Penis Physiotherapy can be applied to three main problems:
1) Small penis congenital or acquired;
2) Erectile dysfunction ;
3) Glans hypersensitivity with praecox ejaculation (PE).
As congenital small penis we mean a penis that when erected do not reach the length deemed to be normal on statistic base and corresponding to about 5,2 Inch. So called “small” penis is a penis harmoniously developed but having reduced measures in confront with median values. In case of very small penis we use the term of micro-penis. In those cases we try to increase penis dimensions by surgical procedures which commonly have poor results. As “achieved small penis” we intend a median size penis which because of an extended fibrosis process or fibro-sclerotic scars development get shorter, lose elasticity and length in flaccid as well as, more markedly, in erected state.
Actually there are worldwide some dozens millions people presenting with real small penis syndrome. Dimensions range on average from 4,4 In to 6 In with a medium value of 5,2 measured on stretched penis by a rigid ruler placed horizontally on the pubic symphysis from its base to the glans tip. Under these measure there is a lot of people who, although not suffering from micropenis condition as such, anyway show sizes below the average corresponding to 4/5 In of stretched penis. This condition, even though not involving functional troubles, implies some psycho discomfort above all because, in my opinion, nowadays are available on web images of men shafts meanly much bigger than the average: those images implies in men as in female people comparisons and disappointed expectations. Taking advantage of psycho vulnerability of these people, have been published on web a lot of sites selling devices and pills and creams promising fast and assured results with elongation of many Inches, results impossible to be get.
Physical methods here proposed get limited but surely achievable results provided that procedures had been correctly and on schedule performed, with patience and tenacity based onto the confidence to obtain with time the desired effects. Any therapy based onto the application of strengths arises from a inborn concept of human mind confirmed by experiences gained over the centuries, i.e. any body structure submitted to appropriate and continuous physical strengths endures small but continuous changings that with the time lead to permanent dimensional variations of the structure itself. Everyone is, you know, aware about tribal practice by some African women of pulling on their own neck some narrow rings : those women with the time are able to modify length of their own necks of up to many inches. And into the neck, you know, is present a hard osseous structure as cervical spine really difficult to be elongated. In this case structures more pliable as, in addition to soft tissues, the intervertebral ligaments have been forced to yield progressively to tensile strengths with increasing distance of vertebral bodies from each other. This example demonstrate as a continuous but low intensity traction is able to produce remarkable anatomic variations. Nowadays should be really difficult to follow procedures like these mainly because man today seems never have enough time for so slow and prolonged practices demanding sacrifices and perseverance. We believe that types and timing of treatments we’re going to propose at the end of current chapter would be compatible with speed and multiplicity of actions and interests of man today.
Between those procedures I want to briefly describe:
- Jelq, a type of penis massage known and practiced in the Arab world in the old days that nowadays can be associated with other procedures. The self-massage of penis must be performed following some specified fundamental rules but above all by dosing the applied stretching strength. It’s advisable that the massage should be preceded by warming that can be made by applying onto the penis some warm water soaked and squeezed nappies; otherwise, in a more fast and simple way, by warm air ejected from a hair dryer. Once we get a good vasodilation we can proceed to lubrication of penis cylinder by applying on it appropriate gel cream and to massage by grabbing it at its base between thumb and index of right hand articulated as a ring around the penis to squeeze the best fluid inside (blood and lymph) from the base towards the glans. In such a way fluid inside works by itself as a powerful dilator of surrounding structures that expand over time. You must consider that the penis, also in a flaccid state, is fully of blood having its main anatomic structure, as corpora cavernosa, consisting of erectile tissue that is indeed a vascular tissue. You must give this massage repeatedly keeping from unintentionally ejaculating as a result of continuous stimulation of so sensitive body parts. This massage must be continued for at least five minutes. It is similar to milking of cows nipples to withdraw milk; and term Jelq means indeed squeeze nipples or milking. In addition to milking you can perform other manipulations with the aim of stretching penis cylinder and suspensory ligament. To doing Stretching, penis must be grabbed between thumb and index/middle finger of right hand around balanic region ( under the glans) and stretched towards ahead and laterally from the right as well as the left side. The penis must be kept so stretched for at least a minute in each described positions. Those tractions must be made by dosing the strength to not give damages. As I will say later those tractions will be more effective after wearing rings for some months. Much useful are exercises of suspensory ligament traction. The suspensory ligament, S.L. ( refer to specific chapter) is a strong structure able to keep the penis anchored to the pubic symphysis so reducing its elastic elongation under traction. By reducing progressively the anchorage strength of this ligament you can promote a bigger extention of penis in traction as well as in erection and allow wider movements of erected penis. The more effective exercise to exert a traction on S.L., according to my experience, consists of grabbing penis cylinder between fingers and palm of your right hand ( or left, if you prefer) standing up onto your knees little bit flexed and passing your right (or left) forearm under the thighs from the back to the front; in this way ,displacing laterally the scrotum by the other hand, you ‘ll be able to exert on grabbed penis a good traction pulling it backwards and holding traction for at least one minute. With the other hand you’ll be able to feel the S.L. stretched under the skin below the pubis arcade and to push and stretch it additionally , enhancing the indirect traction exerted all over the penis. You can employ advantageously both hands in grabbing penis overlapping the right onto the left one to enhance the traction strength. Also this exercise get more advantages if the penis already gained length and girth through previous courses of stretching and ring wearing.
RESULTS. The Jelq get poor results in comparison with time spent. We recommend the exercise for S.L. able to achieve more relevant results.
- Stretching. The penis stretching, according to its best simple modalities of application, is part of Jelq. In this section we want to describe the stretching performed by using some devices. Those devices are the silicon rings and systems known as so named Stretchers designed to the specific aim of penis traction. Stretching is part, according to easiest ways of application, of Jelq. In this section we want to describe the Stretching performed with the help of some devices. Those devices are silicon rings and gears named Stretchers designed for this purpose. Both procedures can be performed by the subject himself at his home even though, especially that with rings, could be better applied by Andrologist physiotherapist who must lay the patient on the tables with reclining backrest that make easier and powerful the traction. Moreover the Andrologist will check on a dynamometer inserted in the traction chain the actual traction strength, so avoiding damages caused by excessive traction power.
The Stretching with rings entails the application of two silicon rings, whose one, more soft, at direct contact with glans, the other more hard to withstand the traction. On this ring must be tied the traction tape anchored at its turn to the patient’s neck always putting in this system a dynamometer to check the traction power. The strength of traction is settled varying the inclination angle of table backrest by its electric control. The patient is held in traction for thirty minutes.
The Stretchers are small devices that must be applied on the penis. They are composed of a ring shaped base leaning on the pubis and of two cylinders containing metal springs able to push ahead the penis strangled by a silicon lace. From stretchers sellers are proposed times of use too much long that should compromise the vascular supply with tissues vitality impairment as touch sensitivity . Furthermore is better stay at home whilst wearing device because is difficult having it applied under the jeans. It’s better, I think, to apply the traction by rings having the right strength and check the traction power by manometers at home.
The Stretching can be usefully employed in association with infiltration therapy to treat IPP in case the penis is straight as slightly bent in erection.
Of course the efficacy of this association therapy is better as much as early has been his onset related to the appearance of first symptoms.
RESULTS. The Stretching get the result of having a longer penis at rest. This effect is real because the elastic fibers present in all compartments of organ loosen and lengthen so making the penis less shrunk in flaccid state. This result is felt and checked from the patient who, after some time, according to the individual feedback, realizes pleasant variation of his own penis. Different matter is real increasing of it, especially in erected state, that take place much more slowly and in limited extent. The efficacy as adjuvant therapy of IPP will depends on his timeliness related to the beginning of disease.