Introduction Penile augmentation surgery has become increasingly common though there is no consensus about the management strategy for men with a complaint of small penis. Aim To introduce and evaluate the outcome of a structured management and counseling protocol for patients with a complaint of a small-sized penis. Methods A structured protocol for consultation and management of (physically normal) patients with a complaint of a small penis through a descriptive study comprised of a series of 250 patients. Main Outcome Measures Percentage of patients who elect to undergo penile augmentation surgery. Results Only nine patients (3.6%) chose to seek further surgical intervention. Two had a buried penis, two had true micropenis and five had normal penile size. Conclusions Using a structured management and counseling protocol, most men chose not to undergo penile augmentation surgery, even when offered for free.

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