A male genital organ that is less than 9. 5 cm long when stretched or erect. The term "micropenis" refers to a penis that, when fully stretched, has a size that is 2. 5 standard deviations smaller than the average age norm. The presence of a small penis and micropenis negatively affects male self-esteem and in some casesthe reproductive function and prevents a fulfilling sexual life.
Small penis syndrome is a collective term for diseases in which a man's reproductive function is disrupted due to the size of the penis, making a normal sexual life impossible. Micropenis is a pathology that arose as a result of endocrine disorders during embryogenesis; in other cases of a small penis it is said that the organ is underdeveloped.
For men in our country, the average size of the erect penis is 14 cm, and the lower limit of the norm is considered to be a penis with a length of 9. 5 cm. That is, a penis with a length of less than 9. 5 cm is called a small penis. A true small penis should not be confused with the concept of "false micropenis" - the latter condition occurs in overweight men in whom the visual shortening of the penis is due to an overhanging fold of skin and fat.
Diagnosis of the causes of deviations from the norm
Diagnosis of possible causes of deviations from the norm is carried out by a urologist-andrologist and includes:
- hormone profile study,
- Ultrasound of the penis and scrotal organs.
Enlargement of the small penis is possible using methods of phalloplasty (penile lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of a small penis
If the size of the elongated penis is 2. 5 standard deviations smaller than the average size characteristic of a given age, this condition falls under the term micropenis or micropenia. Today, more than 20 congenital pathologies are known, which are characterized by a violation of the production of sex hormones, thereby causing the clinical picture of a small penis and, in some cases, infertility. The estimated incidence is around one case per five hundred newborn boys, but the actual numbers are slightly higher. In some boys, this syndrome remains undiagnosed because clinicians do not have the necessary qualifications and therefore can only identify cases of small penis syndrome that have obvious clinical manifestations. To identify all cases, it is necessary to examine the boy by both a pediatrician and an andrologist-endocrinologist, because if small penis syndrome is diagnosed before the age of 14, the treatment will be more effective than one in theTreatment started after puberty.
Boys aged 3 to 4 years suffering from Kallmann syndrome are seen by a urologist due to cryptorchidism; With this disease, the testicles do not descend into the scrotum, but are located in the abdominal cavity. Surgery to lower the testicles into the scrotum, where treatment ends, is not enough, since in Kallmann syndrome the formation of pituitary cells responsible for the synthesis of hormones that stimulate testosterone production is impaired; later in life this becomes the cause of small penis syndrome. And between the ages of 18 and 25, this problem becomes particularly noticeable, since the young person notices a difference in the development of the reproductive organs in himself and his peers, and the treatment of small penis syndrome is associated with great difficulties. Little by little, an inferiority complex develops: young men withdraw, narrow their social contacts and refuse to go to gyms and swimming pools. Young people with small penis syndrome avoid dating and any communication with girls and try to choose a profession that does not require frequent verbal contact with people. Isolation and deep, frequent depression are often the cause of organic psychological damage, and then the help of psychiatrists is required.
In Klinefelter syndrome, a gene mutation occurs and the genetic set contains an additional chromosome that is responsible for the development of female sexual characteristics. Men with Klinefelter syndrome usually have an asthenic build, narrow shoulders and small penis syndrome, which is manifested by underdevelopment of the scrotum and a small penis. In this case, insufficient penis length is the consequence of a violation of hormonal regulation in adolescence and childhood. Reproductive function may not be affected, although some patients have problems having children. Most patients with Klinefelter syndrome do not consider small penis syndrome a disease, believing that a small penis is an individual characteristic and therefore there is no reason to see an andrologist.
Diagnosis and treatment of small penis syndrome
It is important to diagnose this syndrome in a timely manner, since treatment is most effective at an early age and the boy does not suffer psychological trauma. Therefore, in addition to being examined by a pediatrician, boys also need to undergo an examination by a urologist. Because when treating small penis syndrome in older age, it is necessary to carry out penis enlargement operations and long-term social rehabilitation.
When diagnosing and prescribing correction, you must remember that penis size depends on both testosterone stimulation and genetic factors. Assessing penis size in childhood is much more difficult because the age category, testicle size and other anthropometric data must be taken into account. For early diagnosis of possible problems with the reproductive system, the child must be regularly examined by an andrologist. Self-diagnosis based on tabular data can lead to the need for correction at an older age.
Indications for surgical treatment
Surgical penis lengthening is indicated if the penis size is less than 4 cm when resting and less than 7 cm when erect. At the same time, men with larger body sizes can also undergo surgical penis lengthening.
The main indications for penis enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic penile reduction and micropenis.
In addition, there are dysfunctions such as the hidden penis and rectum. Surgical intervention is indicated and if the patient wants to change the appearance of the penis, penile plastic and aesthetic correction are performed.
The goal of any surgical procedure is to improve the patient's quality of life.
Penile dysmorphophobiaIf a patient with normal penis size is not satisfied with its appearance or size, this is not a contraindication to surgical treatment. On the contrary, after a small plastic surgery, the patient is completely relieved of complexes and discomfort.
ForCorrection of small penis syndromeresort to methods that combine the following:
- Penis lengthening with an extension device,
- Hormone therapy
- and plastic surgery.
The earlier treatment is started, the higher its effectiveness; After correcting small penis syndrome, psychological problems disappear without the intervention of psychologists and psychiatrists.
However, when treating a small penis, it is important to restore both a man's ability to have a normal sexual life and reproductive function. If the treatment was started in childhood, there is still the possibility of having children because the testicles still have the ability to produce spermatogenesis. The best results are achieved with pulsed hormone therapy.
That is, the skills of modern andrology are able not only to completely correct small penis syndrome while maintaining reproductive function, but also to change the appearance of the penis. In addition, after the entire complex of treatment, social rehabilitation is practically not required.