A male genital organ that is 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 smallersmaller 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 also on the reproductive function and hinders a full sexual life.
Small penis syndrome is a collective term for conditions in which, due to the size of the penis, the male's reproductive function 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 the erect penis is 14 cm, and a penis with a length of 9. 5 cm is considered the lower limit of the norm. That is, a penis under 9. 5 cm is called a small penis. A true small penis should not be confused with the term "false micropenis" - the latter condition occurs in obese men, in which the visual shortening of the penis is defined by an overhanging fold 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:
- hormonal profile study,
- Ultrasound of the penis and scrotal organs.
Increasing the size of the small penis is possible with the help of 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 typical for 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 established frequency is about one case in five hundred newborn boys, but the real figures are slightly higher. In some boys, this syndrome remains undiagnosed due to the fact that clinical doctors do not have the necessary qualifications and therefore can identify only those cases of small penis syndrome that have obvious clinical manifestations. In order to identify all cases, it is necessary to examine the boy both by a pediatrician and an andrologist-endocrinologist, because if the small penis syndrome is diagnosed before the age of 14, the treatment is more effective than the treatment that started during puberty.
Boys aged 3-4 years who have Kallmann syndrome come to the attention of a urologist 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 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 disturbed; at a later age this becomes the cause of small penis syndrome. And at the age of 18-25, this problem arises especially clearly, because the young man notices a difference in the development of the reproductive organs in himself and in his peers, and the treatment of the small penis syndrome is associated with great difficulties. An inferiority complex gradually develops: young men close in on themselves, narrow their social circles, refuse to visit 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, frequent depression often become the cause of organic mental disabilities, and then the help of psychiatrists is needed.
In Klinefelter 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 a 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, because they believe that a small penis is an individual feature, so there is no reason to contact 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 psychological trauma. Therefore, in addition to an examination by a pediatrician, boys should also be examined by a urologist. Because in the treatment of small penis syndrome in older age, it is necessary to perform operations for penis enlargement 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, since it is necessary to take into account the age category, the size of the testicles 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 can lead to the fact that the 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 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 penile 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 wishes to change the appearance of the penis, 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 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 a mild plastic surgery, the patient completely gets rid of the complexes and discomfort.
Forcorrection of small penis syndromeresort to methods that combine:
- penis enlargement using an extension device,
- hormone therapy
- and plastic surgery.
The earlier the treatment begins, the higher its effectiveness; After correction of the small penis syndrome, psychological problems disappear without the intervention of psychologists and psychiatrists.
But in the treatment of a small penis, it is important to restore both the ability to lead a normal sexual life and the reproductive function of the man. If the treatment was started in childhood, then the possibility of having children remains, since the testicles still retain the ability to spermatogenesis. The best results are obtained with pulse hormone therapy.
That is, the possibilities that modern andrology has 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, social rehabilitation is practically not required after the entire complex of treatment.