A male sexual organ that has a length of less than 9. 5 cm in the reclining or erect state. The term "micropenis" refers to a penis that, at its widest extent, has a size that is 2. 5 standard deviations less than the average norm for age. The presence of a small penis and micropenis negatively affects a man's 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, the reproductive function of a man is disrupted and normal sexual life becomes impossible. Micropenis is a pathology that arose as a result of endocrine disorders during embryogenesis; in other cases of a small penis, they talk about 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, a penis less than 9. 5 cm is called small. the 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 an exaggerated fold of skin and fat.
Diagnosis of the causes of deviations from the norm
The 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 using phalloplasty methods (penile lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of small penis
If the size of the elongated penis is 2. 5 standard deviations less than the average characteristic size of a certain age, this condition falls under the concept of micropenis or micropenis. Today, more than 20 congenital pathologies are known, which are characterized by a violation of the production of sex hormones, as a result of which they cause the clinical appearance of a small penis, and in some cases, infertility. The identified incidence is about one case per five hundred newborn boys, but the true figures are somewhat higher. In some boys, this syndrome remains undiagnosed due to the fact that clinic doctors do not have the necessary qualifications and therefore are able to identify only those cases of small penis syndrome that have obvious clinical manifestations. To identify all cases, it is necessary to examine the boy both by a pediatrician and an andrologist-endocrinologist, since if the small penis syndrome is diagnosed before the age of 14, the treatment is more effective than the treatment started at puberty.
Boys aged 3-4 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 to lower the testicles into the scrotum, where the treatment ends, is not enough, since in Kallmann syndrome the formation of pituitary cells, which are responsible for the synthesis of hormones that stimulate testosterone production, is damaged; in later life this. causes small penis syndrome. And at the age of 18-25, this problem arises especially clearly, since the young man notices a change in the development of the reproductive organs in himself and in his peers, and the treatment of the small penis syndrome is accompanied by great difficulties. An inferiority complex gradually develops: young people become withdrawn, narrow their social circles and refuse to attend gyms and swimming pools. Young men 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 required.
With Klinefelter syndrome, a genetic mutation occurs and the genetic group contains an additional chromosome that is 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 small penis. In this case, the insufficient length of the penis is the result of a violation of hormonal regulation in adolescence and childhood. Reproductive function may not be impaired, although some patients have problems conceiving children. Most patients with Klinefelter's syndrome do not consider small penis syndrome as a disease, since they believe that a small penis is an individual feature, so there is no reason to contact an andrologist.
Diagnosis and treatment of small penis syndrome
It is important that this syndrome is diagnosed in time, since the treatment started at an early age is more effective and the boy does not experience any psychological trauma. Therefore, in addition to the examination by the pediatrician, the boys should also be checked by the urologist. Since in the treatment of small penis syndrome at an older age, it is necessary to perform 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. Estimating the size of the penis in childhood is much more difficult, as it is necessary to take into account the age category, the size of the testicles and other anthropometric data. 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 lengthening of the penis is indicated when its size in a relaxed state is less than 4 cm and in an erect state less than 7 cm. At the same time, even larger men can undergo penis enlargement surgery.
The main indications for penile enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic reduction of the penis and micropenis.
In addition, there are functional disorders such as the hidden penis and the rectal one. Surgical intervention is indicated, and if the patient wants to change the appearance of the penis, then plastic surgery of the penis and its aesthetic correction is performed.
The goal of any surgical intervention is to improve the patient's quality of life.
Penile dysmorphophobiawhen a patient with a normal penis size is not satisfied with its appearance or size, this is not a contraindication for surgical treatment. On the contrary, after a small plastic surgery, the patient is completely free from complexes and worries.
ABOUTcorrection of small penis syndromeuse methods that combine:
- penis enlargement using an extension device,
- hormonal therapy
- and plastic surgery.
The earlier the treatment is started, the higher its effectiveness; After the correction of the small penis syndrome, the psychological problems disappear without the intervention of psychologists and psychiatrists.
But when treating a small penis, it is important to restore the ability to lead a normal sexual life and reproductive function in a man. If the treatment was started in childhood, then the possibility of having children remains, since the testicles still retain the ability of spermatogenesis. The best results are achieved with pulsatile hormone therapy.
That is, the capabilities of modern andrology are capable of not only completely correcting the syndrome of a small penis, while maintaining reproductive function, but also changing the appearance of the penis. Moreover, after the entire complex of treatment, social rehabilitation is practically not required.