A male sexual organ that is less than 9. 5 cm in length when stretched or erect. The term "micropenis" refers to a penis that, at its widest point, has a size that is 2. 5 standard deviations smaller than the age average. The presence of a small penis and micropenis negatively affects male self-esteem and in some cases reproductive function and prevents a full sex life.
Small penis syndrome is a collective concept of conditions in which, due to the size of the penis, the reproductive function of a man is disturbed and normal sex life becomes impossible. Micropenis is a pathology that arose as a result of endocrine disorders during embryogenesis; in other cases of a small penis, they speak of 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 considered a penis with a length of 9. 5 cm. That is, a penis smaller than 9. 5 cm is called a small penis. A real 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
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 scrotal organs.
Increasing the size of the small penis is possible using phalloplasty methods (penile lengthening, ligandotomy, 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 of a certain age, this condition falls under 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, as a result of which they cause 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 true figures are somewhat higher. In some boys, this syndrome remains undiagnosed due to the fact that clinic doctors do not have the necessary qualifications and therefore are able to identify only those cases of small penis syndrome that have obvious clinical manifestations. In order to detect all cases, it is necessary to examine the boy both by a pediatrician and an andrologist-endocrinologist, since if small penis syndrome is diagnosed before the age of 14, treatment is more effective than treatment started atpuberty.
Boys aged 3-4 years who have 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 reduce the testicles in the scrotum, where the treatment ends, is not enough, since in Kallmann syndrome the formation of pituitary cells, which are responsible for the synthesis of hormones that stimulate the production of testosterone, is reduced. becomes the cause of small penis syndrome. And at the age of 18-25, this problem appears especially clearly, as the young man notices a difference in the development of the 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 withdraw, limit their social circles and refuse to attend gyms and swimming pools. Young men with small penis syndrome avoid dating and all 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 mental damage, and then the help of psychiatrists is required.
With Klinefelter syndrome, a gene mutation occurs and the genetic set contains an extra chromosome that is responsible for the formation of female sexual characteristics. Men with Klinefelter syndrome usually have a weak build, 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 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's syndrome do not consider small penis syndrome as a disease, since 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 diagnose this syndrome early, as treatment started at a young age is more effective and the boy does not experience any psychological trauma. Therefore, in addition to being examined by a pediatrician, boys should also be examined by a urologist. Since in the treatment of small penis syndrome in older 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, as it is necessary to take into account the age category, the size of the testicles and other anthropometric data. For the early diagnosis of possible problems with the reproductive system, the child should be periodically examined by an andrologist. Self-diagnosis using table 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 indicated when its size in a relaxed 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 lengthening of the penis.
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 erect penis. Surgery is indicated and if the patient wishes to change the appearance of the penis, then penile plastic surgery and its cosmetic correction is performed.
The goal of any 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, this is not a contraindication for surgical treatment. On the contrary, after small plastic operations the patient is completely relieved of the complexes and discomforts.
Forcorrection of small penis syndromeresort to methods that combine:
- penis lengthening using an extender device,
- hormone therapy
- and plastic surgery.
The earlier 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 both the ability for normal sexual life and reproductive function in a man. If the treatment was started in childhood, then the possibility of childbearing remains, since the testicles still retain the ability of spermatogenesis. The best results are achieved with pulsed hormone therapy.
That is, the possibilities of modern andrology are able not only to completely correct the small penis syndrome, while maintaining reproductive function, but also to change the appearance of the penis. In addition, after the entire treatment complex, social rehabilitation is practically not required.