Non-invasive and surgical interventions of penile enhancement for aesthetic or therapeutic purposes: a systematic review.

Despite the lack of guidelines, a wide variety of non-invasive and surgical interventions for penile enhancement with aesthetic and therapeutic purposes is available.

To systematically review the literature in order to investigate the efficacy and safety of surgical and non-invasive penile enhancement procedures for aesthetic and therapeutic purposes.

A systematic research investigating penile enhancement procedures was performed using the MEDLINE database. Articles published from January 2010 to December 2019, written in English, including >10 cases, reporting objective length and/or girth outcomes, were included. Studies without primary data and conference abstracts were excluded. The main outcome measure was objective length and/or girth improvement. The review was conducted in accordance with the PRISMA Statement.

Out of 220 unique records, a total of 57 were reviewed. 18 studies assessed interventions for penile enhancement in 1,764 healthy men complaining of small penis. 39 studies investigated 2,587 men with concomitant pathologies consisting mostly of Peyronie's Disease (PD) and Erectile Dysfunction (ED). 25 studies evaluated non-invasive interventions and 32 studies assessed surgical interventions, for a total of 2,192 and 2,159 men, respectively. Non-invasive interventions, including traction therapies and injection of fillers, were safe and mostly efficacious, whereas surgical interventions were associated with minor complications and mostly increased penile dimensions and/or corrected penile curvature. Overall, the quality of studies was low, and standardized criteria to evaluate and report efficacy and safety of procedures, as well as patient satisfaction, were missing.

The quality of the studies on penile enhancement procedures published in the last decade is still low and precluded establishing recommendations based on scientific evidence about the efficacy and safety of the available interventions to increase penile dimensions with aesthetic or therapeutic indication.

BJU international. 2020 Jun 23 [Epub ahead of print]

Javier Romero-Otero, Celeste Manfredi, David Ralph, Daniar Osmonov, Paolo Verze, Fabio Castiglione, Ege Can Serefoglu, Giorgio Bozzini, Borja García-Gómez

Urology Department, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain., Urology Unit, Department of Neurosciences, Reproductive Sciences, and Odontostomatology. University of Naples "Federico II", Naples, Italy., The Institute of Urology, University College London Hospitals, London, UK., Department of Urology, University Hospital Schleswig Holstein, Campus Kiel, Germany., Department of Medicine, Surgery and Dentistry "Scuola MedicaSalernitana",, University of Salerno, Salerno, Italy., Department of Urology, University College London Hospitals NHS Trust, London, UK., Department of Urology, Biruni University School of Medicine, Istanbul, Turkey., Department of Urology, ASST Valle Olona, Busto A. Lombardia, Italy.

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