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While penitential manuals listed what was prohibited, trial records documented what people were accused of. Artificial penile nodules are inert objects inserted beneath the skin of the penis to enhance the pleasure of female/male sexual partners during intercourse. Moreover, one of the first treatment options for erectile dysfunction (ED) was detailed in the Kama Sutra, detailing dildos and penis extensions made of wood or reeds tied to the waist. It is probably a representation of a courtesan or entertainer performing a sexually-explicit show.

The growth of this market can be attributed to the increasing use of sex toy products and the rising awareness of sexual health among adolescents &amp