Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
Int J Impot Res. 2022 May;34(4):337-342. doi: 10.1038/s41443-021-00459-y. Epub 2021 Jul 13.
The present study aimed to describe and critically discuss the current evidence regarding the penile girth enhancement procedures for aesthetic purposes. We designed a narrative review of the literature. A comprehensive search in the MEDLINE database was performed. Original articles in English-language, published until March 2021, were selected. A total of 29 studies were included (3 reporting non-invasive approaches, 11 injection therapies, and 15 surgical procedures). The vast majority of articles (26, 89.7%) were not randomized controlled trials, with overall low quality and limited level of evidence. Only 1 (33.3%) paper regarding non-invasive approaches reported a minimal (+0.03 cm) but a significant increase of penile girth (p = 0.034). A low rate (11.2-14.4%) of mild, temporary adverse events and poor-to-moderate patient satisfaction were found. Eight (72.7%) articles concerning injection therapies showed a significant increase in penile girth (p < 0.05). A low rate of mild complications, generally at the injection site, and a high patient satisfaction rate (75-100%) were highlighted. Nine (60%) papers on surgical treatments found a significant increase in penile girth (p < 0.05), while the other 6 (40%) studies reported a generic improvement in penile circumference. Skin necrosis or ulcers, wound infections, or need for reoperation were reported in 8 (53.3%) studies. A high patient satisfaction rate (60-100%) was reported. Our review highlighted the overall positive results of injection procedures, the poor outcomes associated with non-invasive techniques, and the good efficacy and satisfaction with a non-negligible risk of complications in patients undergoing surgical treatments. However, the adverse events are probably largely under-reported and these procedures should still be considered under investigation due to the limited evidence available and the lack of guidelines.
本研究旨在描述和批判性讨论目前关于美容目的的阴茎周径增大手术的证据。我们设计了文献的叙述性综述。在 MEDLINE 数据库中进行了全面搜索。选择了截至 2021 年 3 月发表的英文原始文章。共纳入 29 项研究（3 项报告非侵入性方法，11 项注射疗法，15 项手术）。绝大多数文章（26，89.7%）是非随机对照试验，整体质量低，证据水平有限。只有 1 篇（33.3%）关于非侵入性方法的论文报告了最小（+0.03cm）但显著增加的阴茎周径（p=0.034）。发现轻度、暂时的不良事件发生率较低（11.2-14.4%），患者满意度较差至中等。8 篇（72.7%）关于注射疗法的文章显示阴茎周径显著增加（p<0.05）。轻度并发症发生率低，一般在注射部位，患者满意度高（75-100%）。9 篇（60%）关于手术治疗的论文发现阴茎周径显著增加（p<0.05），而其他 6 篇（40%）研究报告阴茎周长普遍改善。8 项（53.3%）研究报告了皮肤坏死或溃疡、伤口感染或需要再次手术。报告了高患者满意度（60-100%）。我们的综述强调了注射程序的整体积极结果、非侵入性技术相关的不良结果，以及手术治疗患者的良好疗效和满意度，同时并发症风险不容忽视。然而，不良事件可能在很大程度上被低估了，由于现有证据有限且缺乏指南，这些程序仍应被视为在研究中。
