Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Therapeutic strategies for patients with micropenis or penile dysmorphic disorder

Abstract

Micropenis in adults is defined as a stretched length of <7.5 cm. Many aetiologies exist, including congenital and endocrinological causes as well as pathological conditions, such as penile lichen sclerosus, trauma and genital cancer. The resulting reduction in functional penile length can lead to considerable psychosexual morbidity. Furthermore, the subset of patients with micropenis who also suffer from penile dysmorphic disorder require careful and intensive psychological counselling. Corrective surgery for micropenis can be performed in patients with realistic expectations. Total phalloplasty using radial-artery-based forearm skin flaps can offer restoration of normal penile length in selected patients. More-conservative surgical techniques to improve length or girth are limited by minimal enhancement but associated with a significantly lower rate of complications and comorbidity compared to total phalloplasty. Emerging tissue engineering techniques might represent a suitable alternative to penile replacement surgery in the future.

Key Points

  • Micropenis is defined as a stretched penile length of <7.5 cm based on population studies

  • True micropenis can manifest as a result of congenital abnormalities of testosterone production or function; other causes of micropenis include trauma, surgery, infection and cancer

  • Avoidance of micropenis can be achieved by using contemporary reconstructive techniques in order to maintain penile length

  • Patients with penile dysmorphic disorder require careful and intensive psychological counselling

  • Corrective surgery can be performed in patients with realistic expectations; total phalloplasty using radial-artery-based forearm flaps can offer restoration of normal penile length to selected patients

  • Penile-sparing surgical techniques to improve length or girth are limited by minimal enhancement but associated with a significantly lower rate of complications and comorbidity compared to total phalloplasty

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1: Glans resurfacing.
Figure 2: Buried penis after radiotherapy.
Figure 3: Buried penis owing to genital malignancy.
Figure 4: Radial artery forearm flap phalloplasty.

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 4th edn (American Psychiatric Publishing, Arlington, 1994).

  2. Wylie, K. R. & Eardley, I. Penile size and the 'small penis syndrome'. BJU Int. 99, 1449–1455 (2007).

    Article  PubMed  Google Scholar 

  3. Aaronson, I. A. Micropenis: medical and surgical implications. J. Urol. 152, 4–14 (1994).

    Article  CAS  PubMed  Google Scholar 

  4. Schonfeld, W. A. & Beebe, G. W. Normal growth and variation in the male genitalia from birth to maturity. J. Urol. 48, 759–777 (1942).

    Article  Google Scholar 

  5. Wessells, H., Lue, T. F. & McAninch, J. W. Penile length in the flaccid and erect states: guidelines for penile augmentation. J. Urol. 156, 995–997 (1996).

    Article  CAS  PubMed  Google Scholar 

  6. Kinsey, A. C., Pomeroy, W. R. & Martin, C. E. Sexual behavior in the human male (W. B. Saunders, Philadelphia, 1948).

    Google Scholar 

  7. Ponchietti, R. et al. Penile length and circumference: a study on 3,300 young Italian males. Eur. Urol. 39, 183–186 (2001).

    Article  CAS  PubMed  Google Scholar 

  8. Lee, P. A. et al. Micropenis. I. Criteria, etiologies and classification. Johns Hopkins Med. J. 146, 156–163 (1980).

    CAS  PubMed  Google Scholar 

  9. Danish, R. K., Lee, P. A., Mazur, T., Amrhein, J. A. & Migeon, C. J. Micropenis. II. Hypogonadotropic hypogonadism. Johns Hopkins Med. J. 146, 177–184 (1980).

    CAS  PubMed  Google Scholar 

  10. Lee, P. A., Danish, R. K., Mazur, T. & Migeon, C. J. Micropenis. III. Primary hypogonadism, partial androgen insensitivity syndrome, and idiopathic disorders. Johns Hopkins Med. J. 147, 175–181 (1980).

    CAS  PubMed  Google Scholar 

  11. Rossiter, K. & Diehl, S. Gender reassignment in children: ethical conflicts in surrogate decision making. Pediatr. Nurs. 24, 59–62 (1998).

    CAS  PubMed  Google Scholar 

  12. Frimberger, D. & Gearhart, J. P. Ambiguous genitalia and intersex. Urol. Int. 75, 291–297 (2005).

    Article  PubMed  Google Scholar 

  13. Hughes, I. A., Houk, C., Ahmed, S. F. & Lee, P. A. Consensus statement on management of intersex disorders. Arch. Dis. Child. 91, 554–563 (2006).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Maghnie, M., Ghirardello, S. & Genovese, E. Magnetic resonance imaging of the hypothalamus-pituitary unit in children suspected of hypopituitarism: who, how and when to investigate. J. Endocrinol. Invest. 27, 496–509 (2004).

    Article  CAS  PubMed  Google Scholar 

  15. Bin-Abbas, B., Conte, F. A., Grumbach, M. M. & Kaplan, S. L. Congenital hypogonadotropic hypogonadism and micropenis: effect of testosterone treatment on adult penile size why sex reversal is not indicated. J. Pediatr. 134, 579–583 (1999).

    Article  CAS  PubMed  Google Scholar 

  16. Choi, S. K., Han, S. W., Kim, D. H. & de Lignieres, B. Transdermal dihydrotestosterone therapy and its effects on patients with microphallus. J. Urol. 150, 657–660 (1993).

    Article  CAS  PubMed  Google Scholar 

  17. Burstein, S., Grumbach, M. M. & Kaplan, S. L. Early determination of androgen-responsiveness is important in the management of microphallus. Lancet 2, 983–986 (1979).

    Article  CAS  PubMed  Google Scholar 

  18. Ishii, T., Hayashi, M., Suwanai, A., Amano, N. & Hasegawa, T. The effect of intramuscular testosterone enanthate treatment on stretched penile length in prepubertal boys with hypospadias. Urology 76, 97–100 (2010).

    Article  PubMed  Google Scholar 

  19. Ishii, T. et al. Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis. J. Urol. 172, 319–324 (2004).

    Article  PubMed  Google Scholar 

  20. Reilly, J. M. & Woodhouse, C. R. Small penis and the male sexual role. J. Urol. 142, 569–571 (1989).

    Article  CAS  PubMed  Google Scholar 

  21. Money, J., Lehne, G. K. & Pierre-Jerome, F. Micropenis: gender, erotosexual coping strategy, and behavioral health in nine pediatric cases followed to adulthood. Compr. Psychiatry 26, 29–42 (1985).

    Article  CAS  PubMed  Google Scholar 

  22. Husmann, D. A. The androgen insensitive micropenis: long-term follow-up into adulthood. J. Pediatr. Endocrinol. Metab. 17, 1037–1041 (2004).

    Article  CAS  PubMed  Google Scholar 

  23. Wisniewski, A. B. et al. Congenital micropenis: long-term medical, surgical and psychosexual follow-up of individuals raised male or female. Horm. Res. 56, 3–11 (2001).

    CAS  PubMed  Google Scholar 

  24. Reiner, W. G. & Gearhart, J. P. Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth. N. Engl. J. Med. 350, 333–41 (2004).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Perovic´, S. Phalloplasty in children and adolescents using the extended pedicle island groin flap. J. Urol. 154, 848–853 (1995).

    Article  PubMed  Google Scholar 

  26. Garaffa, G., Raheem, A. A. & Ralph, D. J. An update on penile reconstruction. Asian J. Androl. 13, 391–394 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gralnek, D., Wessells, H., Cui, H. & Dalkin, B. L. Differences in sexual function and quality of life after nerve sparing and nonnerve sparing radical retropubic prostatectomy. J. Urol. 163, 1166–1169 (2000).

    Article  CAS  PubMed  Google Scholar 

  28. Park, K. K., Lee, S. H. & Chung, B. H. The effects of long-term androgen deprivation therapy on penile length in patients with prostate cancer: a single-center, prospective, open-label, observational study. J. Sex. Med. 8, 3214–3219 (2011).

    Article  CAS  PubMed  Google Scholar 

  29. Engel, J. D., Sutherland, D. E., Williams, S. B. & Wagner, K. R. Changes in penile length after robot-assisted laparoscopic radical prostatectomy. J. Endourol. 25, 65–69 (2011).

    Article  PubMed  Google Scholar 

  30. Pahlajani, G., Raina, R., Jones, S., Ali, M. & Zippe, C. Vacuum erection devices revisited: its emerging role in the treatment of erectile dysfunction and early penile rehabilitation following prostate cancer therapy. J. Sex. Med. 9, 1182–1189 (2012).

    Article  PubMed  Google Scholar 

  31. Li, L. Y. et al. Comparison of penile size and erectile function after high-intensity focused ultrasound and targeted cryoablation for localized prostate cancer: a prospective pilot study. J. Sex. Med. 7, 3135–3142 (2010).

    Article  PubMed  Google Scholar 

  32. Benson, J. S., Abern, M. R. & Levine, L. A. Penile shortening after radical prostatectomy and Peyronie's surgery. Curr. Urol. Rep. 10, 468–474 (2009).

    Article  PubMed  Google Scholar 

  33. Yu Ko, W. F., Degner, L. F., Hack, T. F. & Schroeder, G. Penile length shortening after radical prostatectomy: men's responses. Eur. J. Oncol. Nurs. 14, 160–165 (2010).

    Article  PubMed  Google Scholar 

  34. McCullough, A. Penile change following radical prostatectomy: size, smooth muscle atrophy, and curve. Curr. Urol. Rep. 9, 492–499 (2008).

    Article  PubMed  Google Scholar 

  35. Ralph, D. J. et al. The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur. Urol. 56, 1033–1038 (2009).

    Article  PubMed  Google Scholar 

  36. Khan, S., Somani, B., Lam, W. & Donat, R. Establishing a reference range for penile length in Caucasian British men: a prospective study of 609 men. BJU Int. 109, 740–744 (2012).

    Article  PubMed  Google Scholar 

  37. Levine, L. A. & Rybak, J. Traction therapy for men with shortened penis prior to penile prosthesis implantation: a pilot study. J. Sex. Med. 8, 2112–2117 (2011).

    Article  PubMed  Google Scholar 

  38. Kamel, I., Gadalla, A., Ghanem, H. & Oraby, M. Comparing penile measurements in normal and erectile dysfunction subjects. J. Sex. Med. 6, 2305–2310 (2009).

    Article  PubMed  Google Scholar 

  39. Briganti, A. et al. Choosing the best candidates for penile rehabilitation after bilateral nerve-sparing radical prostatectomy. J. Sex. Med. 9, 608–617 (2012).

    Article  PubMed  Google Scholar 

  40. Aydogdu, O., Gokce, M. I., Burgu, B., Baltaci, S. & Yaman, O. Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy. Int. Braz. J. Urol. 37, 336–344 (2011).

    Article  PubMed  Google Scholar 

  41. Hatzimouratidis, K. et al. Phosphodiesterase type 5 inhibitors in postprostatectomy erectile dysfunction: a critical analysis of the basic science rationale and clinical application. Eur. Urol. 55, 334–347 (2009).

    Article  CAS  PubMed  Google Scholar 

  42. Mulhall, J. P. Penile rehabilitation following radical prostatectomy. Curr. Opin. Urol. 18, 613–620 (2008).

    Article  PubMed  Google Scholar 

  43. Gontero, P. et al. Use of penile extender device in the treatment of penile curvature as a result of Peyronie's disease. Results of a phase II prospective study. J. Sex. Med. 6, 558–566 (2009).

    Article  PubMed  Google Scholar 

  44. Pestana, I. A., Greenfield, J. M., Walsh, M., Donatucci, C. F. & Erdmann, D. Management of “buried” penis in adulthood: an overview. Plast. Reconstr. Surg. 124, 1186–1195 (2009).

    Article  CAS  PubMed  Google Scholar 

  45. Li, C. Y. et al. Penile suspensory ligament division for penile augmentation: indications and results. Eur. Urol. 49, 729–733 (2006).

    Article  PubMed  Google Scholar 

  46. Oderda, M., Mondaini, N. & Gontero, P. Advice on the counseling of patients seeking treatment for short penis. BJU Int. 108, 1039–1040 (2011).

    Article  PubMed  Google Scholar 

  47. Shamloul, R. Treatment of men complaining of short penis. Urology 65, 1183–1185 (2005).

    Article  PubMed  Google Scholar 

  48. Mondaini, N. et al. Penile length is normal in most men seeking penile lengthening procedures. Int. J. Impot. Res. 14, 283–286 (2002).

    Article  CAS  PubMed  Google Scholar 

  49. Oderda, M. & Gontero, P. Non-invasive methods of penile lengthening: fact or fiction? BJU Int. 107, 1278–1282 (2011).

    Article  PubMed  Google Scholar 

  50. Ralph, D. et al. Trauma, gender reassignment, and penile augmentation. J. Sex. Med. 7, 1657–1667 (2010).

    Article  PubMed  Google Scholar 

  51. Phonsombat, S., Master, V. A. & McAninch, J. W. Penetrating external genital trauma: a 30-year single institution experience. J. Urol. 180, 192–195 (2008).

    Article  PubMed  Google Scholar 

  52. Minhas, S. et al. What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJU Int. 96, 1040–1043 (2005).

    Article  PubMed  Google Scholar 

  53. Antunes, A. A., Dall'Oglio, M. F. & Srougi, M. Organ-sparing treatment for penile cancer. Nat. Clin. Pract. Urol. 4, 596–604 (2007).

    Article  PubMed  Google Scholar 

  54. Mackay, D. R., Manders, E. K., Saggers, G. C., Schenden, M. J. & Zaino, R. The fate of dermal and dermal-fat grafts. Ann. Plast. Surg. 31, 42–46 (1993).

    Article  CAS  PubMed  Google Scholar 

  55. Bruno, J. J. 2nd, Senderoff, D. M., Fracchia, J. A. & Armenakas, N. A. Reconstruction of penile wounds following complications of AlloDerm-based augmentation phalloplasty. Plast. Reconstr. Surg. 119, 1e–4e (2007).

    Article  CAS  PubMed  Google Scholar 

  56. Austoni, E., Guarneri, A. & Cazzaniga, A. A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts--three years of experience. Eur. Urol. 42, 245–253 (2002).

    Article  CAS  PubMed  Google Scholar 

  57. Bogoras, N. Uber die volle plastische wiederherstellung eines zum Koitus fahigen Penis (peniplastica totalis). Zentralbl. Chir. 63, 1271 (1936).

    Google Scholar 

  58. Orticochea, M. A new method of total reconstruction of the penis. Br. J. Plast. Surg. 25, 347–366 (1972).

    Article  CAS  PubMed  Google Scholar 

  59. Puckett, C. L., Reinisch, J. F. & Montie, J. E. Free flap phalloplasty. J. Urol. 128, 294–297 (1982).

    Article  CAS  PubMed  Google Scholar 

  60. Chang, T. S. & Hwang, W. Y. Forearm flap in one-stage reconstruction of the penis. Plast. Reconstr. Surg. 74, 251–258 (1984).

    Article  CAS  PubMed  Google Scholar 

  61. Song, R., Gao, Y., Song, Y., Yu, Y. & Song, Y. The forearm flap. Clin. Plast. Surg. 9, 21–26 (1982).

    CAS  PubMed  Google Scholar 

  62. Semple, J. L., Boyd, J. B., Farrow, G. A. & Robinette, M. A. The “cricket bat” flap: a one-stage free forearm flap phalloplasty. Plast. Reconstr. Surg. 88, 514–519 (1991).

    Article  CAS  PubMed  Google Scholar 

  63. Papadopulos, N. A., Schaff, J. & Biemer, E. The use of free prelaminated and sensate osteofasciocutaneous fibular flap in phalloplasty. Injury 39 (Suppl. 3), S62–S67 (2008).

    Article  PubMed  Google Scholar 

  64. Felici, N. & Felici, A. A new phalloplasty technique: the free anterolateral thigh flap phalloplasty. J. Plast. Reconstr. Aesthet. Surg. 59, 153–157 (2006).

    Article  CAS  PubMed  Google Scholar 

  65. Rubino, C. et al. Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals. J. Plast. Reconstr. Aesthet. Surg. 62, e45–e49 (2009).

    Article  CAS  PubMed  Google Scholar 

  66. Jordan, G. H. Penile reconstruction, phallic construction, and urethral reconstruction. Urol. Clin. North Am. 26, 1–13 (1999).

    Article  CAS  PubMed  Google Scholar 

  67. Djordjevic, M. L., Bumbasirevic, M. Z., Vukovic, P. M., Sansalone, S. & Perovic, S. V. Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children. J. Pediatr. Urol. 2, 333–339 (2006).

    Article  PubMed  Google Scholar 

  68. Perovic, S. V., Djinovic, R., Bumbasirevic, M., Djordjevic, M. & Vukovic, P. Total phalloplasty using a musculocutaneous latissimus dorsi flap. BJU Int. 100, 899–905 (2007).

    Article  PubMed  Google Scholar 

  69. Garaffa, G., Christopher, N. A. & Ralph, D. J. Total phallic reconstruction in female-to-male transsexuals. Eur. Urol. 57, 715–722 (2010).

    Article  PubMed  Google Scholar 

  70. Leriche, A. et al. Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism. BJU Int. 101, 1297–1300 (2008).

    Article  PubMed  Google Scholar 

  71. Garaffa, G., Raheem, A. A., Christopher, N. A. & Ralph, D. J. Total phallic reconstruction after penile amputation for carcinoma. BJU Int. 104, 852–856 (2009).

    Article  PubMed  Google Scholar 

  72. Rashid, M. & Sarwar, S. U. Avulsion injuries of the male external genitalia: classification and reconstruction with the customised radial forearm free flap. Br. J. Plast. Surg. 58, 585–592 (2005).

    Article  PubMed  Google Scholar 

  73. De Fontaine, S., Loréa, P., Wespes, E., Schulman, C. & Goldschmidt, D. Complete phalloplasty using the free radial forearm flap for correcting micropenis associated with vesical exstrophy. J. Urol. 166, 597–599 (2001).

    Article  CAS  PubMed  Google Scholar 

  74. Ricketts, S., Hunter-Smith, D. J. & Coombs, C. J. Quality of life after penile reconstruction using the radial forearm flap in adult bladder exstrophy patients—technique and outcomes. ANZ J. Surg. 81, 52–55 (2011).

    Article  PubMed  Google Scholar 

  75. Casoli, V. et al. One-stage complete phalloplasty with forearm free flap after severe electrical burns. Plast. Reconstr. Surg. 113, 313–316 (2004).

    Article  PubMed  Google Scholar 

  76. Kim, K. H. The evolution of urogenital tissue engineering. Int. Neurourol. J. 15, 107–108 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Shokeir, A. A., Harraz, A. M. & El-Din, A. B. Tissue engineering and stem cells: basic principles and applications in urology. Int. J. Urol. 17, 964–973 (2010).

    Article  CAS  PubMed  Google Scholar 

  78. Fu, Q. & Cao, Y. L. Use of tissue engineering in treatment of the male genitourinary tract abnormalities. J. Sex. Med. 7, 1741–1746 (2010).

    Article  PubMed  Google Scholar 

  79. Matoka, D. J. & Cheng, E. Y. Tissue engineering in urology. Can. Urol. Assoc. J. 3, 403–408 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  80. Roth, C. C. & Kropp, B. P. Recent advances in urologic tissue engineering. Curr. Urol. Rep. 10, 119–125 (2009).

    Article  PubMed  Google Scholar 

  81. Wood, D. & Southgate, J. Current status of tissue engineering in urology. Curr. Opin. Urol. 18, 564–569 (2008).

    Article  PubMed  Google Scholar 

  82. Naderi, H., Matin, M. M. & Bahrami, A. R. Review paper: critical issues in tissue engineering: biomaterials, cell sources, angiogenesis, and drug delivery systems. J. Biomater. Appl. 26, 383–417 (2011).

    Article  CAS  PubMed  Google Scholar 

  83. Place, E. S., Evans, N. D. & Stevens, M. M. Complexity in biomaterials for tissue engineering. Nat. Mater. 8, 457–470 (2009).

    Article  CAS  PubMed  Google Scholar 

  84. Chen, K. L., Eberli, D., Yoo, J. J. & Atala, A. Bioengineered corporal tissue for structural and functional restoration of the penis. Proc. Natl Acad. Sci. USA 107, 3346–3350 (2010).

    Article  PubMed  Google Scholar 

  85. Perovic, S. V. et al. New perspectives of penile enhancement surgery: tissue engineering with biodegradable scaffolds. Eur. Urol. 49, 139–147 (2006).

    Article  PubMed  Google Scholar 

  86. Hu, W. et al. A preliminary report of penile transplantation. Eur. Urol. 50, 851–853 (2006).

    Article  PubMed  Google Scholar 

  87. Zhang, L.-C., Zhao, Y.-B. & Hu, W.-L. Ethical issues in penile transplantation. Asian J. Androl. 12, 795–800 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  88. Loeb, H. Harnrohencapacitat und tripperspritzen. Munch. Med. Wochenschr. 46, 1016–1017 (1899).

    Google Scholar 

  89. Schonfield, W. Normal growth and variation in the male genitalia from birth to maturity. J. Urol. 48, 759–777 (1949).

    Article  Google Scholar 

  90. Bondil, P. et al. Clinical study of the longitudinal deformation of the flaccid penis and of its variations with aging. Eur. Urol. 21, 284–286 (1992).

    Article  CAS  PubMed  Google Scholar 

  91. da Ros, C. Caucasian penis: what is the normal size? [abstract] J. Urol. 151, 323a (1994).

    Google Scholar 

  92. Bogaert, A. F. & Hershberger, S. The relation between sexual orientation and penile size. Arch. Sex. Behav. 28, 213–221 (1999).

    Article  CAS  PubMed  Google Scholar 

  93. Schneider, T., Sperling, H., Lümmen, G., Syllwasschy, J. & Rübben, H. Does penile size in younger men cause problems in condom use? A prospective measurement of penile dimensions in 111 young and 32 older men. Urology 57, 314–318 (2001).

    Article  CAS  PubMed  Google Scholar 

  94. Awwad, Z. et al. Penile measurements in normal adult Jordanians and in patients with erectile dysfunction. Int. J. Impot. Res. 17, 191–195 (2005).

    Article  CAS  PubMed  Google Scholar 

  95. Miller, M. A. & Grant, D. B. Severe hypospadias with genital ambiguity: adult outcome after staged hypospadias repair. Br. J. Urol. 80, 485–488 (1997).

    Article  CAS  PubMed  Google Scholar 

  96. van Seters, A. P. & Slob, A. K. Mutually gratifying heterosexual relationship with micropenis of husband. J. Sex Marital Ther. 14, 98–107 (1988).

    Article  CAS  PubMed  Google Scholar 

  97. Aghamir, M. K., Hosseini, R. & Alizadeh, F. A vacuum device for penile elongation: fact or fiction? BJU Int. 97, 777–778 (2006).

    Article  PubMed  Google Scholar 

  98. Gontero, P. et al. A pilot phase-II prospective study to test the 'efficacy' and tolerability of a penile-extender device in the treatment of 'short penis'. BJU Int. 103, 793–797 (2009).

    Article  PubMed  Google Scholar 

  99. Roos, H. & Lissoos, I. Penis lengthening. Int. J. Aesth. Restor. Surg. 2, 89–96 (1994).

    Google Scholar 

  100. Perovic, S. V. & Djordjevic, M. L. Penile lengthening. BJU Int. 86, 1028–1033 (2000).

    Article  CAS  PubMed  Google Scholar 

  101. Monstrey, S. et al. Penile reconstruction: is the radial forearm flap really the standard technique? Plast. Reconstr. Surg. 124, 510–518 (2009).

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

O. Kayes researched data for the article. M. Shabbir and D. Ralph made substantial contribution to the discussion of content. O. Kayes and S. Minhas wrote and reviewed the manuscript before submission.

Corresponding author

Correspondence to Oliver Kayes.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kayes, O., Shabbir, M., Ralph, D. et al. Therapeutic strategies for patients with micropenis or penile dysmorphic disorder. Nat Rev Urol 9, 499–507 (2012). https://doi.org/10.1038/nrurol.2012.150

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2012.150

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing