Male genitalia less than 9. 5 cm in length when stretched or erect. The term "micropenis" refers to a penis whose size at maximum elongation is 2. 5 standard deviations smaller than the average age norm. The presence of a small penis and a micropenis negatively affects a man's self-esteem and, in some cases, reproductive function, and prevents fullsex life.
Small penis syndrome is a collective term for conditions in which, due to the size of the penis, a man's reproductive function is disturbed and a normal sexual life becomes impossible. Micropenis is a pathology that has developed as a result of endocrine disorders occurring during embryogenesis; in other cases, a small penis speaks of the organ's underdevelopment.
In our country, the average size of an erect penis 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 smaller than 9. 5 cm is called small. penis. A real small penis is not to be confused with the concept of a "false micropenis" - the latter condition occurs in obese men, in whom the visual shortening of the penis is defined by an overhanging fold of skin and fat.
Diagnosing the causes of deviations from the norm
The diagnosis of the possible causes of the deviation from the norm is carried out by a urologist-andrologist and includes:
- hormonal profile test,
- Ultrasound of the penis and scrotal organs.
It is possible to increase the size of the small penis with phalloplasty methods (penile lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of small penis
If the size of the elongated penis is 2. 5 standard deviations smaller than the average size for a given age, this condition is referred to as 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 the clinical picture of a small penis and, in some cases, cause infertility. The identified incidence is about one case per five hundred newborn boys, but the real numbers are slightly higher. In some boys, this syndrome is not diagnosed, because the doctors of the clinic do not have the necessary qualifications, and therefore they can only identify those small penis syndromes that have obvious clinical manifestations. In order to identify all cases, the boy should be examined by a pediatrician and an andrologist-endocrinologist, since if the small penis syndrome is diagnosed before the age of 14, then the treatment is more effective than the treatment started at puberty.
3-4-year-old boys with Kallmann syndrome were referred to a urologist for cryptorchidism; in this disease, the testicles do not descend into the scrotum, but are located in the abdominal cavity. Lowering the testicles into the scrotum, where the treatment ends, is not enough, because in Kallmann's syndrome the formation of pituitary cells, which are responsible for the synthesis of hormones that stimulate the production of testosterone, is damaged; later in life, this will be 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 genitals in himself and in his peers, and the treatment of small penis syndrome involves great difficulties. Gradually, an inferiority complex develops: young men withdraw, their social circles narrow, and they 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, frequent depression are often the cause of physical and mental damage, in which case the help of psychiatrists is needed.
In Klinefelter syndrome, a gene mutation occurs and the genetic pool contains an additional chromosome responsible for the development of female sexual characteristics. Men with Klinefelter syndrome usually have an asthenic build, narrow shoulders, and small penis syndrome, which is manifested by underdevelopment of the scrotum and a small penis. In this case, the insufficient length of the penis is the result of a violation of hormonal regulation during adolescence and childhood. Reproductive function may not be affected, although some patients have problems conceiving. 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, and therefore there is no reason to consult an andrologist.
Diagnosis and treatment of small penis syndrome
It is important that this syndrome is diagnosed in time, since treatment started at an early age is the most effective, and the boy is not psychologically traumatized. Therefore, boys should be examined by a urologist in addition to a pediatric examination. Because the treatment of small penis syndrome in older age requires penis enlargement surgeries and long-term social rehabilitation.
When diagnosing and prescribing correction, you must remember that the size of the penis depends on both testosterone stimulation and genetic factors. Determining the size of the penis in childhood is much more difficult, as age, testicle size and other anthropometric data must be taken into account. In order to detect possible problems related to the reproductive system at an early stage, the child should be regularly examined by an andrologist. Self-diagnosis with tabular data can lead to the fact that correction should be carried out at an older age.
Indications for surgical treatment
Surgical lengthening of the penis is recommended if its size is less than 4 cm in a relaxed state and less than 7 cm in an erection, but men with larger sizes can also be surgically lengthened.
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 hidden and rectal penis. Surgical intervention is justified, and if the patient wishes to change the appearance of the penis, then penisplasty and its aesthetic correction are performed.
The goal of all surgical interventions 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 complexes and discomfort.
Becausecorrection of small penis syndromeuses methods that combine:
- penis enlargement with an extension device,
- hormonal therapy
- and plastic surgery.
The earlier the treatment begins, the greater 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 man's ability to have a normal sexual life and reproductive function. If the treatment was started in childhood, there is a possibility of having a child, since the testicles still retain the ability of spermatogenesis. The best results are achieved with pulsating hormone therapy.
In other words, the capabilities of modern andrology are not only able to fully correct small penis syndrome and preserve reproductive function, but also to change the appearance of the penis. In addition, social rehabilitation is practically not required after the entire treatment complex.