Male genital organ less than 9. 5 cm in length when stretched or erect. The term "micropenis" refers to a penis that, at its greatest elongation, has a size that is 2. 5 standard deviations smaller than the average age norm. The presence of a small penis and a micropenis has a negative effect on male self-esteem, and in some cases on reproductive function, and makes a full sexual life impossible.
Small penis syndrome is a collective term for conditions in which, due to the size of the penis, the reproductive function of a man is impaired and a normal sexual life becomes impossible. Micropenis is a pathology that arose as a result of endocrine disorders during embryogenesis; in other cases, a small penis indicates underdevelopment of the organ.
For men in our country, the average size of an erect penis is 14 cm, and the lower limit of the norm is a penis length of 9. 5 cm, that is, a penis smaller than 9. 5 cm is called a small penis. A true small penis should not 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 determined by excessive folds of skin and fat.
Diagnosis of the cause of deviation from the norm
The 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 scrotum.
Increasing the size of the small penis is possible with phalloplasty methods (penile lengthening, ligamentotomy, penile prosthesis, etc. ).
Causes of small penis
If the size of the enlarged penis is 2. 5 standard deviations smaller than the average size characteristic for a certain age, this condition belongs to the concept of micropenis or micropenis. Today, more than 20 congenital pathologies are known, which are characterized by a violation of the production of sex hormones, which causes the clinical picture of a small penis, and in some cases, infertility. The established incidence is about one case per five hundred newborn boys, but the actual figures are somewhat higher. In some boys, this syndrome remains undiagnosed due to the fact that the doctors of the clinic do not have the necessary qualifications, so they are able to identify only those cases of small penis syndrome that have obvious clinical manifestations. In order to identify all cases, the boy should be examined by both 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 at puberty.
Boys aged 3-4 years who have Kallmann's syndrome come to the eyes of urologists because of cryptorchidism; in this disease, the testicles do not descend into the scrotum, but are located in the abdominal cavity. The operation to lower the testes 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 disturbed, which in later life becomes the cause of small penis syndrome. And at the age of 18-25, this problem appears especially clearly, because a young person notices a difference in the development of 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 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 often become the cause of organic psychological damage, and then the help of a psychiatrist is needed.
In Klinefelter's 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 small penis. In this case, the insufficient length of the penis is the result of 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's syndrome do not consider small penis syndrome to be a disease, because 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, because treatment started at an early age is most effective, and the boy does not experience any psychological trauma. Therefore, in addition to an examination by a pediatrician, boys must also be examined by a urologist. Because in the treatment of small penis syndrome in old age, it is necessary to perform penis enlargement operations and long-term social rehabilitation.
When diagnosing and prescribing correction, you must remember that penis size depends on both testosterone stimulation and genetic factors. Estimating the size of the penis in childhood is much more difficult, because it is necessary to take into account the age category, the size of the testicles and other anthropometric data. For an early diagnosis of possible problems with the reproductive system, the child must periodically be 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 at rest is less than 4 cm, and in erection 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 reduction of the penis 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 penis, plastic surgery of the penis and its aesthetic correction is performed.
The goal of every 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, it is not a contraindication for surgical treatment. On the contrary, after minor plastic surgery, the patient is completely relieved of the complex and discomfort.
Forcorrection of small penis syndromeresort to methods that combine:
- penis lengthening with the help of an extension device,
- hormone therapy
- and plastic surgery.
The earlier treatment is started, the greater 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 the ability to have a normal sexual life and reproductive function in men. If the treatment was started in childhood, then the possibility of giving birth remains, because the testicles still retain the ability of spermatogenesis. The best results are achieved with pulse hormone therapy.
That is, the possibilities that modern andrology has are capable not only of completely correcting the syndrome of a small penis, while maintaining reproductive function, but also of changing the appearance of the penis. Moreover, after the entire complex of treatment, social rehabilitation is practically not required.