Micropenis is a term for describing a small human penis size, with a penile length of nine or less centimeters (about 3,5 inches). Usually the condition can be recognized shortly after birth (penile length of less than 2 cm). The term is most often used medically when the rest of the penis, scrotum, and perineum is well-formed. About 0,5 % of the human population suffer from this disease.
Criteria
A stretched penis smaller by at least 2,5 standard deviations than the mean penis size is characterized as a micropenis.
Diagnosis of micropenis usually made by physical examination, athough you can do it by yourself by properly measuring your penis. In the case of the children diagnosis usually occurs a little time after birth. The child may then be referred to several specialists including a pediatric urologist (a physician who specializes in the in disorders and care of the urinary tract and the male genital tract) and a pediatric endocrinologist (a physician who specializes in hormones).
Causes
Micropenis is a hormonal problem that takes place sometime after 14 weeks gestation when the penis has already formed. Micropenis can occur alone, but usually occurs in combination with other, usually hormone, disorders. Hormone disorders that cause an abnormal level of hormones which are involved in development of the sexual organs may be seen in combination with micropenis. Of the abnormal conditions associated with micropenis, most are conditions of reduced prenatal androgen production or effect. Examples include abnormal testicular development (testicular dysgenesis, Klinefelter syndrome, Leydig cell hypoplasia), specific defects of testosterone or dihydrotestosterone synthesis (17,20-lyase deficiency, 5α-reductase deficiency), androgen insensitivity syndromes, inadequate pituitary stimulation (gonadotropin deficiency) or other forms of congenital hypogonadism. Micropenis can also occur as part of many genetic malformation syndromes not involving the sex chromosomes. It sometimes is a sign of congenital growth hormone deficiency or congenital hypopituitarism. Finally, several Homeobox genes have been identified which affects penis and digit size without detectable hormone abnormalities.
Treatment
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Until now there is no real treatment for micropenis, especially for some rare cases that the penis is extremely small (less than 5 cm), although there are some methods that might help the condition a little.
If the condition is diagnosed in childhood a hormone therapy might be suggested to stimulate penile growth based on :
-the child's age, overall health, and medical history
-the extent of the condition
-your child's tolerance for specific medications, procedures, or therapies
-expectations for the course of the condition
If the penis grows during a 3 month test period of testosterone, there is a good chance that the person will enjoy a full grown penis and a normal sex life in adulthood.
A variety of surgical methods have been suggested and performed for penis enlargement without much of a success and as a result they are not widely adopted and rarely performed in childhood. There are reports of unsuccessful surgeries that actually resulted in even smaller penises !
Sex Reassignment as a solution of micropenis in the past
In the past sex reassignment procedure was suggested to people having micropenis but this practice rarely occurs today and only for really extreme cases of micropenis. This practice was held after the hormone therapy failed. The boy would then undergo a sex reassignment surgery for the testicles to be removed and a technical vagina would then be formed. It would also receive various mainly female hormones so that a more female body would be achieved.
That was done based on three beliefs that are under serious doubt today:
a) gender identity and sex differences were solely a matter of social learning rather than biology.
b) a male with a penis too small to put into a vagina would be unlikely to find a satisfactory social and sexual place in society.
c) functionally acceptable vagina could be constructed surgically.
The center most known for this approach (Johns Hopkins Hospital) performed twelve such reassignments between 1960 and 1980. By the mid-1990s reassignment was less often offered, and all three premises had been challenged. Former subjects of such surgery, vocally dissatisfied with adult outcome, played a large part in discouraging this practice. As a result, sexual reassignment is rarely performed today for severe micropenis.
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