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| {{short description|Unusually small penis}} | |||
| {{Infobox_Disease | |||
| {{for|the informal term in libel law|Small penis rule}} | |||
| ⚫ | | |
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| {{pp-move}} | |||
| | Image = Flacid_micropenis2_highres.jpg | |||
| {{pp-semi-indef}} | |||
| ⚫ | |||
| {{More citations needed|date=April 2024}} | |||
| ⚫ | |||
| {{Use dmy dates|date=April 2023}} | |||
| ⚫ | | ICD10 = |
||
| {{Infobox medical condition (new) | |||
| ⚫ | | ICD9 = {{ICD9|752.64}} | ||
| | name = Micropenis | |||
| | image = Male micro.jpg | |||
| ⚫ | | caption = A flaccid micropenis | ||
| ⚫ | | MedlinePlus = |
||
| | field = ] | |||
| ⚫ | | eMedicineSubj = ped | ||
| | symptoms = | |||
| | complications = | |||
| | onset = | |||
| | duration = Permanent (lifetime) | |||
| | causes = | |||
| | risks = | |||
| | diagnosis = | |||
| | differential = | |||
| | prevention = | |||
| | treatment = | |||
| | medication = | |||
| | prognosis = | |||
| | frequency = {{circa}} 0.6% of men | |||
| | deaths = | |||
| | alt = | |||
| | Average Size = | |||
| }} | |||
| A '''micropenis''' or microphallus is an unusually small ]. A common criterion is a dorsal (measured on top) ] of at least 2.5 ]s smaller than the ] ] for age.<ref name="pmid7366061">{{cite journal |author=Lee PA |title=Micropenis. I. Criteria, etiologies and classification |journal=The Johns Hopkins Medical Journal |volume=146 |issue=4 |pages=156–63 |year=1980 |pmid=7366061 |name-list-style=vanc|author2=Mazur T |author3=Danish R |display-authors=3 |last4=Amrhein |first4=J |last5=Blizzard |first5=RM |last6=Money |first6=J |last7=Migeon |first7=CJ}}</ref> A micropenis is stretched penile length equal to or less than 1.9 ] (0.75 ]) in term ], and 9.3 cm (3.67 in) in adults. The condition is usually recognized shortly after ]. The term is most often used medically when the rest of the penis, ], and ] are without ], such as ]. Traditionally, a '''microphallus''' describes a micropenis with ].<ref>{{Cite journal|url=https://emedicine.medscape.com/article/923178-overview|title=Microphallus: Practice Essentials, Pathophysiology, Epidemiology|date=29 December 2022|journal=Medscape|via=eMedicine}}</ref> Micropenis incidence is about 1.5 in 10,000 male ] in ].<ref name="ScienceDaily04">ScienceDaily.com (2004). "," 6 Dec. 2004, retrieved 2 April 2012.</ref> | |||
| '''Micropenis''' is a medical term that describes an unusually small ]. A common criterion is a dorsal (measured on top) erect ] of at least 2.5 ]s smaller than the ] ].<ref name="pmid7366061">{{cite journal |author=Lee PA, Mazur T, Danish R, ''et al'' |title=Micropenis. I. Criteria, etiologies and classification |journal=The Johns Hopkins medical journal |volume=146 |issue=4 |pages=156–63 |year=1980 |pmid=7366061 |doi=}}</ref> The condition is usually recognized shortly after ]. The term is most often used medically when the rest of the penis, ], and ] is without ] such as ]. | |||
| ==Causes== | ==Causes== | ||
| ] |
] | ||
| Of the abnormal conditions associated with micropenis, most are conditions of reduced prenatal ] production or effect |
Of the abnormal conditions associated with micropenis, most are conditions of reduced prenatal ] production or effect, such as abnormal testicular development (testicular dysgenesis), ], ], specific defects of ] or dihydrotestosterone synthesis (], ]), ]s, inadequate ] stimulation (] deficiency), and other forms of congenital ]. Micropenis can also occur as part of many genetic malformation syndromes that do not involve the sex chromosomes. It is sometimes a sign of congenital ] or congenital ]. Several ] genes affect penis and digit size without detectable hormone abnormalities.{{citation needed|date=May 2021}} | ||
| In addition, ] exposure to some estrogen-based ] like ] (DES) has been linked to genital abnormalities or a smaller than normal penis.<ref>{{cite news|author=Center for Disease Control|title=DES Update: Consumers|url=https://www.cdc.gov/des/consumers/about/effects_sons.html}}</ref> | |||
| ⚫ | After evaluation to detect any of the conditions described above, micropenis can often be treated in infancy with injections of various ]s, such as ] |
||
| ⚫ | After evaluation to detect any of the conditions described above, micropenis can often be treated in infancy with injections of various ]s, such as ] and ].<ref name="auto">{{cite journal |vauthors= Hatipoglu N, Kurtoglu S | ||
| Most eight to fourteen year old boys referred for micropenis do not have the micropenis condition. Such concerns are usually explained by one of the following: | |||
| |date= December 2013|title=Micropenis: Etiology, Diagnosis and Treatment Approaches | |||
| |journal=Journal of Clinical Research Pediatric Endocrinology |volume=5 |issue= 4|pages=217–223 |doi=10.4274/Jcrpe.1135 |pmid= 24379029|pmc= 3890219}}</ref> | |||
| ⚫ | ==Treatment== | ||
| # a penis concealed in ] (extra fat around the mons pubis). | |||
| # a large body and frame for which a prepubertal penis simply appears too small. | |||
| # ] with every reason to expect good future growth. | |||
| ⚫ | ==Treatment== | ||
| ===Hormone treatment=== | ===Hormone treatment=== | ||
| ⚫ | Growth of the penis both before birth and during childhood and puberty is strongly influenced by ] and, to a lesser degree, the ].{{Citation needed|reason=This information needs to be referenced from MEDRS sources.|date=January 2025}} However, later endogenous hormones mainly have value in the treatment of micropenis caused by hormone deficiencies, such as ] or ].{{Citation needed|reason=This information needs to be referenced from MEDRS sources.|date=January 2025}} | ||
| ] | |||
| ⚫ | Growth of the penis both before birth and during childhood and puberty is strongly influenced by ] and, to a lesser degree, ], |
||
| Regardless of the cause of micropenis, if it is recognized in infancy, a brief course of testosterone is often prescribed<ref name="pmid15201804">{{cite journal | |
Regardless of the cause of micropenis, if it is recognized in infancy, a brief course of testosterone is often prescribed<ref name="pmid15201804">{{cite journal |vauthors=Ishii T, Sasaki G, Hasegawa T, Sato S, Matsuo N, Ogata T |title=Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis |journal=J. Urol. |volume=172 |issue=1 |pages=319–24 |year=2004 |pmid=15201804 |doi=10.1097/01.ju.0000129005.84831.1e}}</ref> (usually no more than three months). This usually induces a small amount of growth, confirming the likelihood of further growth at puberty, but rarely achieves normal size. No additional testosterone is given during childhood, to avoid unwanted ] and ]. There is also some evidence that premature administration of testosterone can lead to reduced penis size in the adult.<ref name="pmid7609189">{{cite journal |vauthors=McMahon DR, Kramer SA, Husmann DA |title=Micropenis: does early treatment with testosterone do more harm than good? |journal=J. Urol. |volume=154 |issue=2 Pt 2 |pages=825–9 |year=1995 |pmid=7609189|doi=10.1016/S0022-5347(01)67175-1}}</ref> | ||
| Testosterone treatment is resumed in adolescence only for boys with hypogonadism. Penile growth is completed at the end of puberty, |
Testosterone treatment is resumed in adolescence only for boys with hypogonadism. Penile growth is completed at the end of puberty, similar to the completion of ], and provision of extra testosterone to post-pubertal adults produces little or no further growth.<ref name="auto"/> | ||
| ===Surgery=== | ===Surgery=== | ||
| Because hormone treatment rarely achieves average size, |
Because hormone treatment rarely achieves average size, several surgical techniques similar to ] for ] have been devised and performed, but they are not generally considered successful enough to be widely adopted and are rarely performed in childhood.{{citation needed|date=May 2021}} | ||
| In extreme cases of micropenis, there is barely any shaft, and the glans appears to sit almost on the pubic skin. From the 1960s until the late 1970s, it was |
In extreme cases of micropenis, there is barely any shaft, and the glans appears to sit almost on the pubic skin. From the 1960s until the late 1970s, it was common for ] and ] to be recommended. This was especially likely if evidence suggested that response to additional testosterone and pubertal testosterone would be poor. With parental acceptance, the boy would be reassigned and renamed as a girl, and surgery performed to remove the testes and construct an artificial vagina (]). This was based on the now-questioned idea that gender identity was shaped entirely from socialization, and that a man with a small penis can find no acceptable place in society.{{citation needed|date=May 2021}} | ||
| #gender identity and sex differences were solely a matter of social learning rather than biology. | |||
| #a male with a penis too small to put into a vagina could not find a satisfactory social and sexual place in society. | |||
| #a functionally acceptable vagina could be constructed surgically. | |||
| ], the center most known for this approach, performed twelve such reassignments from 1960 to 1980,{{Citation needed|date=May 2022}} most notably{{Citation needed|date=April 2010}} that of ] (whose penis was destroyed by a circumcision accident), overseen by ]. By the mid-1990s, reassignment was less often offered, and all three premises had been challenged. Former subjects of such surgery, vocal about their dissatisfaction with the adult outcome, played a large part in discouraging this practice. Sexual reassignment is rarely performed today for severe micropenis (although the question of raising the boy as a girl is sometimes still discussed).<ref name="pmid10228285">{{cite journal |author=Calikoglu AS |title=Should boys with micropenis be reared as girls? |journal=J. Pediatr. |volume=134 |issue=5 |pages=537–8 |year=1999 |pmid=10228285 |doi=10.1016/S0022-3476(99)70236-2 |last2=Calikoglu |first2=A|doi-access=free }}</ref> | |||
| ==See also== | ==See also== | ||
| * ] | * ] | ||
| * ] | * ] | ||
| * ] | |||
| * ] | |||
| * ] | * ] | ||
| * ] | |||
| ==References== | ==References== | ||
| {{reflist}} | |||
| <references/> | |||
| ==External links== | ==External links== | ||
| {{Commons category|Micropenis}} | |||
| *, by Melissa Hendricks, '']'' | * , by Melissa Hendricks, '']'' | ||
| *, from '']'' (]) | |||
| * from the '']'' | * from the '']'' | ||
| {{Medical condition classification and resources | |||
| ⚫ | {{ |
||
| ⚫ | | DiseasesDB = 14839 | ||
| ⚫ | | ICD10 = | ||
| ⚫ | ] | ||
| ⚫ | | ICD9 = {{ICD9|752.64}} | ||
| ⚫ | ] | ||
| | ICDO = | |||
| ⚫ | | OMIM = 607306 | ||
| ⚫ | | MedlinePlus = | ||
| ⚫ | | eMedicineSubj = ped | ||
| | eMedicineTopic = 1448 | |||
| | MeshID = }} | |||
| ⚫ | {{Male congenital malformations of genital organs, indeterminate sex and pseudohermaphroditism}} | ||
| ] | |||
| ] | |||
| ⚫ | ] | ||
| ] | |||
| ⚫ | ] | ||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
Latest revision as of 13:31, 2 January 2025
Unusually small penis For the informal term in libel law, see Small penis rule.
 | This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Micropenis" – news · newspapers · books · scholar · JSTOR (April 2024) (Learn how and when to remove this message) |
Medical condition
| Micropenis | |
|---|---|
 | |
| A flaccid micropenis | |
| Specialty | Urology |
| Duration | Permanent (lifetime) |
| Frequency | c. 0.6% of men |
A micropenis or microphallus is an unusually small penis. A common criterion is a dorsal (measured on top) penile length of at least 2.5 standard deviations smaller than the mean human penis size for age. A micropenis is stretched penile length equal to or less than 1.9 cm (0.75 in) in term infants, and 9.3 cm (3.67 in) in adults. The condition is usually recognized shortly after birth. The term is most often used medically when the rest of the penis, scrotum, and perineum are without ambiguity, such as hypospadias. Traditionally, a microphallus describes a micropenis with hypospadias. Micropenis incidence is about 1.5 in 10,000 male newborns in North America.
Causes
Of the abnormal conditions associated with micropenis, most are conditions of reduced prenatal androgen production or effect, such as abnormal testicular development (testicular dysgenesis), Klinefelter syndrome, Leydig cell hypoplasia, specific defects of testosterone or dihydrotestosterone synthesis (17,20-lyase deficiency, 5α-reductase deficiency), androgen insensitivity syndromes, inadequate pituitary stimulation (gonadotropin deficiency), and other forms of congenital hypogonadism. Micropenis can also occur as part of many genetic malformation syndromes that do not involve the sex chromosomes. It is sometimes a sign of congenital growth hormone deficiency or congenital hypopituitarism. Several homeobox genes affect penis and digit size without detectable hormone abnormalities.
In addition, in utero exposure to some estrogen-based fertility drugs like diethylstilbestrol (DES) has been linked to genital abnormalities or a smaller than normal penis.
After evaluation to detect any of the conditions described above, micropenis can often be treated in infancy with injections of various hormones, such as human chorionic gonadotropin and testosterone.
Treatment
Hormone treatment
Growth of the penis both before birth and during childhood and puberty is strongly influenced by testosterone and, to a lesser degree, the growth hormone. However, later endogenous hormones mainly have value in the treatment of micropenis caused by hormone deficiencies, such as hypopituitarism or hypogonadism.
Regardless of the cause of micropenis, if it is recognized in infancy, a brief course of testosterone is often prescribed (usually no more than three months). This usually induces a small amount of growth, confirming the likelihood of further growth at puberty, but rarely achieves normal size. No additional testosterone is given during childhood, to avoid unwanted virilization and bone maturation. There is also some evidence that premature administration of testosterone can lead to reduced penis size in the adult.
Testosterone treatment is resumed in adolescence only for boys with hypogonadism. Penile growth is completed at the end of puberty, similar to the completion of height growth, and provision of extra testosterone to post-pubertal adults produces little or no further growth.
Surgery
Because hormone treatment rarely achieves average size, several surgical techniques similar to phalloplasty for penis enlargement have been devised and performed, but they are not generally considered successful enough to be widely adopted and are rarely performed in childhood.
In extreme cases of micropenis, there is barely any shaft, and the glans appears to sit almost on the pubic skin. From the 1960s until the late 1970s, it was common for sex reassignment and surgery to be recommended. This was especially likely if evidence suggested that response to additional testosterone and pubertal testosterone would be poor. With parental acceptance, the boy would be reassigned and renamed as a girl, and surgery performed to remove the testes and construct an artificial vagina (vaginoplasty). This was based on the now-questioned idea that gender identity was shaped entirely from socialization, and that a man with a small penis can find no acceptable place in society.
Johns Hopkins Hospital, the center most known for this approach, performed twelve such reassignments from 1960 to 1980, most notably that of David Reimer (whose penis was destroyed by a circumcision accident), overseen by John Money. By the mid-1990s, reassignment was less often offered, and all three premises had been challenged. Former subjects of such surgery, vocal about their dissatisfaction with the adult outcome, played a large part in discouraging this practice. Sexual reassignment is rarely performed today for severe micropenis (although the question of raising the boy as a girl is sometimes still discussed).
See also
References
- Lee PA, Mazur T, Danish R, et al. (1980). "Micropenis. I. Criteria, etiologies and classification". The Johns Hopkins Medical Journal. 146 (4): 156–63. PMID 7366061.
- "Microphallus: Practice Essentials, Pathophysiology, Epidemiology". Medscape. 29 December 2022 – via eMedicine.
- ScienceDaily.com (2004). "Surgeons Pinch More Than An Inch From The Arm To Rebuild A Micropenis," 6 Dec. 2004, retrieved 2 April 2012.
- Center for Disease Control. "DES Update: Consumers".
- ^ Hatipoglu N, Kurtoglu S (December 2013). "Micropenis: Etiology, Diagnosis and Treatment Approaches". Journal of Clinical Research Pediatric Endocrinology. 5 (4): 217–223. doi:10.4274/Jcrpe.1135. PMC 3890219. PMID 24379029.
- Ishii T, Sasaki G, Hasegawa T, Sato S, Matsuo N, Ogata T (2004). "Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis". J. Urol. 172 (1): 319–24. doi:10.1097/01.ju.0000129005.84831.1e. PMID 15201804.
- McMahon DR, Kramer SA, Husmann DA (1995). "Micropenis: does early treatment with testosterone do more harm than good?". J. Urol. 154 (2 Pt 2): 825–9. doi:10.1016/S0022-5347(01)67175-1. PMID 7609189.
- Calikoglu AS; Calikoglu, A (1999). "Should boys with micropenis be reared as girls?". J. Pediatr. 134 (5): 537–8. doi:10.1016/S0022-3476(99)70236-2. PMID 10228285.
External links
- Into the Hands of Babes, by Melissa Hendricks, Johns Hopkins Magazine
- "Effect of penile size on nocturnal erections: evaluation with NPTR testing with men having micropenis" from the International Journal of Impotence Research
| Classification | D |
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| External resources |
| Female and male congenital anomalies of the genitalia, including intersex and DSD | |||||||||||||||||
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