A male sexual organ that is less than 9. 5 cm in length in an elongated or erect state. The term "micropenis" refers to a penis that, at its maximum elongation, is 2. 5 standard deviations smaller than the average age norm. The presence of a small penis and a 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, a man's reproductive function is disrupted and normal sexual life becomes impossible. The 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 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 caused by a protruding 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:
- study of the hormonal profile,
- Ultrasound of the penis and scrotal organs.
Increasing the size of the small penis is possible with 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, as a result of which they cause the clinical picture of a small penis and, in some cases, infertility. The identified incidence is approximately one case per five hundred newborns, but the real figures are slightly higher. In some guys this syndrome remains undiagnosed because the doctors at the clinic do not have the necessary qualifications and therefore are able to identify only cases of small penis syndrome that have obvious clinical manifestations. To identify all cases, it is necessary to visit the boy both to a pediatrician and to an andrologist-endocrinologist, since if small penis syndrome is diagnosed before the age of 14, the treatment is more effective than that started during puberty.
3-4 year old boys 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. The operation to lower the testicles into the scrotum, where the treatment ends, is not sufficient, since in Kallmann syndrome the formation of the pituitary cells, responsible for the synthesis of hormones that stimulate the production of testosterone, is compromised; in later life this becomes the cause of small penis syndrome. And at the age of 18-25, this problem arises especially clearly, since the young man notices a difference in the development of reproductive organs in himself and his peers, and the treatment of small penis syndrome is associated with great difficulties . An inferiority complex gradually develops: young people withdraw, narrow their social circle and refuse to go to 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 therefore the help of psychiatrists is needed.
In Klinefelter syndrome, a genetic mutation occurs and the gene set contains an additional chromosome responsible for the formation of female sexual characteristics. Men affected by Klinefelter syndrome usually have an asthenic physique, narrow shoulders and small penis syndrome, which is manifested by an 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 affected, although some patients have problems conceiving children. Most patients with Klinefelter syndrome do not consider small penis syndrome to be a disease, as they believe that 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 more effective and the boy does not suffer 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 in old age, it is necessary to carry out penis enlargement operations and long-term social rehabilitation.
When diagnosing and prescribing correction, it should be remembered that the size of the penis 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, 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 the correction will have to be carried out at an older age.
Indications for surgical treatment
Surgical lengthening of the penis is indicated when its dimensions in a calm state are less than 4 cm and in an erect state less than 7 cm. At the same time, men of larger size can also undergo surgical penis enlargement.
The main indications for penis enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic penile reduction and micropenis.
In addition, there are functional disorders such as hidden penis and rectal. Surgery is indicated and if the patient wants to change the appearance of the penis, penile plastic surgery and its aesthetic correction is performed.
The goal of any surgical procedure is to improve the patient's quality of life.
Penis dysmorphophobiawhen a patient with a normal penis size is not satisfied 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,
- hormone therapy
- and plastic surgery.
The earlier treatment is started, the greater 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 in a man both the ability to lead a normal sexual life and reproductive function. If treatment is started in childhood, the possibility of having children remains, since the testes still retain the capacity for spermatogenesis. The best results are achieved with pulsed hormone therapy.
That is, the capabilities that modern andrology has at its disposal are capable of not only completely correcting small penis syndrome, maintaining reproductive function, but also changing the appearance of the penis. Moreover, after the entire complex of treatment, social rehabilitation is practically not necessary.