Many devices, prosthetics, medications (both herbal and pharmaceutical), and techniques are used as penis extenders. From penis pumps and stretchers to vibrating prosthetics, from herbal treatments to erectile dysfunction pills, from cosmetic surgeries to manual treatments, the practice of penis extension is approached from a variety of angles. Most of these approaches stimulate blood flow to the penis and attempt to increase the penis's blood capacity by expanding the corpora cavernosa—two "spongy" chambers in the penis that fill with blood during erection.
Penis extenders are typically considered to be mechanical devices that are used to add length and girth to the penis. Most mechanical penis extenders fall into two categories: pumps and stretchers. Penis pumps are hollow cylinders that are inserted over the penis. Using the body to complete the closure, a penis pump creates a vacuum in the tube, elongating and thickening the penis by suction. The pumps themselves are usually operated mechanically or by hand, but they are also available as suction pumps operated by the user's mouth.
Penis stretchers are also typically hollow cylinders, but, unlike pumps, stretchers are built with a ring or other device for securing the head of the penis. The stretcher operates on a system of adjustable rods, cranks, or locking mechanisms that increase the length and pressure of the cylinder, thereby pulling the head of the penis away from the body and stretching it at increasing increments of frequency, duration, and pressure. Widely considered to be the most reliable alternative to cosmetic surgery, penis stretchers are the most expensive of the mechanical extension devices, usually selling for around $400 or more. Web-based sex shops and penis extender product web sites represent the most common and widely used method of purchase, but penis extenders are often also sold in traditional sex shops.
Many mechanical extension devices mimic manual techniques for penis extension. The masturbatory technique called "jelqing," for example, also lengthens and stretches the penis. Jelqing involves stretching the penis with one hand holding the head—typically by placing the thumb and fingers around the base of the head in an "OK" gesture—while "milking" the shaft from its base to the head. The aim of jelqing is to expand the corpora cavernosa by forcing blood into the erectile tissue. In jelqing, the penis is considered to be a muscle, and thus can be expanded through exercise. Other stretches, called "power stretches," purport to lengthen the penis by stretching the ligament in the penis. Similar to the jelq technique and to penis stretchers, power stretches are done by pulling the penis away from the body for extended periods of time. According to Pankaj Relan, studies show that these techniques do not usually succeed in permanently elongating the penis. Other techniques, such as "Kegels," made famous by Dr. Arnold Kegel, are practiced to strengthen the pubococcygeus muscle by squeezing, holding, and releasing this muscle in order to control ejaculation. While Kegels do not technically add length to the penis, they do enable the user to better control ejaculation, thereby allowing him to maintain harder erections for longer periods.
Herbal pills and topical ointments are occasionally used in conjunction with penis extender devices or manual practices. Pills and ointments are typically marketed as methods of increasing blood flow to the penis, augmenting the aims of penis extending devices and techniques. Erectile dysfunction medication, such as Viagra and Cialis, can also be used for penis extension because such medications promote blood flow to the penis for extended periods of time; this method of penis extension, however, is typically viewed as less safe than taking herbal remedies.
Also commonly referred to as penis extenders, prosthetics that are fitted over a man's penis are typically used not only to add length and girth to the penis but also to increase sexual stimulation. Some of these prosthetics, often called "cyberskin" penis sleeves, are fleshy prosthetics worn over the penis. Such sleeves can be purchased at varying lengths and widths. Others, such as studded or shaped latex or silicone penis sleeves, are designed to provide increased genital stimulation to the user's sex partner by stimulating the G-spot, prostate, or vaginal or anal rims with raised studs or angled heads. Additionally, this type of penis extender may also function as a vibrator that can be operated either by the user or, remotely, by the user's partner.
Aside from penis-extending prosthetics, the only surefire method of penis extension is surgery. Penis extension surgeries typically take two different approaches. One approach is to insert a prosthetic into the penis, elongating it, but often making it look permanently half-erect. In other surgeries, ligament is cut, torn, or stretched so that the base of the shaft that runs into the body is freed to move away from the body. This method might add up to an inch and a half to the penis, but usually no more. Penis extension surgery can potentially significantly decrease the sensitivity of the penis, making sex less enjoyable and, in some cases, erection more difficult to achieve.
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Relan, Pankaj. "Does Penis Enlargement Work?" IndiaTimes.com. Available from http://health.indiatimes.com/articleshow/msid-804958,curpg-1.cms.
Jeremy C. Justus