Dear Dr G,

I read with interest the recent articles you published on penile enlargement and piercing. I was somewhat surprised that you didn’t mention the insertion of beads or pearls, which are well recognised for enhancing the sexual experience for couples.

I’m a thirty-year-old man who is sexually active, and I have an open relationship with my twenty-eight-year-old girlfriend. We communicate openly about our sexual needs and are willing to explore various possibilities in bed.

My girlfriend recently came across some articles discussing the insertion of beads or pearls in the upper part of the penis, which apparently heightens stimulation of the G-spot. I began researching this practice and found that it is common in Southeast Asia and Japan. I found that the use of pearls is popular because their inert properties may help prevent immune rejection.

I would like to take this opportunity to ask Dr G about his views on the use of pearls for sexual pleasure enhancement.

Firstly, how long has the practice of penile beading been around?

Who typically performs the bead insertions?

What are the risks associated with penile pearl insertions?

Lastly, what scientific evidence exists to support the idea that this practice enhances sexual pleasure?

Yours truly,

Pearly Pete

The insertion of beads or other foreign objects beneath the skin of the penis is often referred to as penile implants, subcutaneous nodules, or pearling. This practice has existed for centuries across cultures and social groups. While sometimes such practice is portrayed as a modern body modification trend, its roots extend into traditional rituals, incarceration subcultures, and contemporary sexual experimentation. Despite its persistence, penile bead insertion remains medically controversial due to the significant risks involved.

Historically, penile bead insertion has been documented in parts of Southeast Asia, Japan, and among seafaring communities. Such cultures have beliefs that are associated with rites of passage, masculinity, or sexual prowess. In modern times, for unknown reasons, the practice of penile bead insertion has also been observed more frequently in prison populations. These improvised materials, such as plastic, metal, or glass, are inserted without sterile technique. Only until more recently, elective insertion procedures under sterile techniques, using silicone beads or medical-grade implants, have emerged in some underground or informal cosmetic and medical settings.

Accurately determining the prevalence of penile bead insertion is challenging, as many men do not disclose the practice to healthcare providers unless complications arise. Studies suggest a higher prevalence among incarcerated men and in some areas of East and Southeast Asia, though isolated cases are reported worldwide. In clinical settings, urologists typically encounter the practice incidentally during examinations or when treating complications such as infection or pain. Under such circumstances, patients have no choice but to disclose their thought process regarding the insertion. In other words, the true prevalence of penile beadings will never be known.

Men who undergo penile bead insertion often report perceived sexual benefits, including increased stimulation for a partner, heightened self-confidence, or a sense of uniqueness or control over their body. The perceived benefits are often associated with the location of the beads having the ability to stimulate the G spot in the vagina. Some also describe psychological benefits rather than consistent physical effects, and reported sexual enhancement varies widely between individuals. Importantly, there is no scientific evidence demonstrating consistent improvement in sexual function or satisfaction attributable to penile beads.

From a medical standpoint, the risks associated with penile bead insertion are significant, particularly when the procedure is performed outside of a sterile medical environment. Immediate risks include bleeding, tissue trauma, nerve injury, and severe pain. Infections are common, ranging from localised abscesses to more severe soft-tissue infections that may require surgical drainage or implant removal. Long-term complications can include scarring, chronic inflammation, erectile discomfort, altered sensation, and migration or extrusion of the bead through the skin. In rare but severe cases, complications may interfere with urination or lead to deformity of the penis. Removal of beads is sometimes necessary and can be surgically challenging, especially when scar tissue has formed or when multiple objects are present. The psychological impact should also be considered, as regret, anxiety, or body image concerns may arise following complications.

Penile bead insertion is a practice rooted in cultural tradition and personal choice, but it carries notable medical risks with no established health or sexual benefit. Awareness, accurate information, and access to medical care are critical in reducing harm and ensuring men can make informed decisions about their bodies. Medical organisations and urologists generally advise against penile bead insertion due to the lack of proven benefit and the substantial risk profile. Men considering any form of genital modification are strongly encouraged to seek professional medical advice and to avoid non-medical or improvised procedures. Education and open discussion with healthcare providers are essential, as early intervention can prevent more serious outcomes.

Men contemplating the precious pearly penis as a form for sexual enhancement often put Dr G on the spot for his opinion. His view is “Risking penis with a pearl can potentially turn precious to grey and ulcerous!” On that note, wishing all readers a precious, pearly Christmas!