European Association of Urology Guidelines on Penile Size Abnormalities and Dysmorphophobia: Summary of the 2023 Guidelines.
Autor: | Falcone M; Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Turin, Italy. Electronic address: marco.falcone@unito.it., Bettocchi C; Department of Andrology and Male Genitalia Reconstructive Surgery, University of Foggia, Foggia, Italy., Carvalho J; William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal., Ricou M; Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal., Boeri L; Department of Urology, IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy., Capogrosso P; Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy., Cocci A; Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy., Corona G; Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy., Gül M; Department of Urology, School of Medicine, Selcuk University, Konya, Turkey., Hatzichristodoulou G; Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany., Jones TH; Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Trust, Barnsley, UK., Kadioğlu A; Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey., Kalkanli A; Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey., Martinez-Salamanca JI; Department of Urology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain., Milenkovic U; Department of Urology, University Hospitals Leuven, Leuven, Belgium., Morgado LA; Urology Service, Centro Hospitalar Universitário São João, Porto, Portugal; Department of Biomedicine, Faculty of Medicine, Porto University, Porto, Portugal., Russo GI; Urology Section, Department of Surgery, University of Catania, Catania, Italy., Serefoğlu EC; Department of Urology, Biruni University School of Medicine, Istanbul, Turkey., Tharakan T; Department of Urology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, UK., Verze P; Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Fisciano, Italy., Minhas S; Department of Urology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, UK., Salonia A; Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. |
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Jazyk: | angličtina |
Zdroj: | European urology focus [Eur Urol Focus] 2024 May; Vol. 10 (3), pp. 432-441. Date of Electronic Publication: 2023 Sep 13. |
DOI: | 10.1016/j.euf.2023.08.012 |
Abstrakt: | Context: Recommendations regarding the management of penile size abnormalities and dysmorphophobia are important in guiding evidence-based clinical practice. Objective: To present a summary of the 2023 European Association of Urology sexual and reproductive health evidence-based recommendations for the management of penile size abnormalities and dysmorphophobia. Evidence Acquisition: A broad and comprehensive scoping exercise covering all areas of the guidelines was performed. Databases searched included Medline, EMBASE, and the Cochrane Libraries. A level of evidence and a strength of recommendation were assigned for each recommendation according to the evidence identified. The evidence cutoff date for the 2023 guidelines is June 1, 2022. Evidence Synthesis: Well-structured studies reporting high level of evidence, with standardized PROMS were deficient on penile size abnormalities and dysmorphohobia. A shared definition for short penis/micropenis was also lacking. Categorisation of penile abnormalities according to congenital, acquired, and dysmorphophobic aetiology is deemed compulsory. A detailed medical and psychosexual history and precise measurements of penile size are essential in the diagnostic pathway. Patients with normal penile size who are seeking penile augmentation should be referred for psychological evaluation for potential dysmorphophobic disorders. Penile length and girth enhancements can be achieved via a multitude of treatments, but a personalised management plan is crucial for satisfactory results. Endocrinological therapies, when indicated, are effective in the prepubertal setting only. Vacuum therapy has a limited evidence base in treatment protocols, although acceptable outcomes have been reported for penile traction therapy. Surgical techniques to enhance penile length and girth have limited evidence and should only be proposed after extensive patient counselling. Conclusions: Management of penile abnormalities and dysmorphophobia is a complex issue with considerable ethical concerns. The adoption of a structured diagnostic and therapeutic pathway is crucial, as recommended in the guidelines. Patient Summary: Requests for medical/surgical treatments to increase penis size have increased dramatically worldwide. Several conservative and surgical treatments are available. However, few patients receive clear information on the benefits and possible harms of these treatments. These guidelines aim to provide a structured path to guide both physicians and patients in the selection of appropriate treatment(s) to increase penis size. (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.) |
Databáze: | MEDLINE |
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