Introduction: Aesthetic penile augmentation is considered by the AUA to be investigational and not shown to be safe or efficacious. Despite this, men are increasingly seeking medical solutions to address concerns regarding genital size. YouTube is the second most visited website in the world, and is often an initial source in patients seeking medical information. This study aims to characterize the quality and reliability of YouTube videos on the topic of penile augmentation. Methods: A systematic search using the terms "penis enlargement," "penile augmentation," and "bigger penis” was performed on August 3, 2022. Over 400 YouTube videos were identified and added to a single playlist. After sorting the videos by popularity (views) and removing non-English duplicates and irrelevant videos, we examined the top 100 videos. Measures assessed included basic video characteristics such as likes, number of views, video length, publisher type, and specific augmentation methods discussed. The videos were then evaluated by 2 independent urologists for reliability and quality using a modified DISCERN scoring system and Global Quality Scale (GQS). Both scoring systems are out of a total of 5 points with scores under 3 representing poor reliability or quality respectively. Results: The median total views were 530,612 (IQR 296,565-1,309,596; range 123,478 - 32,914,713). The median DISCERN and GQS scores for all 100 videos were generally poor at 1.75 (IQR 1-2.63) and 2.5 (IQR 1.5-3.5) respectively. A little under half of the videos had a physician present (44.66%). In addition to urologists (41.3%), dermatologists (26.09%) and plastic surgeons (23.91%) combined to represent half of the physicians. DISCERN and GQS scores were significantly higher in videos with physicians compared to those without one (p < 0.001 and p<0.001 respectively). The majority of videos discussed nonsurgical methods of penile augmentation (65.05%) with penile traction devices being the most frequently discussed (19.15%). Only 18% of videos define average penis size or address the topic of penis dysmorphia. In total, videos making claims about penile length gains (n=25) promised a median increase of 7.62 cm (IQR 3.8-11.4). Conclusions: YouTube is home to hundreds of videos about penile augmentation with millions of views, however many of them are unreliable and of poor quality. Videos with physicians and specifically urologists tend to be more reliable, higher quality, and ultimately of greatest use to patients. The majority of videos discuss nonsurgical methods of penile augmentation which may reflect general trends towards minimally invasive methods. Urologists should strive to have more of a presence in this space to ensure patients are appropriately educated and counseled before pursuing potentially harmful treatments. SOURCE OF Funding: None
