Erectile dysfunction

• "Prostate cancer is the most common form of cancer in men, affecting one in eight men in their lifetimes.
• According to Dr. Raman, "This image-guided therapy maximizes our ability to kill cancer cells while minimizing collateral damage to the prostate to achieve the ultimate trifecta in prostate cancer treatment: full local cancer control while maintaining urinary continence and potency.
• The latter are the complications of most prostate cancer therapies that patients hate and often result from a lack of precision in treatment monitoring."
• Abstract #135 : Five-year outcomes after MRI-guided transurethral ultrasound ablation (TULSA) of localized prostate cancer.

• In case you’re wondering, the human urethra is a tube that carries urine from the bladder to outside the body.
• Some people find it sexually pleasurable to insert objects – known as sounds, which are typically small glass or metal rods – or even fluid into the urethra.
• Many objects have been used for sounding, however, and that’s one of the reasons the practice is so hazardous.
• The urethra is a narrow outflow tube, usually less than 9mm wide, so squeezing objects into it isn’t usually recommended.
• Megalouretha can lead to retention of objects in the urethra or bladder from clinical examinations such as cervical screening.

Risky business

• It takes several turns to pass through the pelvic floor muscles, prostate and then, if inserted far enough, the bladder.
• Urethral damage exposes the underlying connective tissues which can cause blood in the urine, as well as erectile dysfunction and even bladder rupture.
• Trauma and damage may lead to further narrowing of the urethra in later life which may require medical intervention.

Sounds painful

• But sounding can be highly sexually gratifying for some people.
• The arousal and subsequent stimulation of the erectile tissue of the penis and clitoris usually occurs through one of two mechanisms: psychogenic (images or thoughts) or reflexogenic (touching).
• The reflexogenic pathway is served by nerves which also innervate the lining of the urethra – the dorsal nerve(s) of the penis or clitoris.

Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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• Posts advise that stretching a semi-erect penis could add up to an inch in length and girth by exploiting the body’s repair mechanisms.
• Jelqing is just the latest in a long line of dubious penis enlargement techniques stretching (sorry) back millennia.
• The ancient Greek method of lengthening the foreskin with a kynodesme (dog leash) seems positively mild compared with ancient Indian methods.
• Penis pumps are also used for erectile dysfunction, but unlike some online claims, they don’t lengthen the penis.

Surgical interventions

• Fillers are increasing in popularity, particularly hyaluronic acid (HA) injections.
• HA is popular because it is doesn’t generate an immune response.
• Surgery to cut the suspensory ligament anchoring the penis is the most widely accepted surgical elongation method.
• A recent review concluded that evidence for supporting surgical procedures for penis enlargement is weak and the complications are under-reported.

Not needed, in most cases

• A micropenis, usually diagnosed at birth, is where the penis is 2.5 standard deviations less than the average stretched penis length (2.3 to 2.5cm depending on ethnicity).
• It is typically caused by a deficiency or imbalance of hormones such as testosterone or human chorionic gonadotropin (hCG), or genetics.
• The female vagina is on average 2.5 to 3.8 inches deep, but lengthens during sexual arousal to accommodate a penis longer than this.
• The female genitalia have multiple erogenous structures that can result in orgasm, so penile length isn’t the key characteristic.

A closer look at jelqing

• The top two consist of numerous spaces that are surrounded by smooth muscle, which keeps most blood out of the spaces.
• During an erection, the muscles relax allowing blood to flow in, filling these spaces, and enlarging penile volume.
• While the theory sounds good, smooth muscle cells in the penis don’t respond in the same way skeletal muscle does.
• If jelqing, or any other trend, was really that effective, we would have seen evidence of it in medical journals, and the sale of extra-large underwear would be making the headlines.

Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.