Male genitalia less than 9. 5 cm long when extended or erect. The term "micropenis" refers to a penis that is less than 2. 5 standard deviations from the average age norm at its greatest elongation. . The presence of a small penis and a micropenis negatively affects men's self-confidence, and in some cases, reproductive function, and prevents a full sex life.
Small penis syndrome is a collective concept of conditions in which male reproductive function is impaired and normal sexual life is impossible due to the size of the penis. Micropenis, a pathology caused by endocrine disorders during embryogenesis; in other cases of a small penis, they talk about the underdevelopment of the organ.
In our country, the average size of the penis in an erect position for men is 14 cm, and the lower limit of the norm is a penis with a length of 9. 5 cm. That is, a penis below 9. 5 cm is called small. penisA real small penis should not be confused with the concept of "false micropenis" - the latter condition occurs in obese men, where the visual shortening of the penis is determined by excessive folds of skin and fat.
Diagnosis of the causes of deviations from the norm
The diagnosis of the possible causes of deviation from the norm is carried out by a urologist-andrologist and includes the following:
- hormonal profile study,
- Ultrasound of the penis and scrotum.
It is possible to increase the size of the small genital organ using phalloplasty methods (penis extension, ligamentotomy, penile prosthesis, etc. ).
Causes of small penis
If the size of the elongated penis is less than 2. 5 standard deviations from the average size typical for a certain age, this condition refers to the concept of micropenis or micropenis. Today, more than 20 congenital pathologies characterized by a violation of the production of sex hormones are known, as a result of which the clinical picture of a small penis and, in some cases, infertility. The reported incidence is about one case in five hundred newborn boys, but the true numbers are slightly higher. In some boys, this syndrome remains undiagnosed, because clinic doctors do not have the necessary qualifications and therefore can only identify cases of small penis syndrome with obvious clinical manifestations. To identify all cases, the boy should be examined by both a pediatrician and an andrologist-endocrinologist, because if the small penis syndrome is detected before the age of 14, the treatment is more effective than the treatment started in adulthood.
3-4-year-old boys with Kallman's syndrome come to the urologist's attention because of cryptorchidism; with this disease, the testicles do not descend into the scrotum, but are located in the abdominal cavity. One operation is not enough to lower the testicles to the testicle, because in Kallmann's syndrome, the formation of pituitary cells, which are responsible for the synthesis of hormones that stimulate testosterone production, is disturbed; later in life it becomes the cause of small penis syndrome. At the age of 18-25, this problem appears especially clearly, because a young person feels 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. Gradually, an inferiority complex develops: young men become withdrawn, narrow their social circle, refuse to go to gyms and swimming pools. Young men with small penis syndrome avoid meeting girls and any communication and try to choose a profession that does not require frequent verbal contact with people. Isolation and deep, often depression, are often the cause of organic mental damage, and then the help of psychiatrists is required.
With Klinefelter's syndrome, a gene mutation occurs, and the genetic set contains an additional chromosome responsible for the formation of female sexual characteristics. Men with Klinefelter syndrome typically have an asthenic physique, narrow shoulders, and small penis syndrome, which is characterized by underdevelopment of the scrotum and small penis. In this case, the insufficient length of the penis is the result of hormonal imbalance during adolescence and childhood. Although some patients have problems with childbearing, reproductive function may not be impaired. Most patients with Klinefelter's syndrome do not consider small penis syndrome as a disease, because they believe that a small penis is an individual characteristic, so there is no reason to contact an andrologist.
Diagnosis and treatment of small penis syndrome
It is important to detect this syndrome in time, because treatment started at an early age is most effective and the boy does not suffer any psychological trauma. Therefore, boys should be examined by a urologist in addition to a pediatric examination. 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 is important to remember that penis size depends on both testosterone stimulation and genetic factors. It is more difficult to estimate the size of the penis in childhood, because it is necessary to take into account age category, testicle size and other anthropometric data. For early diagnosis of possible problems in the reproductive system, the child should be periodically examined by an andrologist. Self-diagnosis using table data may lead to the need for correction at an older age.
Indications for surgical treatment
Surgical lengthening of the penis is indicated when its size is less than 4 cm in the relaxed position and less than 7 cm in the erect position. At the same time, men of larger size can undergo surgical enlargement of the genital organ.
The main indications for penis enlargement surgery are Peyronie's disease, cavernous fibrosis, post-traumatic penile shrinkage and micropenis.
In addition, there are functional disorders such as hidden and rectal penis. Surgical intervention is indicated, and if the patient wants to change the appearance of the genital organ, 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 dysmorphophobiaIf 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 is completely freed from complications and discomfort.
forcorrection of small penis syndromerefer to connecting methods:
- penis enlargement using an extender,
- hormonal therapy
- and plastic surgery.
The earlier the treatment starts, the higher its effectiveness; After the 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 sexual life and reproductive function in a man. If the treatment started in childhood, the possibility of having a child remains, because the testicles still retain the ability of spermatogenesis. The best results are achieved with pulsed hormonal therapy.
That is, the capabilities of modern andrology are capable not only of completely correcting the small penis syndrome, preserving reproductive function, but also of changing the appearance of the penis. Moreover, social rehabilitation is practically not required after the entire treatment complex.