I don’t know if here is the right place to post it; if not, I’m sorry- feel free to eliminate this post. I translated some of my posts from Spanish into English. You can access them through my signature as well:
1) An illustrated vocabulary of external anatomy of the penis. 10 illustrations (the last one, about secretions, is on page #3) with a very detailed vocabulary. It’s full of information about the parts of the penis. Some readers said now they really know that what they considered a disease is actually a normal part of the penis. The original version in Spanish is kept in the Library (La biblioteca), with another useful articles.
To evaluate the possible effects of Tribulus terrestris herbal medicine in the erectile dysfunction treatment and to quantify its potential impact on serum testosterone levels.
DESIGN AND METHODS:
Prospective, randomized, double-blind and placebo-controlled study including thirty healthy men selected from 100 patients who presented themselves spontaneously complaining of erectile dysfunction, ≥ 40 years of age, nonsmokers, not undergoing treatment for prostate cancer or erectile dysfunction, no dyslipidemia, no phosphodiesterase inhibitor use, no hormonal manipulation and, if present hypertension and/or diabetes mellitus should be controlled. International Index of Erectile Function (IIEF-5) and serum testosterone were obtained before randomization and after 30 days of study. Patients were randomized into two groups of fifteen subjects each. The study group received 800mg of Tribulus terrestris, divided into two doses per day for thirty days and the control group received placebo administered in the same way.
The groups were statistically equivalent in all aspects evaluated. The mean (SD) age was 60 (9.4) and 62.9 (7.9), P=.36 for intervention and placebo groups, respectively. Before treatment, the intervention group showed mean IIEF-5 of 13.2 (5-21) and mean total testosterone 417.1ng/dl (270.7-548.4ng/dl); the placebo group showed mean IIEF-5 of 11.6 (6-21) and mean total testosterone 442.7ng/dl (301-609.1ng/dl). After treatment, the intervention group showed mean IIEF-5 of 15.3 (5-21) and mean total testosterone 409.3ng/dl (216.9-760.8ng/dl); the placebo group showed mean IIEF-5 of 13.7 (6-21) and mean total testosterone 466.3ng/dl (264.3-934.3ng/dl). The time factor caused statistically significant changes in both groups for IIEF-5 only (P=.0004), however, there was no difference between the two groups (P=.7914).
At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.
To describe the indications and results of techniques to change the appearance of the penis for aesthetic reasons. Provide recommendations concerning cosmetic surgery of the male genitalia.
MATERIAL AND METHODS:
We have selected from Medline Database, articles published between 1990 and 2011. Forty articles have been selected excluding papers reporting populations less than five cases per type of procedure.
There is no consensus on the size below which it is justifiable to accept or attempt to modify the size of the penis. Length of the penis in maximal tension less than 9.5 cm or 10 cm in erection can be considered as an acceptable limit, in a patient who suffers from it.
The assessment of men asking for penile enlargement must include a psychosexological or psychiatric evaluation, looking for a dysmorphophobia or another psychiatric condition. Penile extenders under medical control must be the first-line treatment option for patient seeking penile lenghtening procedure when justified. In case of failure, three techniques can be used alone or in combination: penile lengthening by section of the suspensory ligaments and suprapubic skin advancement, lipectomy of Mons pubis and scrotal webbing section. The results are modest, the rate of complications significant and satisfaction low. Girth enlargement techniques by injection of autologous fat give inconsistent aesthetic results and satisfaction rates are low. All other techniques remain experimental.
Cosmetic surgery of the penis is associated with a high risk of forensic exposure and surgery should be only proposed after a multidisciplinary consensus, followed by a time of reflection given to the patient after full disclosure. Applications for the purpose of reconstruction surgery after trauma or consequences of cancer treatment are justified.
On that topic, a crude “sum-up” video on the subject:
Privacy info: Clicking on this image will enable content from youtube.com
I did 1 jelq, why am I not 12" yet.
Combined sildenafil with vacuum erection device therapy in the management of diabetic men with erectile dysfunction after failure of first-line sildenafil monotherapy
To evaluate the efficacy and safety of combination therapy of sildenafil plus vacuum erection devices in men with type 2 diabetes mellitus with moderate to severe erectile dysfunction who are dissatisfied with the results of using sildenafil alone. METHODS:
The study included 66 diabetes mellitus patients presenting erectile dysfunction for at least 6 months and dissatisfied with the use of 100 mg sildenafil monotherapy. The patients were randomized in two groups. Those in group A (n = 33) were instructed to use a vacuum erection device only, whereas those in group B (n = 33) were treated with combination therapy, including sildenafil 100 mg and a vacuum erection device. Erectile function was evaluated subjectively using the International Index of Erectile Function, Sexual Encounter Profile questionnaire questions 2 and 3 at visit 1 (baseline; study entry), visit 2 (4 weeks after baseline), and visit 3 (12 weeks after baseline; study end). RESULTS:
There were no significant differences in average patient age, duration of diabetes, duration of erectile dysfunction, baseline International Index of Erectile Function scores, hypertension, blood testosterone, smoking and alcohol consumption between two groups. Mean International Index of Erectile Function scores were significantly higher for group B at the 1-month (14.86 ± 2.17 vs 12.41 ± 2.63; P < 0.0001) and 3-months (17.53 ± 2.95 vs 14.29 ± 2.81; P < 0.0001) visits. Men in group B had better successful penetration (73.3% vs 46.6%) and successful intercourse (70% vs 46.6%) at 3 months compared with group A.
Combined use of sildenafil and vacuum erection device therapy significantly enhances erectile function, and it is well tolerated by diabetes mellitus patients not responding to first-line sildenafil alone. http://www.ncbi.nlm.nih.gov/pubmed/25039272
“Urol J. 2014 Jan 4;10(4):1072-8. Evaluating the efficacy of vacuum constrictive device and causes of its failure in impotent patients. Khayyamfar F1, Forootan SK1, Ghasemi H2, Miri SR3, Farhadi E4. Author information Abstract PURPOSE:
This study evaluates the efficacy of Vacuum constrictive device (VCD) and the reasons for its failure. MATERIALS AND METHODS:
In this cross-sectional study, 1500 men with organic erectile dysfunction(ED) were enrolled from July 2003 to July 2010. The treatment efficacy was analyzed using International Index of Erectile Function (IIEF) and questioning patient’s partner regarding the man’s ability to perform vaginal penetration (APVP). The patient’s spouses, who responded negatively to APVP, were evaluated by a midwife for virginity, vaginal atrophy and abstained sex. RESULTS:
Totally 1310 (87.4%) patients attained full erection at first training session, remaining 188 (12.6%) were able to have full erection one week after practicing with VCD, 1419 (94.6%)were able to have successful intercourse and responded positively to APVP, 81 (5.4%) were unable to have intercourse as stated by their wife’s (negative response to APVP) that in 43 (53%),30 (37%), and 8 (9.8%) cases the causes of failures were their wife’s virginity, sex abstinence, and senile vaginal atrophy, respectively. Regarding erectile issue of IIEF scores in patients responded positive to APVP there were significant improvement from the scores of 9.3 ± 3.0 to 27.5 ± 5.0 after treatment (P < .05). CONCLUSION:
With proper training and appropriate devices, VCD could induce sufficient erection in all patients. VCD in patients with virgin wife is ineffective, and female factors affect on success rate in VCD therapy”.
This is interesting also: “Treatment method All Patients were trained by an urologist who was expert in VCD as well as watching an instructional locally pro -duced video for VCD (HAMRAH medical group, Tehran, IRAN). The manufacturer had provided vacuum device cylinders and constrictive rings of different sizes that could be adapted to the patient’s penis sizes.
Furthermore, if patient did not achieve full erection that was considered by the patient and the physician to be unsatisfactory for penetration at the first visit, he was advised to practice with VCD for one week by putting penis inside VCD cylinder, producing negative vacuum pressure until achieving full erection and maintaining it for 20 minutes three times a day without using single constrictive ring. (6,9,10,11,12) “
A. A. Raheem, G. Garaffa, T. A. Raheem, M. Dixon, A. Kayes, N. Christopher and D. Ralph
Department of Urology, St. Peter’s Hospitals and Institute of Urology, London, United Kingdom
BJU Int 2010; Epub ahead of print.
Study Type - Therapy (case series) Level of Evidence 4. Objective: To assess the efficacy of vacuum therapy in mechanically straightening the penile curvature of Peyronie’s disease (PD). Patients and Methods: Modelling of the tunica albuginea has been shown to be possible during penile implant surgery and this principle has been applied as an alternative conservative therapy. In all, 31 patients with PD (mean duration 9.9 months; mean age 51 years, range 24–71) completed the study. Over a 12-week period, the patients used a vacuum device (Osbon ErecAid®, MediPlus, High Wycombe, UK) for 10 min twice daily. The assessment at study entry and at completion after 12 weeks included the International Index of Erectile Function questionnaire, a perceived pain intensity score, stretched penile length measurement and the angle of penile deformity after an intracavernous injection with prostaglandin E1. Results: There was a clinically and statistically significant improvement in penile length, angle of curvature and pain after 12 weeks of using the vacuum pump. Of the 31 patients, 21 had a reduction in the angle of curvature by 5–25 degrees, three had worsening of the curvature and there was no change in the remaining seven. The curvature was corrected surgically in 15 patients while the remaining 16 (51%) were satisfied with the outcome. Conclusion: Vacuum therapy can improve or stabilize the curvature of PD, is safe to use in all stages of the disease, and might reduce the number of patients going on to surgery.
Editorial Comment Vacuum pump therapy appears to be a reasonable option for men with Peyronie’s. I recommend this device for men with Peyronie’s, although I reserve this option for men with Peyronie’s without penile pain.
ABSTRACT: To investigate the anatomy of the ischiocavernosus muscle, bulbospongiosus muscle, and tunica albuginea and to determine their relationships to smooth muscle, which is a key element of penile sinusoids, we performed cadaveric dissection and histologic examinations of 35 adult human male cadavers. The tunica of the corpora cavernosa is a bilayered structure that can be divided into an inner circular layer and an outer longitudinal layer. The outer longitudinal layer is an incomplete coat that is absent between the 5-o’clock and 7-o’clock positions where 2 triangular ligamentous structures form. These structures, termed the ventral thickening, are a continuation of the anterior fibers of the left and right bulbospongiosus muscles. On the dorsal aspect, between the 1-o’clock and 11-o’clock positions, is a region called the dorsal thickening, a radiating aspect of the bilateral ischiocavernosus muscles. In the corpora cavernosa, skeletal muscle contains and supports smooth muscle, which is an essential element in the sinusoids. This relationship plays an important part in the blood vessels’ ability to supply the blood to meet the requirements for erection, whereas in the corpus spongiosum, skeletal muscle partially entraps the smooth muscle to allow ejaculation when erect. In the glans penis, however, the distal ligament, a continuation of the outer longitudinal layer of the tunica, is arranged centrally and acts as a trunk of the glans penis. Without this strong ligament, the glans would be too weak to bear the buckling pressure generated during coitus. A significant difference exists in the thickness of the dorsal thickening, the ventral thickening, and the distal ligament between the potent and impotent groups (P ≤ .01). Together, the anatomic relationships between skeletal muscle and smooth muscle within the human penis explain many physiologic phenomena, such as erection, ejaculation, the intracavernous pressure surge during ejaculation, and the pull-back force against the glans penis during anal constriction. This improvement in the modeling of the anatomic-physiologic relationship between these structures has clinical implications for penile surgeries.
Good illustrations to understand how your penis is made.
This is a good one, so are the previous studies you mentioned. It would be interesting to see if pumping can reverse some forms of ED, long term or mid term.
About the last one:
“The young cadavers (Figure 1) show, unequivocally, a remarkable muscle bulk, whereas elderly subjects sustaining chronic diseases tend to demonstrate a lighter skeletal muscle bulk and slimmer distal ligament (Figure 2C) as well as a thinner tunica albuginea.” This has been suggested many times in the past, so not only do older men recover part of their EQ and lost size, but they also have an easier time gaining (now I wonder about the few who gained from pumping, how old were they?). Of course the study state these guys not only were old but also had had various diseases for a while.
I’m curious to know why they call it the distal ligament ( = ending of the tunica inside the glans) ? Does it imply its structure is like a ligament? And then is the structure the same in the TA and the distal ligament?
In any case the importance of IC muscles (and bc muscles for glans and CS) is very obvious. Sitting all day and not doing any form of squats is a recipe for low EQ. I’d say testosterone also helps maintain healthy muscles function and play a part, but I’m not knowledgeable enough to be anywhere near assertive. Imo this suggests (once more) weak or tensed bc muscles could be a nice explanation for the dreaded deflated glans syndrome.
Last edited by Walter5169 : 12-31-2015 at .
As for the intracavernosal pillars, I wonder what they’re made of and if they would be injured easier than the tunica itself from heavy girth work.
I wondered the same.
I am currently undertaking a thorough statistical analysis of the PE data available on this site.
As soon as I am eligible to start a new thread, I will start one entitled “ten thousand penises”.
I hope that this will be of interest to those who wish to think scientifically about PE.