Tuesday, September 3, 2013

Sexual Quality of Life following Hormonal and Surgical Treatment for Micropenis

In this post, we will examine a recent study named "Sexual Quality of Life after Hormonal and Surgical Treatment, Including Phalloplasty, in Men with Micropenis: A Review". The study was published on the 23th of August, 2013 on the The Journal of Sexual Medicine.

Introduction & Method
First, the authors mention that micro penis is a term that encompasses a wide range of congenital and acquired conditions, all of which result in an abnormally short penis, adding that micropenis "may persist into adulthood", becoming a major cause of dissatisfaction and discomfort to the patient.

Then, they explain that the purpose of the study was to assess the effects of hormonal and surgical treatments on psychosexual functioning and quality of life (QoL) in patients with micropenism, who were raised as males.

To do so, the authors investigated the previously published medical literature (1955 to 2012) on how hormonal and surgical treatments affect the sexual QoL in individuals with micropenis.


Results & Conclusions
After a careful review of the medical literature, the authors drew the following results:
  • Most boys born with micropenis should be raised as boys (and not reassigned into girls) because "of the likelihood of male gender development and genitosexual function"
  • If small penis size persists into adulthood -and doesn't respond to hormonal treatment - it usually leads to "dissatisfaction with genital appearance" and jeopardizes sexual QoL
  • There is currently no known surgical intervention to treat micropenis other than phalloplasty
  • The phalloplasty technique considered as the "gold standard" for gender reassignment for female-to-male (FTM) transgenders can also be applied to 46,XY individuals with micropenis
  • Psychological support may be required to "alleviate the distress and impairment of QoL", experienced by men with a micropenis

Micropenis in adults  usually leads to "dissatisfaction with genital appearance" and sexual discomfort

The authors also mention that further studies -  with a larger sample and a longer follow-up - on patients with micropenis are needed.

My opinion on the study
This study was a review and essentially adds no new knowledge on the micropenis condition. It simple collects all the medical knowledge in one place. However, the study mentions two things that I consider to be very important.

The first, is that more research is needed on the micropenis condition. After all, this is the only way to come up with new and better treatments, especially for adults who have very little options available.

The second is something I consider to be of great importance, and it is something that most studies seem to miss. And that is the fact that micropenis needs more recognition. Don't forget, 1 out 200 men has one:
"Only if health-care professionals fully appreciate the impact of this condition can optimal care be provided."


Reference
Callens N, De Cuypere G, Van Hoecke E, T'sjoen G, Monstrey S, Cools M, & Hoebeke P. (2013) Sexual Quality of Life after Hormonal and Surgical Treatment, Including Phalloplasty, in Men with Micropenis: A Review. The journal of sexual medicine. PMID: 23981815

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