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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.Diagnostic investigations

History and physical examination: elicit a comprehensive medical and sexual history in all patients complaining of short penile size.
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  • Screening for body dysmorphic disorder

2.Medical management

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

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.

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  • Psychotherapy

4.Therapeutic procedures

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

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  • Vacuum erection devices

  • Penile girth enhancement

5.Surgical interventions

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