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Men who wore a penile extender every day for six months were able to increase the flaccid length of their viagra cialis online pharmacy pharmacy by up to 32% and their erectile function by up to 36%, according to an independent clinical study published in the March issue of BJU International.

Researchers from San Giovanni Battista Hospital at the University of Turin, Italy, are now suggesting that this treatment could provide a viable alternative to surgery, as the results were significant and patient satisfaction with the technique was high.

"Twenty-one highly motivated patients, with an average age of 47, were enrolled and 16 completed the 12-month study" says consultant urologist Dr Paolo Gontero.

"Having undergone psychosexual counselling, to make sure that the treatment would be beneficial, the men were asked to wear the Andro-Penis device for between four and six hours a day for six months. The device comprises a plastic ring, two dynamic rods that produce the traction and a silicon band to hold the penis in place. The men were told to increase the traction from 600g in month one to up to 1200g in month six. Follow ups were performed in months one, three, six and 12."

Key findings included:

•Men who took part in the study wore the device for an average of five hours in the first month, five hours in the third month and four hours in the sixth month.

•The men's average flaccid penile length was 7.15cm (2.82 inches) at baseline and had increased by 32 per cent to 9.45cm (3.72 inches) in month 12.

•The men's average stretched penile length was 9.62cm (3.79 inches) at baseline and had increased by 18 per cent to 11.32 cm (4.45 inches) in month 12.

•No significant increase in penile girth, which averaged 10.4cm (4.09 inches) at baseline, was reported.

•Average erectile function scores improved by up to 36%, from 19.9 out of 30 at baseline to 27.1 out of 30 at 12 months.

•Four patients discontinued the treatment for four different reasons: pain and penile bruising, satisfactory results after three months, lack of efficacy and inability to follow the protocol. Another was lost to follow-up.

•High satisfaction levels were reported in all categories except penile girth. The average score for overall satisfaction was 2.8 on a scale of zero to four, where four represents the optimal result.

•Flaccid penile length scored 2.31 on a scale of zero to three, where three represents significant improvement. Penile length during erection scored 2.37 out of three and sex life 2.3. Penile girth scored 1.1.

"A number of surgical procedures are available that aim to elongate the shaft of the penis or enlarge the penile girth" says Dr Gontero. "However these have a number of disadvantages, including a lack of standardisation, potential risk of complications and high patient dissatisfaction.

"It should also be pointed out that the majority of men who seek help for a small penis fail to meet the clinical criteria for surgery. For example, only one of the men in our study had a flaccid penis length of less than 4cm and American guidelines strongly discourage surgery if men exceed this measurement. Twelve had dysmorphia (excessive dislike of a body part) and the remaining eight had undergone surgery for curvature of the shaft."

The authors believe that the results are significant.

"Our study showed that the penile extender device produces an effective and durable lengthening of the penis, both in the flaccid and stretched state" concludes Dr Gontero.

"If these results are confirmed by further research, we propose that the device should be used as a first-line treatment option for men seeking a penile lengthening procedure."

Source: Wiley-Blackwell

PI 8:26
LAT 7:00
NYT 6:02
BG untimed
CS 4:42
NYT diagramless untimed

Don't miss Douglas Quenqua's NYT article, "No Puzzle in the Paper? I’m Blank!". It was posted to the website on Saturday and appears in the Sunday Fashion & Style section. The piece is about puzzles getting the axe in print media—the New York Times Magazine won't always include the second Sunday puzzle, the New York Sun folded, the Washington Post dropped its acrostic, the Atlantic Monthly will no longer even publish the Hex cryptics online...please don't make me go on. I don't want to have to list still more puzzle demises. (Sigh.)

Alan Arbesfeld's New York Times crossword, "Links to the Past"

Wow, if you are a native speaker of Modern High Crosswordese, this puzzle can practically fill itself in. Maybe if the TV had been off and my family not talking, I'd have broken the 6-minute mark on this puzzle, and I don't think I've ever come so close on an NYT Sunday puzzle before. It felt like there were more than the usual allotment of such gimmes (which, of course, are probably not gimmes to those who've not dedicated years of study to Modern High Crosswordese), and while they didn't lend extra entertainment value to the puzzle, the "whoo, this crossword is tumbling like a house of cards" speed thrill has its charms. I'm talking about clues like [Indian tourist locale] AGRA, [Former Swedish P.M. Olof ___] PALME, [Pacific capital] APIA, NETTY [Like mesh], and that [Cousin of a raccoon], the COATI. Things that aren't exactly household words unless someone in the household does a boatload of crosswords.

The theme was not too hard to unravel without peeking at the Notepad. Each of the straightforwardly clued theme entries includes a "placement" word, and if you interpret each phrase hyper-literally (as you might in a cryptic crossword or in those tricky crossword clues for the spelled-out names of letters), you'll extract one letter from each one's key word. Those seven letters spell out HISTORY.

23A. The [Boondocks] are the MIDDLE OF NOWHERE, and the middle of the word "nowhere" is H.
34A. [Ambulance destination] is a MEDICAL CENTER. The center of that first word is I.
50A. An [Imam or priest] is a SPIRITUAL LEADER, and the "leader" of that word is an S.
69A. The BEGINNING OF TIME—the letter T—is clued by way of [When the heavens and earth were created].
87A. [Deputy] is the SECOND IN COMMAND, and that second letter is O.
103A. [Week after Christmas] is the END OF DECEMBER. This is the least satisfactory of the theme entries, because "end of December" feels strikingly arbitrary as times of the year go. Here's the R.
118A. BROADWAY CLOSING, or [Lights out in New York City], is the letter Y.

I like how the cryptic-style locator signals are all different—two beginning, two middles, two ends, and one second letter.

On Cruciverb-L, there was a recent discussion about entries like CEE and ESS. The legendary Bob Klahn loves the tricky, hyper-literal clues that go with such answers, while the legendary Merl Reagle interjects that nobody ever uses these spelled-out versions so they oughtn't populate our crosswords. This puzzle's theme kinda splits the difference—the letters are themselves and not the little-used three-letter names for them, and we get the tricky clues, only these tricky clues are found in the grid for a change. It's not the meatiest theme around, but I like how it settles into a neutral ground between the Klahn and Reagle camps and lets us play with hyper-literalism without the "ESS? Really?" eye-rolling.

Without further ado, let's run through some clues:

35D. COED gets a perfect clue: [Like most dorms nowadays]. My husband and I met when we lived across the hall from each other at Carleton. COED is a perfectly fine adjective, but as a noun it's either (a) outdated or (b) used in porn.
5A. [Intelligent, creative sort, supposedly] clues a VIRGO, astrologically. You like the gentle hedging of the "supposedly" in the clue? A friend of mine has sworn off dating VIRGO men owing to their supposed moodiness and incompatibility with her Aquarian nature.
28A. Unusual clue for a VIOLET: [Symbol of modesty]. I approached the answer from the end and had no idea where to go with it. CORSET seemed altogether wrong, and nothing else came to mind. Violets are hardly modest, however—they grow wherever they want to and refuse to leave your garden when instructed.
37A. [Group of genetically related organisms] is a BIOTYPE. Didn't know this one, not even with **OTYPE in place.
48A. [Emulates AZ or T.I.] is RAPS. I've heard of T.I., so this clue was 50% helpful to me. AZ has an album and song called "Doe or Die", but it doesn't appear to be about Bambi.
58A. Man, did I need a lot of crossings to get HEIDI, the [Literary heroine whose best friend is a goatherd].
76A. The AFTON is the ["Sweet" stream in a Burns poem]. No idea how I knew that off **TO*.
80A. BEAN BAG is a great entry. It's a [Noisy but comfy chair].
94A. Ooh, cutting edge! [Tweets, e.g.] clues TEXTS. Most of my tweets are posted from the web, but when I'm out and about, I do text tweets from my phone.
95A. The awkward SRS is clued as [Grandfathers of III's]. I know a guy whose grandfather was not a Sr. but an XXI. The guy's baby son is XXIV. No kidding. A line of same-named descent stretching back a good five centuries!
112A. [Bathroom fixture] is a BIDET. I've never tried one. Do you recommend bidets?
1D. [A mechanic might see it a lot] refers to a real LEMON.
3D. MEDIA BLITZ is an interesting answer. Clued as [Publicity push].
11D. [Choler] is IRE. I'm unreasonably fond of the word "choler," and yet I seldom use it. Must remedy that.
36D. I definitely did not know ANNE [___ Page, woman in "The Merry Wives of Windsor"]. My Shakespeare comedy knowledge involves A Midsummer Night's Dream and maybe one or two others.
46D. [Pleonastic] means REDUNDANT, as in the phrase "ATM machine," where the M means machine.
67D. OFFENSE is [Something to play] when the other side's on defense.
72D. [They may be crunched]? Your ABS. Drop and do 25 crunches, now!
101D, 102D. Aw, OLEO is [Promise, for one], but GREASE doesn't get the same clue. It really could. Instead, it's [Payola, e.g.]. Not to be confused with Mazola.
121D. [Science writer Willy] LEY is not someone I've read, but I reckon I've encountered his name...in crosswords.

Updated Sunday morning:

David Levinson Wilk's syndicated Los Angeles Times Sunday crossword, "Take a Letter"

Alas, I would have enjoyed this theme a lot more if I hadn't just done essentially the same theme—but with an added twist—in the NYT. Here, the hyper-literal theme entries are clued with the letter the answer suggests, rather than the answers being clued straightforwardly and the letters being an add-on. Where Arbesfeld's batch of letters spelled out HISTORY, this one's letters spell out...SACPVEFD. I wish this puzzle had come out a week earlier so I could better appreciate the fun of figuring out these:

23A. [S] is the HEAD OF STATE.
29A. [A] is END OF AN ERA.
34A. [C] is MALCOLM IN THE MIDDLE.
58A. [P] is LEADER OF THE PACK.
66A. [V] is CENTER OF GRAVITY.
85A. [E] is FOREGONE CONCLUSION. This one is terrific—a great phrase to drop into a crossword, and not a tricky/cryptic clue I recall seeing before.
94A. [F] is FALSE START. I had a false start on this one because FALSE FRONT also fit perfectly.
104A. [D] is GRAND FINALE. Perfect to save GRAND FINALE for the last theme entry in the puzzle.

As with the Arbesfeld puzzle, there's a good assortment of positioning words here. Three beginnings (HEAD, LEADER, START), two middles (MIDDLE, CENTER), three ends (END, CONCLUSION, FINALE). None of the theme entries duplicate those in the NYT—there are a zillion such phrases to choose from, I suppose. And while I admired the NYT's extra level of theme action, I'll give the liveliness edge to Levinson Wilk's set of theme answers.

Another echo between these two puzzles: 107A here is [Energetic risk-taking type, so it's said] for ARIES. Hey, it's ZODIAC (31D [Collection of signs]) day!

As for the rest of the fill, PuzzleGirl singled out many of the same words I would've in her L.A. Crossword Confidential post. So read that, but know that I have been to the [Utah ski resort] ALTA so I knew that one.

Merl Reagle's Philadelphia Inquirer puzzle, "Hit It"

Sometimes I'm in the mood for Merl's trademark overcooked puns and sometimes I'm not. This time, I wasn't feelin' it, dawg. This weekend's batch of "Hit It" puns work various hitting utensils into familiar phrases:

23A. ABSENCE OF MALLETS plays on Absence of Malice, a Paul Newman movie. I suppose it was a preexisting phrase before it was a movie title? The clue is [Reason the croquet game was called off?].
38A. An acoustic guitar, one of which resides in my living room, turns into A CUE STICK GUITAR, or [What the pool player started "playing" when his favorite song came on the radio?]. Merl, hon? Ow. This pun hurt.
54A. I had trouble figuring out what THE CLUB COMPARTMENT, or [Storage space in a golfer's car?], played on. The glove compartment.
76A. [Dolls for young tennis players?] are RACQUETY ANN AND ANDY. Ha! Okay, I like this one. It's completely nuts and I like it.
93A. ["___, but we won the game"] clues WE LOST THE PADDLE (battle). Could've avoided the WE dupe with ["___, but won the game"] without losing anything, I think. No question mark in this clue. Which paddle-related game do you suppose it is?
111A. [Messiest game at the Sara Lee company picnic?] is BAT-A-CAKE, BAT-A-CAKE, playing on "pat-a-cake." Oh, the carnage, Please do not pummel the desserts. Unless it's a lemon cake. Go ahead and pummel lemon desserts, but please give me first crack at the chocolate cake, and with a fork, not a bat.

Most unfamiliar word in the grid: 19D is WELTERED, or [Rolled about, as a pig in mud]. My Mac's dictionary tells me this verb means "lie steeped in blood with no help or care" or "move in a turbulent fashion," like a roiling stream. I like this muddy pig application better. 92D is the [Pink Floyd epic] THE WALL—terrific entry. Overall, though, the fill lacked Merl's usual sparkle. Next week will be more to my taste, I'm sure.

Henry Hook's Boston Globe crossword, "Double Ring Ceremony"

Hey, Hubsters—how many weeks back was this puzzle in the newspaper there? Am I still six weeks behind, or have the Across Lite ranks caught up with y'all?

The theme entries are cooked-up two-word phrases in which each word contains RING. For example, 25A's clue is [Caters a fish dinner?] and the answer is BRINGS HERRING. 33D is clued [Outskirts, on "The Simpsons"?]. My kid saw that clue and asked if the answer was SHELBYVILLE. I explained that both words in SPRINGFIELD FRINGE contain a hidden RING. "Huh," he said. "That's confusing." I didn't find it especially confusing, but it also wasn't particularly rewarding. Two theme entries, 27A and 96A, not only are partly stacked with other theme entries, they also cross the Down themers.

Favorite parts: 44A is [Doesn't share], or BOGARTS. I have fond memories of a get-together in Prague at which some "don't bogart that joint, my friend, pass it on over to me" song was playing. Bogarting apparently applies specifically to marijuana cigarettes, but one can certainly request that someone else not bogart the potato chips. 71A's clue, [Some are nothing but air], points towards imaginary GUITARS. I have not witnessed an air guitar competition, but it sounds entertaining.

Weirdest answers: 39A EMESA is an [Ancient Syrian city]. 7D is CABMAN or [Hack], and not a term I ever use for a cabbie/cab driver/taxi driver. 81D is EPERGNE, or [Ornate centerpiece]; I learned this one via crosswords, but it doesn't come up often. At 59A, [Monozygotic] clues ONE-EGG, but I can't say I've seen one-egg used adjectivally at all.

Rich Norris's themeless CrosSynergy "Sunday Challenge"

It seemed like this one was a couple notches harder than the typical "Sunday Challenge" (though still easier than a Saturday NYT).

Hot stuff:

1A. ["I enjoyed this"] clues IT'S BEEN FUN. Do you think there's an intentional mini-theme linking this with its opposite partner in the grid, 69A [Words of gratitude] for MANY THANKS? One might say both when leaving a party.
32A. I am fond of the weirdness of BELEAGUER as a word. This [Vex] synonym derives from a Dutch word, belegeren, meaning "camp around." I find it difficult to type beleagueured (see?) correctly. Beleaguerued. Nope, wrong again. Beleagurued. Wrong a third time. This is what happens when I let my hands type away blithely. 99% of words work out just fine, but this one? Not so much. Slowing down, let's go for beleaguered. There. It takes effort.
63A. APPOMATTOX is a [Historic Civil War town]. I like to pronounce this "uh-POM-uh-tocks" and say "Appomattox o' both your houses!" Yes, I realize that's odd.
32D. BAD APPLES are [Troublemakers], as in the bad apples that spoil the bunch.
34D. The clue, [Shooter's protection], pointed me in any number of directions, but not LENS COVER.
64D. [Pin cushion?] is a solid clue for a wrestling MAT. I've seen the clue before, but it's well worth recycling.

RTS and ACLU aren't clued together but could be—sometimes the ACLU is mentioned in clues for RTS, short for "rights."

At 27A, [Stop holding it in], 4 letters ending in T? Uh, the actual answer, VENT, wasn't my first thought here.

Updated again Sunday afternoon:

Jim Hyres' second Sunday NYT puzzle, a diagramless crossword

This one wasn't too hard to find my way through. I grabbed a piece of scratch paper and started jotting down the first few Across answers, working back and forth with the Down clues. By the fifth row, I hit a width of 17 squares and so could deduce that 1-Across began in the very first square. Ahh, it feels good to transfer answers over to the diagramless grid and know that they're going in the right place—it doesn't always work out so well.

When I filled in 36-Across in the middle of the grid—TONGUE TWISTER, or [It's hard to say]—I read the three longest answers aloud to myself and to my mother. What do YOU'LL BE SORRY (["Not a good idea!"]), LARGER THAN LIFE ([Very imposing]), and TONGUE TWISTER have in common?? Suddenly childhood smacked me in the forehead and I noticed the games at the ends of those phrases. Indeed, the remaining theme answers are STIRS UP TROUBLE ([Is a rabble-rouser]) and RUNNING A RISK ([Not playing it safe]). Trouble is the board game with the noisy Pop-o-matic die in the middle. Risk is the geopolitical board game. Twister...I fear I am now too old to be able to play Twister. Here at home, we have the SpongeBob edition of Life (excuse me, but why is Fry Cook the best-paying career??) and enjoy the turmoil of a round of Sorry. The final Across answer, 69A, is GAMES to tie everything together. Cute theme; the theme is probably much more accessible than the diagramless itself, though as NYT diagramlesses go, this one was pretty easy.

Assorted other clues I liked: 10A ["Uh-uh"] clues NO DICE. You can use dice to play many board games, but I don't think the answer's meant to be thematic here. 23A [Symbol of limpness] is a WET RAG, and I can't say that's an image I see used in online pharmacy and Viagra commercials. [All alternative] pulls double duty as laundry detergent ERA and as quantity SOME. 27D's clue is [You may need to step on it] and I first thought of the GAS pedal, but the answer's a ladder RUNG.