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Penile enlargement surgery—fact or illusion?

Nature Clinical Practice Urology volume 2, pages 114–115 (2005)Cite this article

Genital size has been a source of anxiety for men throughout history. It has various social and psychological ramifications, such as social maladjustment, fear of relationships, and lack of self-confidence. Many men feel a need to enlarge their penis in order to improve their self-esteem, or to satisfy and impress their partners. 'Phallic identity'—the tendency of males to seek their identity in their penis, with an emphasis on the belief that bigger is better—and 'phallocentrism'—the idea that the penis is central to identity and symbolically empowered—are deeply embedded myths that are likely to persist.1

In recent years, surgery to augment penile length or girth has become increasingly common, especially in private settings. Lack of standardization of this controversial procedure has led to a wide variety of poorly documented surgical techniques, with unconvincing results. Since the early 1970s, when it was first described by pediatric urologists in boys with microphallus and bladder exstrophy,2,3 media attention, increased demand for cosmetic surgery, and widespread advertising have contributed to the rising popularity of penile augmentation. The fact that, between 1991 and 1998, 10,000 men underwent penile augmentation in the US alone, is evidence of this phenomenon.4 Interestingly, the main concern of the majority of men having this kind of surgery is flaccid penile size, the so-called 'locker room syndrome', when men feel considerably inadequate despite normal penile length and girth.5 Standard penile length and girth in the flaccid state range from 8.2 to 9.7 cm, and 1.6 to 2.7 cm, respectively.5,6 It is important that a distinction be made between surgery with the esthetic aim of improving penile appearance, and surgery for functional abnormalities. In this Viewpoint, we will discuss only cosmetic penile procedures.

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Authors and Affiliations

  1. Neuro-Urology and Male Sexual Dysfunction Unit at Rambam Medical Center,

    Yoram Vardi

  2. Technion Faculty of Medicine, Haifa, Israel

    Lior Lowenstein

  3. Rambam Medical Center, Neuro-Urology Unit, Haifa, 31096, Israel

    Yoram Vardi

Authors
  1. Yoram Vardi
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  2. Lior Lowenstein
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Correspondence to Yoram Vardi.

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The authors declare no competing financial interests.

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Vardi, Y., Lowenstein, L. Penile enlargement surgery—fact or illusion?. Nat Rev Urol 2, 114–115 (2005). https://doi.org/10.1038/ncpuro0120

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