This is the most commonly sought after treatment throughout the world in sexual medicine. Large number of people visit sexologist to get a bigger organ . This arises out of a misconception that women desire big penis for satisfaction. Many believe that they have to hit the uterus for complete satisfaction. Others assume that people notice the bulge in their crouch while taking bath in the public. Some are so embarrassed that they hesitate to go in public . How much size is normal- Most of these have a normal penis size but suffer due to their misconception. If Stretched Penile Length is equal or more than 2.5 inches, it is normal. Some times , it becomes imperative to increase the dimensions of penis , if there is severe stress to patient, marital discord is present or there is abnormality in the penis.

 

 

 

 

Hypospadias- The urinary opening is present on the underside of penis, instead of being at the tip . The penis may be bent down to make it look very small in both soft and erect state . The patient will complaint of soiling clothes while passing urine . This downward bending is called CHORDAE means it is present since birth . It is treated by surgical correction in 1-3 phases . Results are immediate Hidden Penis or Buried Penis- It is usually found in obese individuals . The penis is buried in the fat of pubic area . I recently saw a gentleman with buried penis who had difficulty in passing urine while warring pent in a public toilet . He didn’t have enough shaft of penis available to pull it out from zip and urinate so there was frequent soiling . As a result , he had to hold urine for long periods. He was treated with removal of extra fat around the base of penis to enable him pull out the penis comfortably for urination. These also make penis longer All others have to be helped by cutting the suspensory ligament of penis and giving regular exercises to shaft for 3-4 months . It may result in gain of up to 1 inch or more but results are highly variable , depends on body composition. Similarly girth can be enhanced by injection of fat taken from your body , The results show soon after surgery but final result may be variable due to reabsorption of fat .

It can be present since birth or early childhood when it becomes more prominent with the onset of puberty . Often people are too obsessed with the size, shape or the curve of their organ. Remember, NO ONE has a perfectly straight penis and it doesn’t matter as well. If you can perform the job of passing urine and intercourse ( that means you should be able to enter vagina and complete sex) , you needn’t worry. A curve of up to 15 degrees in shaft and any deviation to right, left, up or down is normal . Apart from these situations may need assessment . If present since birth , it can be corrected by surgery only and results are very good . but some times one may develop bend after many years of normalcy. One of the conditions responsible for bending is  Peyronie’s Disease.

 

There can be many reasons of developing peyronie’s – Diabetes is commonest . There is repeated injury to the minute blood vessels in penis , resulting in bleeds. It will heal by fibrosis and slowly, patches of fibrosis develop. When this contracts, a curve in penis is seen . Usually it is in upward direction . There can be shortening as well because the stretchability of penis is reduced . It can be first sign of ageing or diabetes . There may be pain on erection associated with low Sex hormone, Erection problems also can be found . Initial complain can be painful erection . Generally pain will subside with time in 6-12 months .

 

During this time, curve may remain stable, increase or be reduced , needing no further treatment. If the bend is bad enough to hinder Vaginal penetration, surgery may be needed Types of surgery – 1- Penile straightening – The aim of surgery is to reduce the bend as much as is needed to have a successful penetrative sex . We never try to make it absolute straight because this is neither possible nor necessary. The results are variable according to the location and size of plaque . One procedure will result in slight shortening of penile length after surgery while other will result in no loss of size but choice depends on many factors. 2- Penile Implant- If it is not successful or surgeon feels it impossible to make it straight, only option left is putting in a Penile implant

Premature Ejaculation is the most common problem in sexually active males . It gives rise to loss of self esteem, marital discord, depression or divorce in some cases. PME is due to many reasons Like hypersensitive penis , reduced levels of serotonin in the spinal centre controlling Ejaculation , anxiety, erection problem . It is difficult to permanently alter the serotonin levels , though relaxation and regular exercise can be helpful . Hypersensitive skin of penis have attracted attention of scientists. There have been attempts to reduce sensitivity permanently. These are still not accepted as a standard mode of treatment by ISSM but extensive trials in Korea have reported good results

 

1- Frenuloplasty- The lower part of glans is having a tag of skin attached so that it can’t be pulled back fully in erect state . This is a normal finding and one needn’t bother about it except when you have Premature Ejaculation, or pain while pulling the skin back in erect state . It is corrected by a surgical procedure where you will be able to take the whole skin back in erect state . In many individuals with Premature Ejaculation, it results in increase of intravaginal latency by 50-70% after a few weeks of surgery . It may be not sufficient to treat your problem fully but can be an aid in severe cases of Premature Ejaculation .

 

2- Glans Enhancement- Here an intern material is injected below the front part of glans so that sensations become less and time increases . It is not practiced in India