Cosmetic penile enhancement procedures: an SMSNA position statement

Area of Science:

• Sexual Medicine
• Cosmetic Surgery
• Urology

Background:

• Penile cosmetic enhancement procedures have a long history with variable success.
• Historically, these procedures were niche, lacking data and mainstream adoption.
• Recent advancements and discussions in academic congresses highlight novel techniques in penile augmentation.

Purpose of the Study:

• To provide evidence-based recommendations for penile cosmetic enhancement procedures.
• To guide patients and sexual medicine providers on current scientific literature and future research.
• To address injection and surgical techniques for penile lengthening and augmentation.

Main Methods:

• A comprehensive literature review of PubMed from inception to December 2023.
• Inclusion of only invasive therapies (injection/surgery) for penile cosmetic enhancement.
• Categorization of similar therapies and summarization of pertinent data for position statement development.

Main Results:

• Six position statements were issued covering five distinct penile cosmetic enhancement procedures.
• Consensus was reached on injectable soft tissue fillers, ligament division, graft-and-flap, silicone implants, and sliding/slicing techniques.
• Recommendations are based on the current literature regarding risks and benefits of each therapy.

Conclusions:

• The position statements offer evidence-based, expert guidance on penile cosmetic enhancement procedures.
• These recommendations aim to establish best practices for patients and clinicians in 2024.
• Future research is expected to refine and update these consensus opinions on penile augmentation.