Male sexual organ that has a length of less than 9. 5 cm when stretched or erect. The term "micropenis" refers to a penis that, at its greatest extent, 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 cases, reproductive function, and prevents a full sex life.
Small penis syndrome is a collective concept of conditions in which, due to the size of the penis, a man's reproductive function is disrupted and normal sex life becomes impossible. Micropenis is a pathology resulting from endocrine disorders during embryogenesis; in other cases of small penis, we speak of underdevelopment of the organ.
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, aPenis less than 9. 5 cm is called a small penis. A real small penis should not be confused with the concept of "false micropenis" - the latter condition occurs in obese men, in whom the visual shortening of the penis is determined by a fold of overhanging skin and fat.
Diagnosis of the causes of deviations from the norm
Diagnosis of possible causes of deviation from the norm is carried out by a urologist-andrologist and includes:
- hormonal profile study,
- Ultrasound of the penis and scrotal organs.
Increasing the size of the small penis is possible thanks to phalloplasty methods (penis lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of a small penis
If the size of the extended penis is 2. 5 standard deviations less than the average size characteristic of a particular age, this condition falls under the concept of micropenis, or micropenia. Today, more than 20 congenital pathologies are known, characterized by a violation of the production of sex hormones, which causes the clinical picture of a small penis and, in some cases, infertility. The identified incidence is approximately one case per five hundred newborn boys, but the actual figures are somewhat higher. In some boys, this syndrome remains undiagnosed because clinical doctors do not have the necessary qualifications and therefore are only able to identify cases of small penis syndrome with obvious clinical manifestations. In order to identify all cases, it is necessary to examine the child both by a pediatrician and by an andrologist-endocrinologist, because if small penis syndrome is diagnosed before the age of 14, treatment ismore effective than that started during puberty.
Boys aged 3 to 4 years with Kallmann syndrome come to the attention of a urologist because of cryptorchidism; with this disease, the testicles do not descend into the scrotum, but are located in the abdominal cavity. An operation aimed at lowering the testicles into the scrotum, where the treatment ends, is not sufficient, because in Kallmann syndrome the formation of pituitary cells, responsible for the synthesis of hormones that stimulate the production of testosterone, is altered; later in life, this operation becomes the cause of small penis syndrome. And at the age of 18-25, this problem arises especially clearly, since the young person notices a difference in the development of the reproductive organs in himself and in his peers, and the treatment of small penis syndrome is associated withgreat difficulties. An inferiority complex gradually develops: young men withdraw into themselves, narrow their social circles and refuse to attend 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 and frequent depression often become the cause of organic mental damage, and then the help of psychiatrists is necessary.
With Klinefelter syndrome, a genetic mutation occurs and the genetic set contains an extra chromosome responsible for the formation of female sexual characteristics. Men with Klinefelter syndrome usually have an asthenic physique, 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 result of a violation of hormonal regulation in adolescence and childhood. Reproductive function may not be impaired, although some patients have difficulty conceiving children. Most patients with Klinefelter syndrome do not consider small penis syndrome a disease, because they believe that a small penis is an individual characteristic and therefore there is no reason to contact an andrologist.
Diagnosis and treatment of small penis syndrome
It is important to diagnose this syndrome in time, because treatment started at an early age is the most effective and the boy does not experience any psychological trauma. Therefore, in addition to examination by a pediatrician, boys should also be examined by a urologist. Because in the treatment of small penis syndrome in old 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, as age range, testicle size and other anthropometric data must be taken into account. For early diagnosis of possible problems with the reproductive system, the child should be periodically examined by an andrologist. Self-diagnosis using tabular data can lead to the fact that correction will have to be carried out at an older age.
Indications for surgical treatment
Surgical penis lengthening is indicated when its size in the calm state is less than 4 cm and in the erect state less than 7 cm. At the same time, taller men can also undergo surgical penis enlargement.
The main indications for penis enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic penis reduction and micropenis.
Added to this are functional disorders such as hidden penis and rectal. Surgical intervention is indicated and if the patient wishes to change the appearance of the penis, then plastic surgery of the penis and its cosmetic correction is carried out.
The goal of any surgical intervention is to improve the patient's quality of life.
Penile dysmorphophobiaWhen a patient with a normal-sized penis is unhappy with its appearance or size, this does not constitute a contraindication to surgical treatment. On the contrary, after a small plastic surgery, the patient completely gets rid of complexes and discomfort.
Forcorrection of small penis syndromeuse methods that combine:
- penis lengthening using an extender device,
- hormonal therapy
- and plastic surgery.
The earlier the treatment is started, the higher its effectiveness; After correction of small penis syndrome, psychological problems disappear without the intervention of psychologists and psychiatrists.
But when treating a small penis, it is important to restore both the ability to lead a normal sex life and reproductive function in a man. If treatment was started in childhood, the possibility of having children remains, because the testicles still retain the capacity for spermatogenesis. The best results are obtained with pulsed hormone therapy.
That is, the capabilities 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. Moreover, after the entire treatment, social rehabilitation is practically not necessary.