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Penile size abnormalities

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The following summarized guidelines for the evaluation and management of penile size abnormalities are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2023).
1

Guidelines

1.Diagnostic investigations

History and physical examination: elicit a comprehensive medical and sexual history in all patients complaining of short penile size.
A
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2.Medical management

Hormonal therapy
Initiate endocrinological therapies to restore penile size in boys with micropenis or disorders of sex development.
A
Do not use testosterone or other hormonal therapies to increase penile size after puberty.
D

3.Nonpharmacologic interventions

Weight loss: offer lifestyle changes and modification of risk factors, particularly weight loss, to minimize acquired buried penis surgical complications and to optimize surgical outcomes.
A

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4.Therapeutic procedures

Penile traction therapy: consider offering penile traction therapy as a conservative treatment to increase penile length.
C

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5.Surgical interventions

Penile enlargement surgery: consider performing surgical reconstructive techniques in adult patients with acquired buried penis.
C
counsel patients extensively regarding the benefits and complications of surgery. Perform penile reconstructive surgery for acquired buried penis in high-volume centers.
B
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