Micropenis

Year 2009, Volume: 36 Issue: 4, 323 - 328, 01.12.2009

Semra Çetinkaya

Abstract

Micropenis refers to an extremely small penis with a stretched penile length of less than 2.5 SD below the mean for age or stage of sexual development. It should be differentiated from a buried or hidden penis and penile agenesis. It is important to use a standard technique of stretched penile measurement and nomograms for age to identify children with micropenis. Based on etiology they can be classified as hypogonadotropic hypogonadism (hypothalamic or pituitary failure), hypergonadotropic hypogonadism (testicular failure), androgen insensitivity syndrome and idiopathic groups.

Keywords

micropenis, diagnosis, treatment

Mikropenis

Abstract

Mikropenis; uzatılmış penis uzunluğunun, yaşa ve ergenliğin derecesine göre ortalama değerden 2,5 standart sapmadan daha küçük olması olarak tanımlanan aşırı küçük penis demektir. Mikropenisi gömülü penisten ve penis agenezisinden ayırmak gerekir. Mikropenisli çocuklarda önemli olan, uzatılmış penis uzunluğunun standart bir biçimde ölçülmesi ve elde edilen ölçümün yaşa göre belirlenmiş nomogramlar kullanılarak değerlendirilmesidir. Etiyolojik olarak mikropenis; hipogonadotropik hipogonadizm (hipotalamik veya hipofizer yetersizlik), hipergonadotropik hipogonadizm (testiküler yetersizlik), androjene duyarsızlık sendromu ve idiyopatik olarak sınıflandırılabilir.

Keywords

mikropenis, tanı, tedavi

References

• Lee PA, Mazur T, Danish R, Amrhein J, et. al. Micropenis. I. Criteria, etiologies and classification. Johns Hopkins Med J 1980; 146:156-163.
• Feldman KW and Smith DW. Fetal phallic growth and pe- nile standarts for newborn male infants. J Pediatr 1975; 86:395-98.
• Aaronson IA. Micropenis: Medical and surgical implica- tions. J Urol 1994; 152:4-14.
• Flatau E, Josefsberg Z, Reisner SH, Bialik O, Iaron Z. Let- ter: Penile size in the newborn infant. J Pediatr 1975; 87:663-64.
• Phillip M, De Boer C, Pilpel D, Karplus M, Sofer S. Clito- ral and penile size of full term newborns in two different ethnic groups. J Pediatr Endocrinol Metab 1996;9:175- 179.
• Lian WB, Lee WR, Ho LY. Penile length of newborns in Singapore. J Pediatr Endocrinol Metab 2000; 13:55-62.
• Cheng PS, Chanoine JP. Should the definition of micro- penis vary according to ethnicity? Horm Res 2001; 55:278-281.
• Clements JA, Reyes FI, Winter JS, Faiman C. Studies on human sexual development. III: fetal pituitary and serum, and amniotic fluid concentrations of LH, CG, and FSH. J Clin Endocr Metab 1976; 42:9-19.
• Kaplan SL, Grumbach MM, Aubert ML. The ontogenesis of pituitary hormones and hypothalamic factors in the human fetus: maturation of central nervous system regulation of anterior pituitary function. Rec Prog Horm Res 1976; 32:161-243.
• De Zegher F, Francois I, Boehmer AL, et al. Androgens and fetal growth. Horm Res 1998; 50:243-44.
• Laron Z, Sarel R. Penis and testicular size in patients with growth hormone insufficiency. Acta Endocrinol 1970; 63:625-33.
• Begeot M, Dubois MP, Dubois PM. Evolution of lacto- tropes in normal and anencephalic human fetuses. J Clin Endocrinol Metab1984; 58:726-730.
• Sadeghi-Nejad A, and Senior B. A familial syndrome of isolated ‘aplasia’ of the anterior pituitary. Diagnostic stud- ies and treatment in the neonatal period. J Ped 1974; 84:79-84.
• Temtamy SA, Meguid NA. Hypogenitalism in the acrocal- losal syndrome. Am J Med Genet 1989; 32:301-305.
• Hoyt WF, Kaplan SL, Grumbach MM, Glaser JS. Septo- optic dysplasia and pituitary dwarfism. Lancet 1970; 25:893-894.
• Whitcomb RW, Crowley WF. Clinical review 4: diagnosis and treatment of isolated gonadotropin releasing hormone deficiency in men. J Clin Endocr Metab 1990; 70:3-7.
• Weiss J, Axelrod L, Whitcomb RW, Harris PE, Crowley WF, Jameson JL. Hypogonadism caused by a single amino acid substition in the beta subunit of luteinizing hormone. New Eng J Med 1992; 326:179-183.
• Goonewardena P, Dahl N, Ritzen M, van Ommen GJ, Pet- tersson U. Molecular Xp deletion in a male:suggestion of a locus for hypogonadotropic hypogonadism distal to the glycerol kinase and adrenal hypoplasia loci. Clin Genet 1989; 35:5-12.
• Edman CD, Winters AJ, Porter JC, Wilson J, MacDonald PC. Embryonic testicular regression. A clinical spectrum of XY agonadal individuals. Obst Gynec 1977; 49:208- 217.
• Abeyaratne MR, Aherne WA, Scott JES. The vanishing testis. Lancet 1969; 18:822-824.
• el-Awady MK, Temtamy SA, Salam MA, Gad YZ. Famil- ial Leydig cell hypoplasia as a cause of male pseudoher- maphroditism. Hum Hered 1987;37:36-40.
• Lee PA, Danish RK, Mazur T, Migeon CJ. Micropenis. III. Primary hypogonadism, partial androgen insensitivity syndrome, and idiopathic disorders. Johns Hopkins Med J 1980;147:175-181.
• Winter JSD, Faiman C, Hobson WC, Prasad AV, Reyes FI. Pituitary-gonadal relations in infancy. 1. Patterns of se- rum gonadotropin concentrations from birth to four years of age in man and chimpanzee. J Clin Endocr Metab 1975; 40: 545-551.
• Winter JSD, Faiman C. Serum gonadotropin concentra- tions in agonadal children and adults. J Clin Endocr Metab 1972; 35: 561-564.
• Lustig RH., Conte FA, Kogan BA, Grumbach MM. On- togeny of gonadotropin secretion in congenital anarchism: sexual dimorphism versus syndrome of gonadal dysgene- sis and diagnostic considerations. J Urol 1987; 138:587- 591.
• Finkelstein JS, Spratt DI, O'Dea LS, et al. Pulsatile gonad- otropin secretion after discontinuation of long term go- nadotropin-releasing hormone (GnRH) administration in a subset of GnRH-deficient men. J Clin Endocrinol Metab 1989; 69:377-385.
• Wu FC, Butler GE, Kelnar CJ, Sterling HF, Huhtaniemi I. Patterns of pulsatile luteinizing hormone and follicle- stimulating hormone secretion in prepubertal (mid- childhood) boys and girls and patients with idiopathic hy- pogonadotropic hypogonadism (Kallmann's syndrome): a study using an ultrasensitive time-resolved im- munofluorometric assay. J Clin Endocr Metab 1991; 72:1229-1237.
• Kaplowitz P. Delayed puberty in obese boys: comparison with c.nstitutional delayed puberty and response to testos- terone therapy. J Pediatr 1998; 133:745-749.
• Menon PS, Khatwa UA. The child with micropenis. Indian J Pediatr 2000; 67:455-460.
• Shaw MB, Sadove AM, Rink RC. Reconstruction after to- tal penile amputation and emasculation. Ann Plast Surg 2003; 50:321-324.
• Cortes D, Thorup J, Visfeldt J. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryp- torchidism. J Urol 2000; 163:1290-1292.
• Rensonnet C, Kanen F, Coremans C, Ernould C, Albert A, Bourguignon JP. Pubertal growth as a determinant of adult height in boys with constitutional delay of growth and pu- berty. Horm Res 1999; 51:223-229.
• Swerdloff RS, Wang C, Cunningham G, et al. Long-term pharmacokinetics of transdermal testosterone gel in hypo- gonadal men. J Clin Endocrinol Metab 2000; 85:4500- 4510.
• Barrio R, de Luis D, Alonso M, Lamas A, Moreno JC. In- duction of puberty with human chorionic gonadotropin and follicle-stimulating hormone in adolescent males with hypogonadotropic hypogonadism. Fertil Steril 1999; 71:244-8.
• Depenbusch M, von Eckardstein S, Simoni M, Nieschlag E. Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone. Eur J Endocrinol 2002; 147:617-624.
• Schopohl J, Mehltretter G, von Zumbusch R, Eversmann T, von Werder K. Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism. Fertil Steril 1991; 56: 1143-1150.
• Money J, Lehne GK. and Pierre-Jerome F. Micropenis: gender, erotosexual coping strategy and behavioral health in nine pediatric cases followed to adulthood. Compr Psy- chiat 1985; 26: 29-42.