The best way to maximize penis size is to maximize your personal health. Four types of standard treatment are used: Would you like to make it the primary and merge this question into it? I think is very good to do this workout. If all of the penis is removed, it is a total penectomy. Douglawi A, Masterson TA. They gradually grow laterally along the surface and can cover the entire glans and prepuce before invading the corpora and shaft of the penis.
#2. THUMB STRETCHER
Information on presence of phimosis often goes unrecorded in underdeveloped countries, and epidemiologic data are lacking. Circumcision has been well established as an effective prophylactic measure for penile cancer. Data from most large series have demonstrated that penile cancer is almost never observed in individuals who are circumcised in the neonatal period.
The disease is found more frequently when circumcision is delayed until puberty. Adult circumcision offers little or no protection. No firm evidence indicates that smegma acts as a carcinogen, although this belief is widely held. The role of viral infection continues to be studied.
Both penile cancer in men and cervical cancer in women have been associated with human papillomavirus HPV infection. In women whose sexual partners had penile cancer, the prevalence of cervical cancer is increased 3- to 8-fold.
Whether these viruses are involved with causation of the cancer or are found as saprophytes has not been determined. No data have indicated that herpes viral infections cause penile cancer. Madsen et al studied a population that included 71 patients with invasive or in situ squamous cell carcinoma, 86 prostate cancer controls, and men as population controls. Risk factors included early and high sexual activity, the lifetime number of sexual partners, the number of sexual partners prior to age 20 years, age at first occurrence of intercourse, penile-oral sex, a history of anogenital warts, and never having used condoms.
A history of phimosis and priapism occurring more than 5 years prior to diagnosis were also significant risk factors. Cigarette smoking and chewing tobacco are also considered to be a risk factors. Harish and Ravi reported that the risk for those smoking more than 10 cigarettes a day was 2. The combination of chewing tobacco and cigarette smoking raised the risk to 3. Penile trauma, usually consisting of small tears or abrasions involving the prepuce, and a history of chronic balanitis that occurred more than 2 years prior to diagnosis had an odds ratio of 23 for carcinoma in situ and 4.
Hellberg et al reported that multiple episodes of balanitis had a relative risk of 9. Abnormalities considered to be nonmalignant include cutaneous horns , pseudoepitheliomatous keratotic and micaceous balanitis, balanitis xerotica obliterans , giant condyloma, and bowenoid papulosis. When carcinoma in situ CIS occurs on the glans, it is termed erythroplasia of Queyrat ; however, when it occurs on the follicle-bearing skin of the shaft, it is termed Bowen disease.
CIS can also develop in the tissue around the urethral meatus and spread down the urethra. These lesions have a red to red-brown appearance and generally have an irregular border. Suspicious lesions should prompt a biopsy to establish a diagnosis. According to SEER data, the proportion of men presenting annually with CIS has tended to increase, although the number of men with localized disease has decreased.
Older age at diagnosis was associated with a higher stage of disease. The mean time until death from cancer was Penile cancers usually begin as small lesions on the glans or prepuce.
They range from white-grey, irregular exophytic to reddish flat and ulcerated endophytic masses. They gradually grow laterally along the surface and can cover the entire glans and prepuce before invading the corpora and shaft of the penis. The more extensive the lesion, the greater the possibility of local invasion and nodal metastasis.
Penile cancers may be papillary and exophytic or flat and ulcerative. Untreated, penile autoamputation can occur. The growth rates of the papillary and ulcerative lesions are similar, but the flat ulcerative lesions tend to metastasize to the lymph nodes earlier and are therefore associated with a lower 5-year survival rate. The Buck fascia, which surrounds the corpora, acts as a temporary barrier. Eventually, the cancer penetrates the Buck fascia and the tunica albuginea, where the cancer has access to the vasculature and from which systemic spread is possible.
Metastasis to the femoral and inguinal lymph nodes is the earliest path for tumor dissemination. The lymphatics of the prepuce join with those from the shaft. These drain into the superficial inguinal nodes. Because of lymphatic crossover, cancer cells have access to lymph nodes in both inguinal areas. The lymphatics of the glans follow a different path and join those draining the corpora.
A circular band of lymphatics that drains to the superficial nodes is located at the base of the penis and can extend to both the superficial and deep pelvic lymph nodes. The superficial inguinal nodes drain to the deep inguinal nodes, which are beneath the fascia lata.
From here, drainage is to the pelvic nodes. Multiple cross connections exist at all levels, permitting bilateral penile lymphatic drainage. Untreated metastatic enlargement of the regional nodes leads to skin necrosis, chronic infection, and, eventually, death from sepsis or hemorrhage secondary to erosion into the femoral vessels.
Clinically apparent distant metastases to the lung, liver, bone, or brain are unusual until late in the disease course, often after the primary disease has been treated. Distant metastases are usually associated with regional node involvement. Microscopically, the tumors vary from well-differentiated keratinizing tumors to solid anaplastic carcinomas with scant keratinization.
Most tumors are highly keratinized and are of moderate differentiation. Poorly differentiated carcinomas have variable amounts of spindle cell, giant cell, solid, acantholytic, clear cell, small cell, warty, basaloid, or glandular components. Penile carcinoma follows a relentless and progressive course that proves to be fatal in most untreated patients within 2 years.
Spontaneous remission has not been reported. Typical presentations of penile cancer include a lesion that has failed to heal, a subtle induration in the skin, a small excrescence, a papule, a pustule, a warty growth, a large exophytic growth, or a reddened area on the glans. The malignancy may appear as a shallow erosion or a deep ulceration with rolled edges.
Because most patients with penile cancer are uncircumcised, they may have a phimosis that obscures the tumor and allows it to grow undetected. Many men do not seek medical attention until the cancer has eroded through the prepuce and has become malodorous because of infection and necrosis. Few symptoms are associated with the development of penile cancer. Even after significant local tissue destruction, pain is uncommon.
Patients with advanced metastatic cancer may report weakness, weight loss, and fatigue; the penile lesion may bleed. The presence of a nonhealing penile lesion usually prompts the patient to visit a physician. While carcinoma may manifest as a hyperemic patch on the glans that is characteristic of erythroplasia of Queyrat or as an ulcerated growth on the inner surface of the prepuce, the differential diagnoses include benign and premalignant lesions.
Penile lesions can be categorized as benign, premalignant, or malignant neoplasms. Benign lesions include pearly penile papules , hirsute papillomas, and coronal papillae. These lesions do not require treatment and are usually found on the glans in uncircumcised males.
Rashes, ulcerations from irritation, and allergic reactions or infections must be considered. Some histologically benign lesions are potentially malignant premalignant or have been associated with the presence of squamous cell carcinoma.
The most common is balanitis xerotica obliterans. This is a variation of lichen sclerosus et atrophicus and manifests as a white patch on the prepuce or glans, where it usually involves the urethral meatus. This can produce severe cicatrization, leading to obstruction of the urethra.
Leukoplakia manifests as solitary plaque or multiple whitish plaques, which often involve the meatus. Leukoplakia has been associated with squamous cell carcinoma. Viral lesions include condyloma acuminata , which are soft papillomatous growths. They are also known as venereal warts and have a predilection for the genital and perineal regions. These lesions are usually sexually transmitted and are caused by HPV. Viral types 6, 11, 42, and 44 are associated with low-grade dysplasia.
Types 16, 18, 31, 33, 35, and 39 are associated with neoplastic changes. De Paula et al studied the presence of koilocytosis, which is a feature of productive HPV infection and is characterized by large halos around cell nuclei. They found that the presence of koilocytosis correlated with Jackson stage and grade but not with nodal disease or survival.
Lichen sclerosus, also known as balanitis xerotica obliterans, is a chronic lymphocyte-mediated skin disease that can develop on any cutaneous surface and has been associated with squamous cell carcinoma of the penis. Biopsy of the lesion should be obtained prior to initiating therapy. A direct causative link between these entities has not been established, but the presence of a chronic inflammatory lesion is thought to promote the development of many types of cancers.
Kaposi sarcoma manifests as a cutaneous neovascular lesion that is raised, usually painful, and often ulcerated with a bluish discoloration. Patients with AIDS are predisposed to develop this condition. Malignant carcinomas include variants of squamous cell carcinoma such as CIS, erythroplasia of Queyrat, or Bowen disease. The diagnosis depends on their appearance and the site of origin. Erythroplasia involves the glans, prepuce, or penile shaft, while similar lesions on the remainder of the genitalia and perineum are termed Bowen disease.
Regardless of the terminology and clinical presentation, these are carcinomas with the same malignant potential; biopsies should be performed, and the carcinoma should be staged and treated. Indications for therapy and therapeutic options depend on the histologic diagnosis of cancer established based on biopsy findings, the location and size of the tumor, and the presence or absence of palpable inguinal lymphadenopathy. All patients with penile cancer require therapy because spontaneous regression does not occur and, untreated, the cancer ultimately causes death.
Rippentrop et al studied the surgical therapy status among the men identified in the SEER database. Surgical therapy was recorded in patients, of whom Excisional biopsy was performed in Of those undergoing surgery, The anatomy of the penis has important implications for the diagnosis and treatment of penile cancer. Embryologically, the 3 erectile bodies of the penis arise from the paired genital tubercles, which give rise to the corpora cavernosa, the caudal portion of the urogenital sinus that creates the corpora spongiosum, and the paired urethral folds, which join in the midline.
For purposes of description, the penis may be divided into the root, which is located within the superficial perineal pouch and is the primary fixation point; the body, which contains the 3 corpora and the overlying tissues; and the glans, which sits as a cap on the corpora cavernosa but is a part of the corpora spongiosa.
The superficial fascia is continuous with dartos fascia posteriorly and with the Scarpa and Camper fascia anteriorly. The superficial fascia consists of a single layer with loose connections to the overlying skin. The corpora are covered by a layer of dense fibrous tissue called the tunica albuginea. The corpora cavernosa are incompletely separated by the septum penis, a thin layer of fibrous tissue continuous with the tunica albuginea.
The fascia overlying the corpora cavernosa blends with the fascia of the urogenital diaphragm. The erectile tissue within the corpora is composed of a spongelike network of endothelium-lined sinusoidal spaces. Incidence trends in primary malignant penile cancer. No major medical organization approves of these surgeries. Some guys opt to travel to other countries for treatments that aren't approved in the U.
If that thought has crossed your mind, slow down -- it's time to have a frank talk with your doctor about the risks you'd be taking. The side effects of lengthening surgeries are numerous and include infections, nerve damage , reduced sensitivity, and difficulty getting an erection. Perhaps most disturbing, scarring can leave you with a penis that's shorter than what you started with. Widening the penis is even more controversial. Side effects can be unsightly -- a lumpy, bumpy, uneven penis.
The few studies that have been done aren't encouraging. Half went on to get more surgery. Wishing you were a little bigger is common. If it's becoming a fixation, stop and think before you do something rash.
Talking to a doctor or a therapist can help. Research has found that when a doctor honestly reassures a guy that his penis is average-sized, he is likely to stop searching for surgery. Ian Kerner, a sex counselor in New York, says that the imagined glories of a gargantuan penis are not all they're cracked up to be.
A quest for a bigger penis could leave you with a lumpy, bruised, discolored, thickened, painful, dysfunctional member. Not to mention a drained bank account. Does risking the inches you have for the hope of an extra half inch make sense? Do you wish you were bigger? Almost certainly, the answer is yes. How Small Is a Small Penis? Think you're smaller than average? Weight Loss There is one safe and effective method for getting a larger-looking penis: Pills, Creams, and Devices What else is there?
Here's a rundown of some unproven options to increase penis size. This is a cylinder that sucks out air. You stick your penis in and the resulting vacuum draws extra blood into it, making it erect and a little bigger. You then clamp off the penis with a tight ring -- like a tourniquet -- to keep the blood from leaking back into your body. In boys, it is difficult to know exactly when puberty is coming. There are changes that happen, but they happen gradually and over a period of time, rather than as a single event.
While each male adolescent is different, the following are average ages when puberty changes may happen:. Girls also experience puberty as a sequence of events, but their pubertal changes usually begin before boys of the same age. Each girl is different and may progress through these changes differently.
The following are average ages when puberty changes may happen:. There are specific stages of development that both boys and girls go through when developing secondary sexual characteristics. These are the physical characteristics of males and females that are not involved in reproduction, such as voice changes, body shape, pubic hair distribution, and facial hair. The following is a brief overview of the changes that happen:.
In boys, the initial puberty change is the enlargement of the scrotum and testes. At this point, the penis does not enlarge. Then, as the testes and scrotum continue to enlarge, the penis gets longer. Next, the penis will continue to grow in both size and length.
In girls, the initial puberty change is the development of breast buds. This is when the breast and nipple elevate. The areola dark area of skin that surrounds the nipple of the breast increases in size at this time.
The breasts then continue to enlarge. Eventually, the nipples and the areolas will elevate again.