Penile growth in response to hormone treatment in children with micropenis

Abstract

Introduction:Micropenis is defined as a stretched penile length 2.5 standard deviations less than the mean for age without the presence of any other penile anomalies, such as hypospadias. The term refers to a specific disorder that has a known set of causative factors and defined treatment modalities. The purpose of this study was to determine the effect of hormonal therapy on the gonadal response and penile growth in children who presented with micropenis.Materials and Methods:Children (<18 years) who met the criteria for micropenis were included in this study. Children more than 11 years old were treated using a standard protocol of 1,500 to 2,000 IU human chorionic gonadotrophin administrated intramuscularly, once per week, for 6 weeks. Children less than 11 years old were treated with parenteral testosterone enanthate 25 mg once a month for 3 months. Response was evaluated in terms of change in testosterone levels and size of penis.Results:Serum testosterone levels at baseline and after 8 weeks of hormonal treatment were <20 and 449.4 ng/mL, respectively (P < 0.0001) in all children more than 11 years old. Stretched penile length after hormonal treatment increased from 15.54 to 37.18 mm in children less than 11 years old and from 26.42 to 64.28 mm in children more than 11 years old (P < 0.001).Conclusions:Management of isolated micropenis revolves around testosterone (direct administration or encouraging the patient's body to make its own), and results with respect to increase in penile length are promising.

A review of penile elongation surgery

“…In this study, prepubertal children were treated with 25 mg of exogenous parenteral testosterone enanthate once a month for 3 months, and pubertal or postpubertal children were treated with intramuscular hCG once a week for 6 weeks. Exogenous administration of hormone replacement in these boys resulted in a significant increase in SPL and suggests that these treatments could be the primary form of therapy for micropenis in paediatric patients ( 25 ). In addition to exogenous testosterone, topical applications have been studied in the micropenis population.…”

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

“…In patients with idiopathic hypogonadotropic hypogonadism and micropenis, Sun-Ouck et al and Rajendra et al found a significant increase of the testicular volume after medical treatment [ 79 , 80 ].…”

Dihydrotestosterone induces minor transcriptional alterations in genital skin fibroblasts of children with and without androgen insensitivity

“…increase in penile length [4], the androgen-AR signaling pathway appears to be preserved even in the prepubertal period when physiological masculinization does not progress. Mutations in AR lead to androgen insensitivity syndrome (AIS), a relatively common form of 46,XY disorders of sex development (DSD) [5].…”