A male sexual organ that has a length of less than 9. 5 cm in a stretched or erect state. The term "micropenis" refers to a penis that, at its greatest stretch, has a size that is 2. 5 standard deviations less 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 sexual 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 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, a penis 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 obese men, in whom the visual shortening of the penis is determined by an overhanging fold of 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 using 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, which are characterized by a violation of the production of sex hormones, as a result of which they cause the clinical picture 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. In order to identify all cases, it is necessary to examine the boy both by a pediatrician and by an andrologist-endocrinologist, since if small penis syndrome is diagnosed before the age of 14, treatment is more effective than treatment started during puberty.
Boys aged 3-4 years who have Kallmann syndrome come to the attention of a urologist due to 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 treatment ends, is not enough, since in Kallmann syndrome the formation of pituitary cells, which are responsible for the synthesis of hormones that stimulate the production of testosterone, is impaired; in later life this becomes the cause of small penis syndrome. And at the age of 18-25 years, 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 with great difficulties. An inferiority complex gradually develops: young men become withdrawn, 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, frequent depression often become the cause of organic mental damage, and then the help of psychiatrists is required.
With Klinefelter syndrome, a gene mutation occurs and the genetic set 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 a small penis. In this case, 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 syndrome do not consider small penis syndrome 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 to diagnose this syndrome in time, since treatment started at an early age is most effective, and the boy does not experience any psychological trauma. Therefore, in addition to examination by a pediatrician, boys must also be examined by a urologist. Since in the treatment of small penis syndrome at an older age, it is necessary to carry out penis enlargement operations and long-term social rehabilitation.
When diagnosing and prescribing correction, you need to remember that penis size depends on both testosterone stimulation and genetic factors. Assessing the size of the penis in childhood is much more difficult, since it is necessary to take into account the age category, testicular size and other anthropometric data. For early diagnosis of possible problems with the reproductive system, the child must 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 calm state is less than 4 cm and in an erect state less than 7 cm. At the same time, men with larger sizes can also undergo surgical lengthening of the penis.
The main indications for penis enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic penis reduction and micropenis.
In addition, there are functional disorders such as the hidden and rectal penis. Surgical intervention is indicated and if the patient wishes to change the appearance of the penis, then penile plastic surgery and its aesthetic correction are 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 minor plastic surgery the patient completely gets rid of complexes and discomfort.
Forcorrection of small penis syndromeresort to methods that combine:
- penis lengthening using an extension device,
- hormonal therapy
- and plastic surgery.
The earlier 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, then the possibility of having children remains, since the testicles still retain the ability of spermatogenesis. The best results are obtained with pulsed hormonal therapy.
That is, the capabilities that modern andrology has are capable of not only completely correcting small penis syndrome, 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.