Microphallus early management in infancy saves adulthood sensual life: A ‎‎comprehensive review

Abstract

Microphallus/Micropenis is a rare condition with significant physical and psychological implications for affected individuals. This article comprehensively reviews micropenis, its etiology, epidemiology, and various treatment options. We conducted a thorough literature review to collect relevant information on micropenis and microphallus, as well as related disorders. Our primary databases were PubMed, Medline, and Google Scholar. We searched for articles published in English between 2000 and 2023. Our analysis included 67 review articles, 56 research studies, 11 case reports, one guideline, and one editorial. Our search terms included "microphallus", "micropenis", "congenital hypogonadotropic hypogonadism", "androgen insensitivity syndrome", "pediatric management of micropenis", "testosterone therapy", and "psychosocial implications of micropenis". We focused on diagnosing micropenis and related conditions, including hormonal assessments, medical and surgical treatment options, psychosocial and psychological well-being, sexual development of adolescents, and sociocultural influences on men's perceptions of penile size. Additionally, we explored parenting and family dynamics in cases of micropenis and disorders of sex development, implications of hormonal treatment in neonates, and studies related to penile augmentation procedures and their effectiveness. The article highlights the importance of early diagnosis and intervention in addressing the physical and psychological well-being of individuals with micropenis. Surgical procedures, such as penile lengthening and girth enhancement, and non-surgical approaches like hormonal therapy are explored. The significance of psychological support, education, and lifestyle modifications is emphasized. Early management and comprehensive care are crucial for individuals with micropenis, from infancy to adolescence and beyond. A multidisciplinary approach involving urologists, endocrinologists, and mental health professionals is recommended. Regular assessment of treatment effectiveness and the need for updated guidelines are essential to provide the best possible care. Healthcare professionals should prioritize early diagnosis, and neonatologists should measure stretched penile length in neonates. A collaborative effort is needed among professionals, parents, and affected individuals to create a supportive environment that recognizes worth beyond physical differences. Continuous research and evidence-based updates are crucial for improving care standards.

Keywords: Microphallus; Micropenis; Hypogonadism; Children; Adults; Sensual life; Testosterone ‎therapy

Core Tip: Early diagnosis is crucial in identifying isolated micropenis, especially when gonads are non-palpable, as it may indicate gonadotropin deficiency. Measuring stretched penile length in neonates is an important step towards early detection. A comprehensive approach involving urologists, endocrinologists, and mental health professionals is recommended to address both the physical and psychological aspects of micropenis. Psychological support is particularly important during childhood and adolescence to help individuals cope with self-esteem, body image, and potential bullying concerns. Regular assessments of treatment effectiveness and guideline updates are encouraged, adapting to evolving evidence and medical technologies. Collaboration among healthcare professionals, parents, and affected individuals is essential.