Journal of Sexual Medicine |date=April 23, 2024 |volume=21 |issue=6 |pages=573–578 |doi=10.1093/jsxmed/qdae045 |pmid=38654638 |doi-access=free }}

Because of great risk and uncertainty, medical professionals are generally skeptical of penile enlargement and avoid attempting it.{{cite web | vauthors = Griffin RM | url=https://www.webmd.com/men/features/penis-enlargement-does-it-work | title=Penis enlargement: Does it work? |year=2010 |website=WebMD | access-date=July 28, 2011 }} A 2019 study in Sexual Medicine Reviews found that surgical methods of penis enlargement are typically ineffective and can be damaging to both physical and mental health.{{Cite web|url=https://www.news-medical.net/news/20190513/Penis-enlargement-surgery-ineffective-and-potentially-dangerous.aspx|title=Penis enlargement surgery ineffective and potentially dangerous|date=July 9, 2020|website=News-Medical.net| vauthors = Ratan NM }} The authors found that such treatments are "'supported by scant, low-quality evidence... Injectables and surgery should remain a last option, considered unethical outside of clinical trials'".{{Cite web|url=https://www.newsweek.com/penis-extensions-are-ineffective-and-risky-leave-men-mercy-charlatans-study-1421829|title=Penis enlargements are "ineffective and risky" and leave men at mercy of charlatans, study finds| vauthors = Kashmira G | date=May 10, 2019|website=Newsweek}} According to the study, "'overall treatment outcomes were poor, with low satisfaction rates and significant risk of major complications, including penile deformity, shortening, and erectile dysfunction'".

Medical doctors do treat micropenis with surgical procedures. In such cases, surgery can improve urinary or sexual function.{{cite journal | vauthors = Campbell J, Gillis J | title = A review of penile elongation surgery | journal = Translational Andrology and Urology | volume = 6 | issue = 1 | pages = 69–78 | date = February 2017 | pmid = 28217452 | pmc = 5313298 | doi = 10.21037/tau.2016.11.19 | doi-access = free }}

Supplements

Penis-enlargement pills, patches, and ointments are sold online. Such products are generally considered ineffective.{{cite journal | vauthors = Nugteren HM, Balkema GT, Pascal AL, Schultz WC, Nijman JM, van Driel MF | title = Penile enlargement: from medication to surgery | journal = Journal of Sex & Marital Therapy | volume = 36 | issue = 2 | pages = 118–123 | date = 2010 | pmid = 20169492 | doi = 10.1080/00926230903554453 | s2cid = 39984361 }}

Physical techniques

Physical techniques involve extension devices, hanging weights, and vacuum pressure. There is also significant overlap between techniques intended to enlarge the penis and techniques intended to achieve other, related objectives, such as reversing impotence, extending the duration of erections, or enhancing sexual climax.

= Pumping{{anchor|Penis pump}} =

File:Water-based Penis Enlargement Pump.jpg

Commonly called a "penis pump", a vacuum erection device, or VED, creates negative pressure that expands and thereby draws blood into the penis.{{cite journal | vauthors = Stein MJ, Lin H, Wang R | title = New advances in erectile technology | journal = Therapeutic Advances in Urology | volume = 6 | issue = 1 | pages = 15–24 | date = February 2014 | pmid = 24489605 | pmc = 3891291 | doi = 10.1177/1756287213505670 | doi-access = free }}{{cite journal | vauthors = Qian SQ, Gao L, Wei Q, Yuan J | title = Vacuum therapy in penile rehabilitation after radical prostatectomy: review of hemodynamic and antihypoxic evidence | journal = Asian Journal of Andrology | volume = 18 | issue = 3 | pages = 446–451 | date = May–June 2016 | pmid = 26289397 | pmc = 4854102 | doi = 10.4103/1008-682X.159716 | doi-access = free }} Medically approved VEDs, which treat erectile dysfunction, limit maximum pressure, whereas the pumps commonly bought by consumers seeking penis enlargement can reach dangerous pressure, damaging penis tissue.{{cite web | vauthors = Engber D | url = http://www.slate.com/articles/news_and_politics/explainer/2006/06/do_penis_pumps_work.html | title = Do penis pumps work? | work = Slate | date = 29 June 2006 }} To retain tumescence after breaking the device's airtight seal, one must constrict the penis' base, but constriction worn over 30 minutes can permanently damage the penis and cause erectile dysfunction.{{cite journal | vauthors = Lehrfeld T, Lee DI | title = The role of vacuum erection devices in penile rehabilitation after radical prostatectomy | journal = International Journal of Impotence Research | volume = 21 | issue = 3 | pages = 158–164 | year = 2009 | pmid = 19225465 | doi = 10.1038/ijir.2009.3 | doi-access = free }} Although vacuum therapy can treat erectile dysfunction sufficiently to prevent penis deterioration and shrinkage, clinical trials have not found it effective for penis enlargement.{{cite book | vauthors = Min KS | chapter = Chapter 20: Penile traction therapy (penile lengthening device | veditors = Park NC, Kim SW, Moon DG | title = Penile Augmentation | publisher = Springer | date = 2016 | chapter-url = https://books.google.com/books?id=T2LNCwAAQBAJ&dq=vacuum&pg=PA162 | page = 162 | isbn = 9783662467534 }}{{cite book | vauthors = Hecht SL, Hedges JC | chapter = Chapter 13: Vacuum therapy for erectile dysfunction | veditors = Köhler TS, McVary KT | title = Contemporary Treatment of Erectile Dysfunction: A Clinical Guide | edition = 2nd | publisher = Humana Press | date = 2016 | chapter-url = https://books.google.com/books?id=-57VDAAAQBAJ&dq=myth&pg=PA181 | page = 181 | isbn = 9783319315874 }}

= Jelqing =

The latinized name "jelqing" is the corrupt form derived from the Persian jalq zadan (جلق زدن), jalq meaning "to masturbate" followed by an auxiliary verb zadan meaning "to strike, hit or throb". Performed on the halfway tumescent penis, jelqing is a manual manipulation of simultaneous squeezing and stroking the shaft from base to corona. Also called "milking",{{cite news| vauthors = Salvini M |title=Size matters|url=http://www.salon.com/2005/04/12/salvini/|access-date=6 January 2013|newspaper=Salon|date=12 April 2005}} the technique has ancient Arab origins.{{cite journal | vauthors = Wylie KR, Eardley I | title = Penile size and the 'small penis syndrome' | journal = BJU International | volume = 99 | issue = 6 | pages = 1449–1455 | date = June 2007 | pmid = 17355371 | doi = 10.1111/j.1464-410X.2007.06806.x | doi-access = free }}{{open access}} Despite many anecdotal reports of success, medical evidence is absent.{{cite web|last=Mayo Clinic Staff|title=Penis-enlargement products|url=http://www.mayoclinic.com/health/penis/MC00026|publisher=Mayo Clinic|access-date=6 January 2013}} Journalists have dismissed the method as biologically implausible,{{cite web |date=February 20, 2007 |title=Penis enlargement products come up short |url=http://www.livescience.com/4387-penis-enlargement-products-short.html |access-date=6 January 2013 |website=livescience.com |publisher=Tech Media Network |vauthors=Wanjek C}} or even impossible. Some clinicians caution against the routine use of jelqing techniques, including excessive or aggressive manipulations of the penis, due to concerns of potential fibrosis and plaque formation. Jelqing may increase the risk of developing hard flaccid syndrome, a condition characterized by a flaccid penis that remains in a firm, semi-rigid state in the absence of sexual arousal.{{Cite journal |last1=Billis |first1=Evdokia |last2=Kontogiannis |first2=Stavros |last3=Tsounakos |first3=Spyridon |last4=Konstantinidou |first4=Eleni |last5=Giannitsas |first5=Konstantinos |date=2023-10-22 |title=Hard Flaccid Syndrome: A Biopsychosocial Management Approach with Emphasis on Pain Management, Exercise Therapy and Education |journal=Healthcare |volume=11 |issue=20 |pages=2793 |doi=10.3390/healthcare11202793 |doi-access=free |issn=2227-9032 |pmid=37893867|pmc=10606578 }}{{Cite web |title=Hard Flaccid Syndrome Proposed to Be Secondary to Pathological Activation of a Pelvic/Pudendal-Hypogastric Reflex - American Urological Association |url=https://auanews.net/issues/articles/2023/may-2023/hard-flaccid-syndrome-proposed-to-be-secondary-to-pathological-activation-of-a-pelvic/pudendal-hypogastric-reflex |access-date=2024-08-15 |website=auanews.net}}

= Traction =

File:Penile Traction Device.jpg

Traction is a nonsurgical method to lengthen the penis by employing devices that pull at the glans of the penis for extended periods of time. As of 2013, the majority of research investigating the use of penile traction focuses on treating the curvature and shrinkage of the penis as a result of Peyronie's disease, although some literature exists on the effects on men with short penises.{{cite journal | vauthors = Chung E, Brock G | title = Penile traction therapy and Peyronie's disease: a state of art review of the current literature | journal = Therapeutic Advances in Urology | volume = 5 | issue = 1 | pages = 59–65 | date = February 2013 | pmid = 23372611 | pmc = 3547530 | doi = 10.1177/1756287212454932 }}

Scientific evidence supports some elongation by prolonged traction. There are also medical studies that indicate that the lengthening effects can be negligible.{{cite journal | vauthors = Usta MF, Ipekci T | title = Penile traction therapy for Peyronie's disease-what's the evidence? | journal = Translational Andrology and Urology | volume = 5 | issue = 3 | pages = 303–309 | date = June 2016 | pmid = 27298777 | pmc = 4893512 | doi = 10.21037/tau.2016.03.25 | publisher = AME Publishing Company | doi-access = free }}

Society and culture

Some doctors say that most men seeking penis enlargement have normal-sized penises, and many may experience penile dysmorphophobia by underestimating their own penis size while overestimating the average penis size.

Products purported to enlarge one's penis were frequently promoted via spam email in the late 1990s and early 2000s.{{cite web | vauthors = Herrman J |title=Is Spam Trying to Tell Us Something? |url=https://www.nytimes.com/2019/08/20/style/spam-email.html |website=The New York Times |access-date=8 October 2021 |date=20 August 2019}} In 2003, a log file from an e-commerce site used by one such spammer was accidentally exposed on the public Internet. It showed that they received around 6,000 orders for their herbal supplement product "Pinacle" {{sic}} in a period of four weeks, with most orders being for $100 worth of product. The US Federal Trade Commission said at the time that "there is no proof the pills work as advertised".{{cite magazine | vauthors = McWilliams B |title=Swollen Orders Show Spam's Allure |url=https://www.wired.com/2003/08/swollen-orders-show-spams-allure/ |magazine=Wired |access-date=8 October 2021}}

In 2013 in Vietnam, many Vietnamese men attempted to enlarge their penises by injecting liquid silicone into them. They were hospitalized for complications such as infections, necrosis, tumors, swelling, deformities, and sexual dysfunction.{{cite news |date= August 31, 2013 |title= More Vietnamese men using silicone to enlarge their penises |url= http://www.thanhniennews.com/health/more-vietnamese-men-using-silicone-to-enlarge-their-penises-1317.html |archive-url= https://archive.today/20140717211152/http://www.thanhniennews.com/health/more-vietnamese-men-using-silicone-to-enlarge-their-penises-1317.html |url-status= dead |archive-date= July 17, 2014 |newspaper= Thanh Nien News |access-date=July 14, 2014 }}