Abstract
This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism.
Highlights
It is difficult to fully understand how or exactly why men develop anxiety about penile size and function – the fact is that many do
There are, some very important medical problems that require surgical treatment and in some cases, other treatments, including endocrine and psychological. For those that present in childhood, there are two real groups of patients: those who have had corrective surgery for conditions such as hypospadias, and those who have been told that either matters will all resolve once adolescence begins or that treatment can and will begin in adolescence
TheScientificWorldJOURNAL (2011) 11, 614–623 male may present with a rare diagnosis that is revealed by the presence of a micropenis[3]
Summary
Received August 13, 2010; Revised January 9, 2011; Accepted January 11, 2011; Published March 7, 2011. The variety of surgical procedures has complicated assessment of outcomes It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There are, some very important medical problems that require surgical treatment and in some cases, other treatments, including endocrine and psychological For those that present in childhood, there are two real groups of patients: those who have had corrective surgery for conditions such as hypospadias, and those who have been told that either matters will all resolve once adolescence begins or that treatment can and will begin in adolescence. It important to understand that previous surgery may reinforce normal anxieties This is exemplified in patients with hypospadias who may demonstrate a broad range of psychological outcomes, often unrelated to the surgical results. When the stretched penile length is
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