Specialties & Diseases > Nephrology & Urology

Patients are asking docs for bigger penises—and one urologist says enhancement procedures now outpace vasectomies

By MDLinx staff

Published April 16, 2025

Key Takeaways

Industry Buzz

"HA fillers are the safest way to enhance girth... It’s become my favorite procedure in the office to do. I actually do more of these than vasectomies." — Urologist Fenwa Famakinwa Milhouse, MD, @drmilhouse

Find more of your peers' perspectives and insights below.

Penile enhancement procedures, particularly those using hyaluronic acid (HA) filler injections, are gaining traction among male patients looking to increase the size of their penis.

Fenwa Famakinwa Milhouse, MD, a urologist based in Chicago, recently shared a video advocating for penile enhancement procedures, noting that HA fillers are the safest way to "enhance girth."

"It’s become my favorite procedure in the office to do. I actually do more of these than vasectomies," she said in an Instagram video. “Once an underground, controversial procedure, penis fillers [and] male enhancement have more than tripled over the last 10 years with 3.5 million performed every year in the United States."

Urologists, in particular, may want to capitalize on the growing trend, but some docs are voicing concerns about the controversial procedure.

The truth behind penile injections

Critics, including board-certified urologist Amy Pearlman, MD, who surveyed 500 patients receiving penile injections over 3 years, have raised significant concerns about the long-term safety of these procedures. ^[]

Filler migration, erectile dysfunction, and cosmetic irregularities are just a few of the potential risks. And while patients in Dr. Pearlman's study didn’t report loss of penile sensation or erectile dysfunction (and no one required an emergency room visit) this doesn’t necessarily mean it's safe for all patients.

“A lot of the perception of penile augmentation comes from studies that use permanent fillers, which can actually require a patient to return to the operating room,” she explained. “But it's a very different intervention. The more research we do in this field, and the more we talk about this very taboo and stigmatized topic, the better we can understand the long-term outcomes.” ^[]

Should urologists embrace this trend?

On one hand, offering HA penile enhancement could cater to a growing market. As aesthetic treatments become more mainstream, urologists could capitalize on a new niche service, increasing patient satisfaction without the need for invasive surgery. On the other hand, the risks and ethical concerns surrounding these procedures cannot be ignored.

For urologists considering offering HA fillers, the key is to balance innovation with caution. Patient selection, proper informed consent, and a solid understanding of potential complications are essential. This isn’t about chasing the latest trend—it’s about ensuring that any procedure performed is in the best interest of the patient’s health and well-being.