A male sexual organ that has a length of less than 9. 5 cm when stretched or erect. The term "micropenis" refers to a penis that, at its greatest stretch, 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 disturbed and normal sexual life becomes impossible. The micropenis is a pathology that arises as a result of endocrine disorders during embryogenesis, in other cases of a small penis there is talk 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 with 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 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:
- hormonal profile study,
- Ultrasound of the penis and scrotal organs.
Increasing the size of a small penis is possible using phalloplasty methods (penile lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of a small penis
If the size of the extended penis is 2. 5 standard deviations smaller than the average size characteristic of a given 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, resulting in 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 real numbers are somewhat higher. In some boys, this syndrome remains undiagnosed due to the fact that the clinic's doctors do not have the necessary qualifications and are therefore 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, because if small penis syndrome is diagnosed before the age of 14, treatment is more effective than treatment started during puberty.
Boys aged 3 to 4 years with Kallmann syndrome seek a urologist due to cryptorchidism; In 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, as in Kallmann syndrome the formation of pituitary cells, responsible for the synthesis of hormones that stimulate testosterone production, is impaired; later in life this becomes the cause of small penis syndrome. And in the age group from 18 to 25 years, this problem arises especially clearly, since young people notice a difference in the development of reproductive organs in themselves and their peers, and the treatment of small penis syndrome is associated with great difficulties . An inferiority complex gradually develops: young people become withdrawn, narrow their social circles and refuse to go to 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 and frequent depression often become the cause of organic mental damage, and then the help of psychiatrists is needed.
In Klinefelter syndrome, a genetic mutation occurs and the gene pool contains an additional chromosome that is responsible for the formation of female sexual characteristics. Men with Klinefelter syndrome often have an asthenic physique, narrow shoulders and small penis syndrome, which is manifested by underdevelopment of the scrotum and small penis. In this case, insufficient penis length 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 to be a disease, as they believe that a small penis is an individual characteristic, so there is no reason to consult an andrologist.
Diagnosis and treatment of small penis syndrome
It is important to diagnose this syndrome in time, as treatment started early is more effective and the boy does not suffer any psychological trauma. Therefore, in addition to the pediatrician's examination, boys should also be examined by a urologist. In the treatment of small penis syndrome in older ages, it is necessary to carry out penis enlargement operations and long-term social rehabilitation.
When diagnosing and prescribing correction, it is necessary to remember that the size of the penis depends on both testosterone stimulation and genetic factors. Assessing penis size in childhood is much more difficult, as it is necessary to take into account age group, testicular size 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 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 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 penis lengthening.
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 penis and rectal. Surgical intervention is indicated and if the patient wishes to change the appearance of the penis, penile plastic surgery and aesthetic correction are performed.
The objective of any surgical intervention is to improve the patient's quality of life.
Penile dysmorphophobiaWhen a patient with a normal-sized penis 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.
Forsmall penis syndrome correctionresort to methods that combine:
- lengthening the penis using an extension device,
- hormone therapy
- and plastic surgery.
The sooner the 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 a man's ability to lead a normal sex life and reproductive function. If treatment was started in childhood, the possibility of having children remains, as the testicles still maintain the capacity for spermatogenesis. The best results are obtained with pulsed hormone therapy.
That is, the capabilities that modern andrology possesses are capable of not only completely correcting small penis syndrome, maintaining reproductive function, but also changing the appearance of the penis. In addition, after the entire complex of treatment, social rehabilitation is practically not required.