"MICROPENIS" AND "SMALL
PENIS": DIAGNOSIS AND TREATMENT
abstract of oral
communication at Congress of the European
Society for Sexual and Impotence Research ESSIR
Congress, in Hamburg, published in International
Journal For Impotence Research. Hamburg, 1 – 4
December 2002
Colpi G.M., Martini P.,
Scroppo F.I., Mancini M., Castiglioni F.
Andrology Service, San Paolo Hospital –
University of Milan, Milan, Italy
“
Micropenis” is used to define a penis less than
2.5 SD long compared to the mean length for age
and sexual development stage, provided that this
organ does not show any other anatomic
anomalies. By “small penis” we mean a penis
having a size objectively within the standard
limits but which is not considered satisfactory
by the subject (“Locker-room syndrome”). This
disorder is included in dysmorphophobia and is
the main reason why some men undergo penile
elongation techniques. Measuring performed with
stretched penis shows a close correlation with
the real length during erection. The mean length
of the flaccid penis in Caucasian post-puberal
male is 8.8 cms; when stretched it is 12.4 cms
(+ 2.7 cms); during erection 12.9 cms. Therefore
we talk about a micropenis when its size is <
6 cms. Medical treatment is limited to
hypogonadic males by increasing serum androgenic
values. Several techniques of penis elongation
exist, which are based on external stretching of
the penis or classic surgery. Surgical
techniques include the subtotal dissection of
the penile suspensory ligament and prepubic
liposuction. Liposculpture is the insertion of
autologuous adipose tissue into the penile
subcutaneous in order to increase the organ
circumference.
Among physiotherapeutic
techniques, our group is making use of the
Andropenis‚ to treat both small penis and penis
curvature due to Peyronie's disease. For “small
penis” our data show a mean increase of the
stretched penis length of 1.8 cms after 4 months
with a daily average use of 6 _ hours; a higher
increase ranging between 2.4 and 3.1 cms was
achieved after longer periods of time (between 7
_ and 9 hours). We applied the same device in
case of Peyronie's disease and we obtained a
mean decrease in the penis curvature of about
40% (from 34.1° + 4.9° to 20.0° + 12.2°) after
three months of treatment. Patient counselling
is at all events essential to have a full
picture of the problem, since a morbid attention
to the size of his own penis might be the
symptom of a more complex psychiatric disorder
where surgery is powerless or may sometimes even
give rise to additional
problems.
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