Micro Penis
Micropenis can have a variety of causes. Since it is defined statistically, a large proportion of males with micropenis are simply normal but in the lowest percentile of normal size. As for many other conditions, the term "idiopathic" is often used when a cause cannot be determined.
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, 5a-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, a gene (HOX9) has been identified which affects penis and digit size without detectable hormone abnormalities.
Pediatric endocrinologists are usually the physicians to whom these boys are referred. After evaluation to detect any of the conditions described above, micropenis can often be treated in infancy with injections of various hormones, such as human chorionic gonadotropin or testosterone.
Most 8-14 year old boys referred for micropenis have (1) a penis concealed in suprapubic fat, (2) a large body and frame for which a prepubertal penis simply appears too small, or (3) delayed puberty with every reason to expect good future growth.
A number of surgical techniques for penis enlargement have been devised and performed but are not generally considered successful enough to be widely adopted and are rarely performed in childhood.
In extreme cases of micropenis, there is barely any shaft, and the glans appears to sit almost on the pubic skin. From the 1960s until the late 1970s, it was not unusual for sex reassignment and surgery to be recommended. This was especially likely if evidence suggested that response to additional testosterone and pubertal testosterone would be poor. If parents accepted, the boy would be reassigned and renamed as a girl, and surgery performed to remove the testes and construct an artificial vagina. This was based on three assumptions: (1) gender identity and sex differences were solely a matter of social learning rather than biology (a primary tenet of some feminist and liberal academic ideology in the 1970s), (2) 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, and (3) a functionally acceptable vagina could be constructed surgically. The center most known for this approach (Johns Hopkins Hospital) performed 12 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 dissatified with adult outcome, played a large part in discouraging this practice. As a result, sexual reassignment is rarely performed today for severe micropenis. Much inaccurate or exaggerated folklore on this topic is available on the internet. See History of intersex surgery for a more complete discussion of this issue.
Sometimes the foreskin forms what is called medically a "phimosis" - which means there's a tight opening at the end of the foreskin which isn't big enough to allow the foreskin to slide smoothly back over the glans and expose the penis head.
The gliding movement of the foreskin over the glans is important for several reasons.
There are two main causes of phimosis - the first is that it's just an accident of nature. Up to ten percent of teenage boys have a tight foreskin like this. The other cause is long term fungal infection (like Athlete's Foot) at the end of the foreskin, which results in the tissue scarring and forming a tight band of scar tissue at the very tip of the foreskin. The remedy for this fungal condition is probably circumcision. But for most tight foreskins, the remedy may lie in a simple bit of home medicine - stretching it gently every day so as to widen the foreskin and allow it to move freely. This works because the restriction is only in the size of the opening at the end of the foreskin, so if you can stretch it a bit, you may be able to get your foreskin moving freely back and forth as it is meant to. Here's how you do it.
Oedema (swelling) of the foreskin can result from sexual activity, including masturbation. It appears worrying but so long as the foreskin is in its normal position and blood flow is present it's harmless. See paraphimosis for situations where the foreskin can't be moved to its normal position or the swelling persists. If the condition recurrs regularly, medical advice should be obtained, since it can be a symptom of conditions such as chronic heart disease. (description of a case resulting from sexual activity, with pictures)
Pathological Phimosis--where a non-retracting foreskin is accompanied by pain or physiological distress, or affects physical hygiene, requires treatment which can be surgical or non-surgical according to the severity of the condition. See Phimosis for more details.
Paraphimosis is an inability to move the foreskin forward over the glans. It can result from fluid trapped in a foreskin which is left retracted, perhaps following a medical procedure, or accumulation of fluid in the foreskin because of friction during vigorous sexual activity. Applying pressure to compress the glans, then moving the foreskin to its normal position is the initial procedure to follow, perhaps with the assistance of a lubricant. Placing the penis in normal granulated sugar can reduce the swelling via osmosis. If the condition persists for more than several hours or there's a sign of lack of blood flow, a hard glans with no erection or an inability to urinate, it should be treated as a medical emergency.
In Peyronie's disease, anomalous scar tissue grows in the soft tissue of the penis, causing curvature. Severe cases can benefit from surgical correction.
A thrombosis can occur during periods of frequent and prolonged sexual activity, especially fellatio. It is usually harmless and self-corrects within a few weeks.
Pudendal nerve entrapment is a condition characterized by pain on sitting and loss of penile (or clitoral) sensation and orgasm. Occasionally there is a total loss of sensation and orgasm. The pudendal nerve can be damaged by narrow hard cycle seats and accidents.
Penile fracture can occur if the erect penis is bent excessively. A pop or cracking sound and pain is normally associated with this event. Emergency medical assistance should be obtained, after which long term consequences are usually prevented. In one study [2], the few patients suffering permanent penile curvature were the ones who had waited longest before seeking treatment.
In diabetes, peripheral neuropathy can cause tingling in the penile skin and possibly reduced or completely absent sensation. The reduced sensations can lead to injuries for either partner and their absence can make it impossible to have sexual pleasure through stimulation of the penis. Since the problems are caused by permanent nerve damage, preventive treatment through good control of the diabetes is the primary treatment. Some limited recovery may be possible through improved diabetes control.
Impotence, sometimes called erectile dysfunction or ED, is the inability to have and maintain an erection sufficiently firm for satisfactory sexual performance. A wide variety of generally effective treatments are available. Diabetes is a leading cause, as is normal aging.
Priapism is a painful and potentially harmful medical condition in which the erect penis does not return to its flaccid state. The causative mechanisms are poorly understood but involve complex neurological and vascular factors. Potential complications include ischaemia, thrombosis, and impotence. In serious cases the condition may result in gangrene, which may necessitate amputation.
Copyright © 2002-2005 penis-enlargement-pill-drug-device.com. All Rights Reserved.
