What Is Normal and Who Qualifies? Validated Questionnaires for Penile Size Assessment and Body Dysmorphic Disorder
The Diagnostic and Statistical Manual of Mental Disorders describes body dysmorphic disorder (BDD) as the preoccupation with imagined imperfections that cause severe anxiety for the patient.
A subset of men with BDD includes those who are consumed with anxiety and worry regarding their genitalia being inadequate and/or too small, despite clinical measurements confirming otherwise.
Patients who hold this false belief and experience significant impairments to daily living are considered to have penile dysmorphic disorder (PDD). Although the rate of PDD is currently unknown, some studies report a 1%–3% prevalence rate of BDD in the general population.
This increases when studying patient populations of specialized esthetic clinics. General cosmetic surgery and rhinoplasty surgery clinics, for example, report the greatest rates of BDD or up to 13.2% and 20.1%, respectively.
It stands to reason that the rates of PDD are likely also increased in urologic clinics that specialize in men's health and penile augmentation.
Choi EJ, Yafi FA. What Is Normal and Who Qualifies? Validated Questionnaires for Penile Size Assessment and Body Dysmorphic Disorder. The Journal of Sexual Medicine. Redirecting
Background Men concerned about their penis size often consult professionals working in urology, andrology, surgery, and sexual medicine.
Aim To inform professionals in the sexual medicine field about small penis syndrome as a clinical syndrome and to provide recommendations for treatment.
Methods This was an overview of the existing literature combined with our extensive clinical experience. Results Small penis syndrome is a syndrome with psychiatric comorbidities and social consequences that impair life. Men with these concerns tend to be susceptible for treatment that is not evidence based and potentially harmful.
Clinical Implications Treatment of men with concerns about penis size should start with a thorough biopsychosocial assessment, followed by extensive psychoeducation, counselling, and psychological interventions, even if surgery is being considered.
Strengths & Limitations The strength of this study is the concise overview of the existing literature combined with clinical experience which leads to important recommendations. Limitation is that this is not a systematic review.
Conclusion Complaints about penis size should be taken seriously, and a thorough biopsychosocial and multidisciplinary assessment is required.