Hello,

Thanks for your query.

1. To date, the use of cosmetic surgery or phalloplasty to enlarge the penis is highly controversial.
The success rate as well the reliability depends on a number of factors like initial length of the penis, the degree of lengthening achieved, the graft tissue used, the physiological state of the individual, post operative factors like proper reconstruction of blood supply & nerve supply, adequate healing, etc.

2. The size of penis is genetically determined and it does not increase after a certain limit.
But one thing should be known that the size of penis does not determine the potency of an individual.

3. Semen volume as well as sperm production can be enhanced with the help of Nutritional supplements & vitamins like Vit E, Vit C, Vit B complex, Folic acid, Selenium, Zinc, L-Carnitine, etc.

4. The foreskin can be reconstructed by taking a skin flap from any of the donor areas such as leg, chest, arm, etc.

One more thing, kindly do not get influenced by any over the counter medication which claim to increase the size of penis or improve performance...it may be harmful.

Wishing you a Good Health.
Please let me know if I need to clarify further.
Thanks & take care.

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Hello,

Thanks for your follow up query.

1. Regarding the hormonal therapy for topical application, they increase the blood flow to the penis & maintain erection.
They should be used only under the guidance of a Doctor.

2. The success rates of phalloplasty is controversial & depends on a number of factors as mentioned in my previous answer.
The final decision is taken by an Urologist or Plastic surgeon based on complete clinical examination & subsequent investigation reports.

3. Restoration of foreskin is indicated for cosmetic purposes, it does not have any effect on size of penis.
And it can only be done by surgical methods.

4. Tadalafil is pharmacologically a Phosphodiesterase inhibitor, which dilates the blood vessels in the penis, increases the blood flow & maintains the erectile state of penis.
Presence of increased erections on taking the medication & flaccid state on discontinuation can be attributed to improper blood supply in the penile arteries.
Investigations like color Doppler study can be done to detect any organic cause.

5. The reasons for difficulty in maintaining erection can be many such as Hypertension, Diabetes mellitus, Atherosclerosis of the arteries, Neurological problems, Chronic illness, Prolonged intake of drugs, Stress, Smoking, Alcohol, etc.

So, investigations like Complete blood count, estimation of blood pressure & blood sugar levels, lipid profile will be helpful in this regard.

Other than that, you need to make certain modifications in your diet & lifestyle:
1. Have a diet XXXXXXX in fruits, vegetables, fish, nuts & honey.
2. Avoid fast foods & lipid containing diet.
3. Avoid smoking & alcohol
4. Keep away stress, think positive.
5. Exercise regularly & practice meditation.

Hope I have been able to answer your queries.
Kindly let me know if you have any further queries.
Take care.

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