Amy M. Pearlman, MD, presents “Penile Preservation, Restoration & Enhancement.”
How to cite: Pearlman, Amy. “Penile Preservation, Restoration & Enhancement.” Grand Rounds in Urology. Published September 25, 2025. Accessed Mar 2026. https://grandroundsinurology.com/penile-preservation-restoration-enhancement/
Penile Preservation, Restoration & Enhancement – Summary
In this conversation with Diane K. Newman, DNP, ANP-BC, FAAN, FAUNA, BCB-PMD, Urology and Pelvic Floor Nurse Specialist, University of Pennsylvania, Philadelphia, Pennsylvania, and Adjunct Professor of Surgery Division of Urology, Perelman School of Medicine Emerita, Amy Pearlman, MD, Prime Institute, Coral Gables, Florida, addresses penile preservation, restoration, and enhancement. Dr. Pearlman notes that the American Urological Association (AUA), the Sexual Medicine Society of North America, and the Urology Care Foundation mainly caution against surgical augmentation (e.g., suspensory ligament division, grafting, slicing procedures) due to safety risks and limited data. Devices, however, are under-discussed yet clinically useful. She shares several options and offers instruction for successful use.
Vacuum pumps (penis pumps): Studied post‑prostatectomy, post‑urethroplasty, and in Peyronie’s disease, protocol recommends ~10 minutes/day for 3–6 months, to preserve penile length, improve curvature, and reduce pain. Technique pearls: trim pubic hair, use generous water‑based lubricant (on rim, inside cylinder, and penis), pump slowly with pauses to allow filling, target ~5–8 engorgements/session.
Traction therapy (RestoreXⓇ): This Mayo Clinic–designed traction device has been tested in patients with Peyronie’s, diabetes, and post-prostatectomy. The typical regimen is 30 minutes/day, ≥5 days/week, showing average length gains of ~1–2 cm over 3–6 months. Dynamic spring‑loaded stretch and comfort modifications (makeup pad, wrap, Comfort Grip accessory) improve tolerance. It has not yet been proven beneficial for healthy men, but it is safe and plausible for enhancement.
Erection rings: This tool aids venous occlusion to improve glans engorgement and durability and is helpful for men with loss of rigidity or “soft tip,” including some post‑implant patients. Selection depends on material, fit, and features (base vs. scrotal support, vibration).
Penile sleeves (e.g., Blissful Creations): These customizable external prostheses can restore penetrative intimacy during rehabilitation and provide temporary enhancement. The typical cost is ~ $100–200. These devices enhance experience, rather than fix a problem.
