"For men who believe size matters  and that their penises dont measure up  success can be found in certain nonsurgical penile lengthening treatments a new study analysis by Italian researchers contends. Concerned that patients were seeking out unproven and potentially dangerous ways of lengthening the penis the researchers examined the medical literature to see whether popular nonsurgical methods had any scientific basis. In a review of five evidencebased surgical studies of  men and six nonsurgical studies of  men published between  and  the researchers found that penile extenders  which stretch the organ over a period of months through traction  were the most effective among noninvasive methods. But one expert cautioned that men are playing with fire if they tinker with their penis size simply for vanitys sake. Dr. Elizabeth Kavaler a urologist at Lenox Hill Hospital in New York City said functional issues resulting from conditions such as birth defects or prostate cancer surgery may warrant penile surgery but such cases are unusual. Its a very fragile organ to begin with Kavaler said and if you start to do all these things to it you can disfigure it... They should leave it alone. Study coauthor Dr. Paolo Gontero said urologists are constantly approached by men concerned about their penis size despite the fact that the majority are average with a flaccid length of  to  inches. However most men complaining of inadequate penile size do have associated sexual problems even if their penile dimensions fall within the normal range  socalled dysmorphophobic penis said Gontero an associate professor of urology at the University of Turin. No study has however specifically addressed the extent and type of sexual bother in this patient category. Dysmorphophobia is a condition consisting of an imaginary flaw in the physical appearance the study noted. Writing in the April issue of the British Journal of Urology International Gontero and his colleagues found that penile extenders work better than techniques such as vacuum devices exercises and Botox injections and that psychological satisfaction is equally as important as any physical changes. A review of surgical techniques showed they increased phallus size an average of about a halfinch to  inch but Gontero cautioned that the safest surgery  which cuts the suspensory ligament of the penis to lengthen it  often yields poor results. On the contrary more complex lengthening procedures are to be considered experimental and potentially dangerous he said.  All procedures aimed to increase the penile girth should be considered unsafe leading to potentially poor cosmetic and functional results Gontero added. I have come across such cases that I had to reoperate in order to remove additive substances injected around the penis. The men studied ranged in age from  to  and were followed between three and  months. More than  of them used penile extenders with six experiencing minor problems such as bruising pain and itching. These devices yielded average flaccid length increases of between . inches and  inch Gontero said and men achieving better results noted their satisfaction. Application of progressive and constant traction forces is a very oldfashioned technique used by the ancestors and currently by some tribal populations to elongate the penis or the neck he said. Gontero noted that cognitive behavioral therapy might help build confidence in some men. Longterm vacuum treatments did not appear effective producing no significant physical changes after six months Gontero said but did provide a degree of psychological satisfaction.  He and his colleagues found no scientific evidence to support penilelengthening exercises.  Dr. E. Douglas Whitehead director of New York Phalloplasty and associate clinical professor of urology at Albert Einstein College of Medicine in New York City said suspensory ligament surgery to increase penis length can be more effective when combined with stretching techniques. The human body even bone can be stretched he said. So stretching the penis when done long enough will work. If anything libido and desire are even better because you look better and feel better about yourself. More information For more about penis size visit Psychology Today http SOURCES Paolo Gontero M.D. associate professor urology University of Turin Italy Elizabeth Kavaler M.D. urologist Lenox Hill Hospital New York City E. Douglas Whitehead M.D. director New York Phalloplasty and associate clinical professor of urology Albert Einstein College of Medicine New York City April  British Journal of Urology International"