Vardi · European urology 2008 · systematic review · n=34 studies

A critical analysis of penile enhancement procedures for patients with normal penile size: surgical techniques, success, and complications.

Cited 138 times in the scientific literature.

Level 4 - case-series / case-control

Systematic review consisting predominantly of small case series and observational cohorts

PubMed 18760874 · doi:10.1016/j.eururo.2008.07.080 · record verified 2026-08-27

What was done

Authors conducted a systematic review of MEDLINE (1965 to 2008) evaluating surgical penile enhancement techniques, success, and complications in men with normal penile size. English-language articles describing surgical treatment and outcomes were included, excluding studies with fewer than five cases. Of 176 identified papers, 34 were critically analyzed.

What was found

Penile enhancement surgery generally achieved a 1-2-cm increase in length and a 2.5-cm augmentation in girth. Reported complications included penile deformity, paradoxical shortening, scarring, granuloma formation, material migration, and sexual dysfunction, with disappointing short- and long-term satisfaction across most studies. Overall aggregate complication rates and total participant counts were not reported in the abstract.

Why it matters

This review highlights that aesthetic penile enlargement procedures lack standardized indications and techniques while carrying substantial risks. It supports recommendations that men with normal baseline anatomy be discouraged from undergoing these invasive interventions.

Limits

The underlying evidence base is restricted to small cohort studies with variable methodology, poorly defined outcome measures, and a lack of standardized surgical protocols. The search was limited to English-language MEDLINE records.

Cited by