title: Position paper: Management of men complaining of a small penis despite an actually normal size.
abstract: BACKGROUND
  With the worldwide increase in penile augmentation procedures and claims of devices designed to elongate the penis, it becomes crucial to study the scientific basis of such procedures or devices, as well as the management of a complaint of a small penis in men with a normal penile size.
  
  
  OBJECTIVE
  The aim of this work is to study the scientific basis of opting to penile augmentation procedures and to develop guidelines based on the best available evidence for the management of men complaining of a small penis despite an actually normal size.
  
  
  METHODS
  We reviewed the literature and evaluated the evidence about what the normal penile size is, what patients complaining of a small penis usually suffer from, benefits vs. complications of surgery, penile stretching or traction devices, and outcome with patient education and counseling. Repeated presentation and detailed discussions within the Standard Committee of the International Society for Sexual Medicine were performed.
  
  
  METHODS
  Recommendations are based on the evaluation of evidence-based medical literature, widespread standards committee discussion, public presentation, and debate.
  
  
  RESULTS
  We propose a practical approach for evaluating and counseling patients complaining of a small-sized penis.
  
  
  CONCLUSIONS
  Based on the current status of science, penile lengthening procedure surgery is still considered experimental and should only be limited to special circumstances within research or university institutions with supervising ethics committees.
authors.affiliation: Department of Andrology, Sexology & STDs, Cairo University, Faculty of Medicine, Cairo, Egypt. hmhghanem@gmail.com
authors.forename: Hussein
authors.initials: H
authors.lastname: Ghanem
authors.forename: Sidney
authors.initials: S
authors.lastname: Glina
authors.forename: Pierre
authors.initials: P
authors.lastname: Assalian
authors.forename: Jacques
authors.initials: J
authors.lastname: Buvat
mesh_terms: D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003376:Counseling; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010413:Penis / Q000033:anatomy & histology* / Q000601:surgery; D017410:Practice Guidelines as Topic / Q000592:standards; D019651:Plastic Surgery Procedures / Q000379:methods / Q000592:standards