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Meskele K, Meseret F, Yesuf A, Fantahun B. Penile Size in Term Newborns in Addis Ababa, Ethiopia. Acta Paediatr 2022; 111:2400-2404. [PMID: 36040421 DOI: 10.1111/apa.16533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/29/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
AIM To determine the normative value of stretched penile length (SPL) for Ethiopian newborns and to set a cut-off point for micropenis. METHODS A total of 221 term newborns were included in the study. Stretched penile length was measured in the first 72 hours of postnatal age in neonates with a gestational age of 37-42 completed weeks. SPL < -2SD was taken as micropenis in this study. RESULTS The minimum and maximum penile length were 2.5cm and 5cm, respectively, with a mean ± SD of 3.28 ± 0.42. SPL at - 2 SD and + 2 SD were 2.43 and 4.12 cm, respectively. A significant correlation was observed between penile length and body length (p = 0.005). Neonates born via instrumental delivery had larger SPL compared to those who were delivered by caesarian section (p = 0.01) or by vaginal delivery (p = 0.006). CONCLUSION The mean stretched penile length in our study mirrors findings from other African studies. SPL less than 2.43 cm can be considered as micropenis in our setting. Therefore, routine genital examination and interpretation at birth is crucial to identify micropenis which might herald a serious underlying condition that needs further investigation.
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Affiliation(s)
- Kisu Meskele
- Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Fikir Meseret
- Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Aman Yesuf
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Fantahun
- Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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O'Hagan LA, Larsen PD, Nataraja RM, Pacilli M, Taghavi K. Nomogram of paediatric male urethral size: A systematic review. J Pediatr Urol 2022; 18:79-85. [PMID: 34782235 DOI: 10.1016/j.jpurol.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Knowledge of the normal size of the urethral meatus in boys is important for safely performing urethral catheterization and fundamental to the diagnosis and treatment of paediatric urological conditions. However, clinicians often rely subjectively on previous experience and clinical judgement, rather than a robust evidence-base. A systematic review of the literature was undertaken to define the calibre of the male urethral meatus in paediatric age-groups. METHODS The MEDLINE and EMBASE databases were systematically searched from inception to December 2020 for studies measuring meatal calibre in boys up to 16 years of age. Google Scholar searches along with forward and backward citation tracking identified additional studies. Studies of subjects >16 years, females, or patients with urethral diseases were excluded. RESULTS Nine articles (2084 paediatric subjects) were included in the final review. Mean meatal calibre increases non-linearly with age, with accelerated growth occurring during infancy (mini-puberty) and adolescence (puberty). Meatal calibre can be approximately grouped by age as follows: neonate (6-10Fr); infant (10-12Fr); child (12-14Fr); and adolescent (14-18Fr). There is substantial individual variability for same-aged children. Meatal calibre has been independently related to height, weight, and penile size, but the effects of ethnicity and circumcision remain unclear. CONCLUSIONS The evidence-base for this fundamental aspect of paediatric urology includes only a few low-quality studies and is largely derived from one early study of circumcised American boys. Further studies are warranted to establish normative urethral size values based on rigorous, contemporary data with known dependent variables also included.
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Affiliation(s)
- Lomani A O'Hagan
- School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Peter D Larsen
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand
| | - Ramesh M Nataraja
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Maurizio Pacilli
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kiarash Taghavi
- Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Victoria, Australia; Department of Urology, Royal Children's Hospital, Melbourne, Victoria, Australia.
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Badawy M, Fawaz LA, Abd El Baky H, Elkhashab A, Hussein AA, Mira MF. Reference values for penile and clitoral lengths of healthy term Egyptian newborn infants. J Paediatr Child Health 2022; 58:157-162. [PMID: 34369621 DOI: 10.1111/jpc.15686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022]
Abstract
AIM Examination of the external genital organs is an integral part of the routine physical examination of the newborn. Early recognition of micropenis or clitoromegaly is important as they may be the only obvious manifestation of pituitary or hypothalamic hormonal deficiencies at birth. Studies suggest that differences in penile or clitoral anthropometry may exist between different populations. Therefore, reference values for genital organs dimensions should be available and well known to medical personnel. We aim to establish reference values for the penile length in Egyptian newborn boys and reference values for the clitoral length in Egyptian newborn girls and to define micropenis and clitoromegaly according to Egyptian reference values. METHODS A total of 500 healthy term newborn boys and 500 healthy term newborn girls were enrolled in the study. Stretched penile length and clitoral length were measured during the first 7 days of postnatal life. Birth weight, length and head circumference were measured and recorded. RESULTS The mean (±SD) stretched penile length was 3.16 ± 0.41 cm. The mean (±SD) clitoral length was 0.51 ± 0.13. There was no significant correlation between penile or clitoral length, and body weight, length or head circumference. CONCLUSION Our study provides reference values for normal penile length and clitoral length in Egyptian newborns. Our study suggests that among healthy term Egyptian newborns, penile length of less than 2.13 cm may be considered micropenis and clitoral length of more than 0.83 cm may be considered clitoromegaly.
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Affiliation(s)
- Magda Badawy
- Department of Pediatrics, Cairo University, Cairo, Egypt
| | - Lubna A Fawaz
- Department of Pediatrics, Cairo University, Cairo, Egypt
| | | | - Amr Elkhashab
- Department of Pediatrics and Neonatology, Al Galaa Hospital, Cairo, Egypt
| | | | - Marwa F Mira
- Department of Pediatrics, Cairo University, Cairo, Egypt
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López-Soto Á, Bueno-González M, Urbano-Reyes M, Garví-Morcillo J, Meseguer-González JL, Martínez-Uriarte J, García-Izquierdo O, Donate-Legaz JM, Leante-Castellanos JL, Martínez-Cendán JP. Stretched penile length at birth: a systematic review. J Pediatr Endocrinol Metab 2021; 34:1211-1223. [PMID: 34323056 DOI: 10.1515/jpem-2021-0189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/11/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Micropenis is an endocrinological condition that is habitually observed at birth. Diagnosis is made by measuring the stretched penile length, a method established 80 years ago. Discrepancies in the normative data from recent studies raise the need for a current revision of the methodology. OBJECTIVES The aims of this systematic review were to compare the different normative data of SPL at birth, to examine the methodological aspects of the technique and to evaluate the independent variables that may be involved. METHODS Searches were performed using MEDLINE, EMBASE, Scielo, the Cochrane Library and Web of Science. A combination of the relevant medical terms, keywords and word variants for "stretched penile length", "penile length", "penile size", "newborn" and "birth" were used. Eligibility criteria included normative studies that used the stretched penile length (SPL) measurement on a population of healthy, full-term newborns during the first month of life. The outcomes studied included characteristics of the studies, methodological aspects and independent variables. RESULTS We identified 49 studies comprising 21,399 children. Significant discrepancies are observed between the different studies. Methodological aspects seem to be consistent and similar. The main independent variables appear to be ethnic group and gestational age. Main limitations were the absence of studies of entire world regions such as Europe or South America, and the heterogeneity of the ethnic background that complicates the analysis. CONCLUSIONS It seems advisable to suggest the creation of customized reference charts for each specific population instead of resorting to the classic cut-off points.
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Liu Y, Zheng Z, Zhu Q. Case Report: Identification of Polygenic Mutations by Exome Sequencing. Front Pediatr 2021; 9:689901. [PMID: 34746046 PMCID: PMC8567987 DOI: 10.3389/fped.2021.689901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022] Open
Abstract
The discovery of rare genetic variation through different gene sequencing methods is a very challenging subject in the field of human genetics. A case of a 1-year-old boy with metabolic acidosis and hypokalemia, a small penis, growth retardation, and G-6PD deficiency was reported. Since the clinical symptoms are complex and seem uncorrelated, the authors hypothesized that the child had chromosome or gene problems, and exome sequencing (ES) was applied to samples from him and his parents. Three main locus mutations in three genes were found in the proband, including SLC4A1, FGFR1, and G6PD genes. A missense mutation (c.1766G>T, p.R589 L) was found in exon 14 of SLC4A1 gene, which was a de novo mutation. Another missense mutation (c.1028 A>G, p.H343R) was found in exon 9 of FGFR1 gene, which was also a de novo mutation. These findings further demonstrate the utility of ES in the diagnosis of rare diseases.
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Affiliation(s)
- Yanfeng Liu
- Department of Endocrinology, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Zhongshi Zheng
- Department of Endocrinology, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Qingling Zhu
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
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Kareem AJ, Elusiyan JBE, Kareem AO. Stretched penile length and total serum testosterone in term male neonates. Pan Afr Med J 2020; 37:61. [PMID: 33244324 PMCID: PMC7680247 DOI: 10.11604/pamj.2020.37.61.21123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/25/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction the reference values of stretched penile length vary with different ethnic group. There is paucity of data on the reference range of total serum testosterone in neonates especially in Africa. This study therefore was to determine the normal stretched penile length, total serum testosterone levels in term male newborns and to correlate them with anthropometric parameters. Methods this was a prospective cross-sectional study. One hundred and twenty-four consecutive healthy term male neonates were recruited in the first 72 hours of postnatal life. The stretched penile length (SPL) was measured with a rigid metric ruler. Weight, length and occipitofrontal circumference were also measured. Total serum testosterone level was determined using Enzyme Linked Immunoassay. Data were analysed using the Statistical Package for Social Sciences for Windows version 20. Results a total of 124 term male neonates were recruited. The postnatal age of recruited neonates was one to 70 hours with a mean of 22.8 ± 17.6 hours and the mean of estimated gestation age was 38.5 ± 1.3 weeks. The range of stretched penile length was from 2.1 to 3.9 cm with a mean of 3.2 ± 0.4 cm and SPL less than 2.2 cm was considered as micropenis. The mean total serum testosterone level was 357.4 ± 241.7 ng/dl. The SPL had a positive correlation with the birth weight, length and total serum testosterone. The total serum testosterone and birth length were predictors of stretched penile length. Conclusion among the studied population the mean stretched penile length was 3.2 cm and mean total serum testosterone was 357.4 ng/dL.
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Affiliation(s)
- Abiodun John Kareem
- Endocrinology and Metabolism Unit, Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Jerome Boluwaji Elutayo Elusiyan
- Endocrinology and Metabolism Unit, Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.,Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Sonographic measure techniques of fetal penile length. Obstet Gynecol Sci 2020; 63:555-564. [PMID: 32810976 PMCID: PMC7494763 DOI: 10.5468/ogs.20087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022] Open
Abstract
Postnatal penile length is a reliable, standardized, and widely used marker for the diagnosis of genitourinary pathology, as well as genetic and hormonal disorders. In contrast, prenatal diagnosis has not been developed equally and there is a lack of relevant literature. Our objective is to review the studies on fetal penile length, and apply findings to clinical practice. Although the most used technique is the outer penile length, there is no consensus regarding the appropriate technique for prenatal measurement. Several reports have provided reference data with high correlation. However, important issues like poor correlation with post-natal measures or presence of confounding variables are still present. Diagnosis of both a micropenis and macropenis can indicate related pathologies, and this information may benefit parental counseling and facilitate fetal management. Therefore, it is necessary to carry out prospective studies that provide reliable normative data.
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Adekoya AO, Fetuga MB, Jarrett OO, Ogunlesi TA, Chanoine J, Oba‐Daini OO. Normative data on penile and anogenital measurements of term male infants in Sagamu, Nigeria. Acta Paediatr 2019; 108:2041-2047. [PMID: 31162733 DOI: 10.1111/apa.14885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/21/2019] [Accepted: 06/03/2019] [Indexed: 12/01/2022]
Abstract
AIM To document normative data on penile size and anogenital distances of apparently normal term male infants in Sagamu, Nigeria. METHODS This cross-sectional study was carried out on 303 term male infants within the first 72 hours of life. Stretched penile length, penile width and three measures of anogenital distances were recorded: anogenital distance-1, anogenital distance-2 and anoscrotal distance. RESULTS The mean (±SD) stretched penile length and penile width were 39.4 ± 4.2 mm and 11.0 ± 1.0 mm, respectively. The mean values for anogenital distance-1, anogenital distance-2 and the anoscrotal distance were 48.7 ± 3.9 mm, 42.8 ± 4.6 mm and 25.5 ± 3.9 mm, respectively. Only penile width and anogenital distance-1 significantly correlated with all the anthropometric parameters but anogenital distance-1 had the strongest correlation (p < 0.01 for all). CONCLUSION The observed mean stretched penile length was greater than previously reported. Local references are preferable in interpreting anogenital measurements in newborns to avoid diagnostic errors. There is need for a consensus on the definition of micropenis.
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Affiliation(s)
- Adesola Olubunmi Adekoya
- Department of Paediatrics Babcock University Teaching Hospital and Ben Carson School of Medicine, Babcock University Ilishan‐Remo Ogun State Nigeria
| | - Musili Bolanle Fetuga
- Department of Paediatrics Olabisi Onabanjo University Teaching Hospital Sagamu Nigeria
| | - Olumide Olatokunbo Jarrett
- Department of Paediatrics University College Hospital and College of Medicine, University of Ibadan Ibadan Nigeria
| | | | - Jean‐Pierre Chanoine
- Endocrinology and Diabetes Unit British Columbia’s Children’s Hospital, University of British Columbia Vancouver BC Canada
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El-Ammawi TS, Abdel-Aziz RT, Medhat W, Nasif GA, Abdel-Rahman SG. Measurement of stretched penile length in prepubertal boys in Egypt. J Pediatr Urol 2018; 14:553.e1-553.e5. [PMID: 30075934 DOI: 10.1016/j.jpurol.2018.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Early diagnosis of penile size abnormalities is both medically and psychologically important. It is important in the diagnosis of penile problems. Therefore, a current established reference for penile size in newborns and children is vital for diagnosis and early management of micropenis. OBJECTIVES The aim of the present study was to establish reference values for penile length in newborn and prepubertal boys at different ages in Minia Governorate, Egypt. METHODS The study was conducted on 1000 boys with ages ranging from 1 day to 13 years. Stretched penile length (SPL) was measured in mm by using a ruler with markings along the dorsum of the penis. The suprapubic fat tissue was pressed with one end of the ruler through the pubic ramus, and the penis was fully stretched and measured. RESULTS The mean SPL increased with age from newborn to 5 years, with a rapid growth observed in the first 8 months of life. After 5 years, SPL showed a slower growth rate until the age of 10 years, where it started to increase significantly again. DISCUSSION Comparison of the SPL in different age groups revealed significant statistical differences between most groups. It showed a noticeable and significant increase, especially from birth to the age of 5 years. Although there was a mild increase in SPL from 5 to 10 years, it showed a significant level in few age groups, indicating that the change is trivial. After that, high growth rate occurred again and statistical differences remained from age 10-13 years. CONCLUSION An updated reference for normal SPL in Egyptian boys from birth to 13 years old was provided in this study.
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Affiliation(s)
- T S El-Ammawi
- Department of Dermatology, STDs and Andrology, Minia University, Minia, Egypt
| | - R T Abdel-Aziz
- Department of Dermatology, STDs and Andrology, Minia University, Minia, Egypt.
| | - W Medhat
- Department of Dermatology, STDs and Andrology, Minia University, Minia, Egypt
| | - G A Nasif
- Department of Dermatology, STDs and Andrology, Minia University, Minia, Egypt
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Al-Hazmi H, Traby M, Al-Yami F, Kattan AE, Al-Qattan MM. Penile reconstruction in a newborn following complicated circumcision: A case report. Int J Surg Case Rep 2018; 51:74-77. [PMID: 30144715 PMCID: PMC6107900 DOI: 10.1016/j.ijscr.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/17/2018] [Accepted: 08/01/2018] [Indexed: 01/07/2023] Open
Abstract
Grade V post-circumcision penile injury is known as “total phallic loss”. We present a case reconstructed with release of the subcutaneous corporal remnant. The outcome was excellent functionally and cosmetically.
Introduction Grade V post-circumcision penile injury is known as “total phallic loss”. It is usually seen with the use of mono-polar electro-cautery for circumcision resulting in penile necrosis. We report on a newborn treated by release of the subcutaneous corporal remnant and explain why this option should be considered of choice in cautery-related Grade V injuries. Report of a case A 25-day old Saudi Arabian newborn with Grade V penile injury underwent reconstruction at our tertiary-care center. Upon exploration, the remnant part of the penis under the suprapubic skin was 2.6 cm. This included the root of the penis (estimated to be 1.8 cm long in the newborn) as well as an extra 0.8 cm of corporal length from the pendulous part of the penis which has retracted under the skin. Full release of the suspensory ligament was done. The result at 6 months was satisfactory both functionally and cosmetically. Discussion Options of management of Grade V injuries include sex-reassignment, phallic reconstruction using flaps, and release of the subcutaneous corporal remnant. We demonstrate that the latter option should be considered of choice in cautery-related Grade V injuries because there is usually preservation of the most proximal part of the corpora of the shaft which becomes retracted under the skin. Hence, the released remnant is of adequate length. Conclusion Post-circumcision Grade V penile injuries of the newborn are best reconstructed with release of the subcutaneous corporal remnant. The neophallus is erectile and has an acceptable length and appearance.
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Affiliation(s)
- H Al-Hazmi
- Division of Urology, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
| | - M Traby
- Division of Urology, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
| | - F Al-Yami
- Division of Urology, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
| | - A E Kattan
- Division of Plastic Surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
| | - M M Al-Qattan
- Division of Plastic Surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
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Soheilipour F, Rohani F, Dehkordi EH, Isa Tafreshi R, Mohagheghi P, Zaheriani SM, Jesmi F, Salehiniya H. The Nomogram of Penile Length and Circumference in Iranian Term and Preterm Neonates. Front Endocrinol (Lausanne) 2018; 9:126. [PMID: 29780352 PMCID: PMC5945872 DOI: 10.3389/fendo.2018.00126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The normal length of penis in preterm and term neonates is different among different nations, and is affected by various factors. The present study aimed to determine stretched penile length (SPL) values and cutoff level of micropenis in term and preterm Iranian neonates, for the first time. MATERIALS AND METHODS All male neonates born in two general hospitals of Tehran (Akbarabadi, and Rasoul hospitals), center of Iran, with gestational age of 28-42 weeks were included and their SPL and penile circumference (PC) were examined on the first 3 days after birth by the same physician. Birth weight (BW), and height, gestational age, type of delivery, mother's age, twin/multiple pregnancy, drug, and medical history of mother during pregnancy were recorded and cutoff levels of two variables were calculated based on the collected variables for different gestational ages. RESULTS Among a total of 587 neonates, 203 neonates were born term and 384 preterm. Mean ± SD of neonates' BW were 2,682.51 ± 739.30 (850-4800) gr. Mean ± SD of their SPL was 22.48 ± 3.34 mm; 25.92 ± 1.54 mm in term and 20.66 ± 2.50 mm in preterm infants (P = 0.001). Mean ± SD of PC was 6.71 ± 1.31 mm; 8.14 ± 0.48 in term and 5.96 ± 0.92 in preterm infants (P = 0.001). SPL and PC were significantly correlated with type of delivery, number of parity, gestational age, BW, and crown-heel length, head circumference (P < 0.001). CONCLUSION This study suggested that SPL in male neonates was 22.48 mm and PC was 6.71 mm, both correlated with gestational age and BW. Due to the ethnical variety of this cutoff points and lack of an appropriate study in Iran, these cutoff points can be used by all physicians as a reference for Iranian newborns (term and preterm), in order to prevent misdiagnosis of micropenis and genital disorders.
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Affiliation(s)
- Fahimeh Soheilipour
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Rohani
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
| | - Elham Hashemi Dehkordi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Isa Tafreshi
- Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Mohagheghi
- Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Jesmi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Zabol University of Medical Sciences, Zabol, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hamid Salehiniya,
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Asafo-Agyei SB, Ameyaw E, Chanoine JP, Nguah SB. Normative penile anthropometry in term newborns in Kumasi, Ghana: a cross-sectional prospective study. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2017; 2017:2. [PMID: 28149308 PMCID: PMC5270225 DOI: 10.1186/s13633-017-0042-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 01/19/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Genital measurements are a useful adjunct in the early detection of various endocrine conditions including hypopituitarism and disorders of sexual differentiation. Standards for genital sizes have been published but racial/ethnic differences exist. This study was done to establish norms for genital sizes in term Ghanaian male newborns. METHODS This was a cross-sectional study of all apparently well full-term newborns of postnatal age < 48 h and birth weight between 2.5 and 4.0 kg delivered at Komfo Anokye Teaching Hospital within the study period. Anthropometric and genital parameters were documented for study subjects as well as parental socio-demographic indices. RESULTS A total of 644 male newborns were recruited between May and September 2014. The mean penile length (MPL) was 3.3 ± 0.5 cm and the mean penile width (MPW) was 1.05 ± 0.1 cm. An inverse relationship was found between maternal age and MPL (correlation coefficient -0.062, 95% CI -0.121 to -0.002; p = 0.04). MPL was also significantly different (p = 0.04) by mode of delivery, with babies delivered by caesarean section having the lowest MPL. MPL correlated positively with both gestational age (p = 0.04) and birth length (p < 0.001), while MPW correlated proportionally with birth weight and length (p < 0.001 for both). CONCLUSIONS Using the conventional definition of micropenis as stretched penile length (SPL) < 2.5 standard deviation (SD) below the mean and macropenis as an SPL > 2.5 SD, a Ghanaian term newborn may warrant investigation if he has an MPL < 2.1 cm or > 4.4 cm.
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Affiliation(s)
| | - Emmanuel Ameyaw
- Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia's Children's Hospital, University of British Columbia, Vancouver, BC Canada
| | - Samuel Blay Nguah
- Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Mondal R, Ray S, Chatterjee K, Sabui TK, Hazra A, Das S, Chaudhuri J, Sil A, Samanta M. Penile Length and Testicular Volume in Newborns. Indian J Pediatr 2016; 83:1398-1404. [PMID: 27272047 DOI: 10.1007/s12098-016-2163-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To measure Penile length (PL) and Testicular volume (TV) in newborn boys for assessing genital abnormalities. METHODS In a tertiary care setting, measurements of PL and TV were recorded from 480 babies born on alternate days except the weekend, at 24 to 72 h of life by one investigator with the same set of instruments. The penis was stretched to the point of increased resistance and the distance from the tip of the glans penis to the pubic ramus was measured as the stretched PL. Testicular volume was measured by a Prader orchidometer. Improvised beads made of plasticine were used for recording volumes <1 ml. RESULTS In the study cohort, 365 (76.04 %) were term babies. The mean PL was 34 ± 4.7 mm for the whole cohort while the corresponding value for mean TV was 0.6 ± 0.2 ml. The gestation age-wise percentile charts of PL and TV have been generated. There was modest positive correlation between PL and TV. Positive correlation was also observed between PL and TV and birth weight, body length, and head, chest and arm circumference. Both PL and TV showed statistically significant increase with gestational age. By the index data, the cut-off for suspecting abnormal penile length should be <24.5 or >45.5 mm for term babies. CONCLUSIONS The normative values generated can serve as reference standard in the diagnosis of penile length abnormalities in Indian babies and in clarifying issues of ambiguous genitalia and maldevelopment of male external genitalia.
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Affiliation(s)
- Rakesh Mondal
- Department of Pediatric Medicine, Medical College Kolkata, Kolkata, India.
| | - Somosri Ray
- Department of Neonatology, Medical College, Kolkata, India
| | | | - Tapas Kumar Sabui
- Department of Pediatric Medicine, Medical College Kolkata, Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Suman Das
- Department of Pediatric Medicine, BC Roy PGIPS, Kolkata, India
| | | | - Archan Sil
- Department of Pediatric Medicine, Medical College Kolkata, Kolkata, India
| | - Moumita Samanta
- Department of Pediatric Medicine, Medical College Kolkata, Kolkata, India
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Ishii T, Matsuo N, Inokuchi M, Hasegawa T. A cross-sectional growth reference and chart of stretched penile length for Japanese boys aged 0-7 years. Horm Res Paediatr 2015; 82:388-93. [PMID: 25471079 DOI: 10.1159/000368965] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM Reference values for penile length have not been established for Japanese boys. We aimed to develop percentiles and means (and standard deviations) of stretched penile length (SPL) in Japanese boys. METHODS A cross-sectional study was performed in 1,628 Japanese boys aged <9 years from 2007 through 2014. The LMS method was used to develop a growth reference and chart for SPL in boys aged 0-7 years. Interobserver variation in SPLs was assessed in 32 boys (aged 0-11 years, median 3 years) using the Bland-Altman plot. The correlation between SPL and stature, weight or body mass index (BMI) was analyzed by the Pearson test. RESULTS SPL increases continuously during the prepubertal period, and most rapidly in the first 4 months of life. No significant fixed or proportional bias was found for interobserver variation (p = 0.5; r = 0.33, p = 0.06). There was no significant correlation between SPL z-score and stature z-score (r = 0.14, p < 0.001), weight z-score (r = 0.09, p < 0.001) or BMI z-score (r = 0.01, p = 0.71). CONCLUSION These data serve as an updated growth reference for SPL in Japanese boys aged 0-7 years.
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Affiliation(s)
- Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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Mohamed MH, Abdou RM, Hamza MT, Hussein MMS. Penile length and cord total and free testosterone in full term male Egyptian neonates. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2015. [DOI: 10.1016/j.epag.2015.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Chikani UN, Chinawa JM, Ikefuna AN, Ibekwe MU. Stretched penile length of healthy term neonates: normative values among Igbo babies in southeastern Nigeria. J Trop Pediatr 2015; 61:69-73. [PMID: 25466913 DOI: 10.1093/tropej/fmu064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM To determine the normative values of stretched penile length in apparently healthy term Igbo newborn males in South eastern Nigeria and its relationship with gestational age, birth weight and birth length. METHODS Eight hundred and eleven apparently healthy term male neonates within the first 72 h of life were studied. Enrolled subjects were consecutively delivered babies of Igbo extraction from three hospitals. The stretched penile length was measured using Schonfeld method, and the smoothed centiles (3 rd to 97th percentile values) for stretched penile length by gestational age were determined. RESULTS The mean stretched penile length of term newborns was 3.46 ± 0.44 cm. The lower and upper limits (±2.5 SD) were 2.36-4.56 cm. Stretched penile length correlated positively with birth length and birth weight (r = 0.343, p = 0.001; r = 0.229, p = 0.001). CONCLUSION This study has created the first smoothed percentile values for stretched penile length by gestational age for Igbo babies.
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Affiliation(s)
- Ugo N Chikani
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Josephat M Chinawa
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Anthony N Ikefuna
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Maryann U Ibekwe
- Department of Paediatrics, Ebonyi State University, Abakaliki, Nigeria
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Alaee E, Gharib MJ, Fouladinejad M. Penile length and anogenital distance in male newborns from different Iranian ethnicities in golestan province. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e16729. [PMID: 25763234 PMCID: PMC4341348 DOI: 10.5812/ircmj.16729] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 08/03/2014] [Accepted: 08/27/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anogenital distance (AGD) is a feasible and accepted parameter of exogenous or endogenous androgens effects on development of reproductive system. OBJECTIVES Since there is no report on penile length (PL) and AGD in our region, we investigated these parameters in male newborns in Golestan Province, Iran. PATIENTS AND METHODS In this cross-sectional study, we measured stretched PL and AGD in term newborns from different races in Dezyani Gynecologic Hospital of Gorgan, Iran. We also recorded the anthropometric parameters and maternal age. The data was analyzed using the SPSS 14. RESULTS Means of PL and AGD of 427 healthy term newborns were 32.1 ± 3.5 and 24.5 ± 2.5 mm, respectively. There was a positive correlation between PL and AGD (r = 0.097, P = 0.046). According to their ethnicity, there were 166 Fars (38.9%), 129 Turkmen (30.2%), and 132 Sistani (30.9%) infants with mean PL of respectively 31.8 ± 3.9, 32.3 ± 3.3, and 32.4 ± 3.3 mm and mean AGD of respectively 25 ± 2.5, 24.3 ± 2.5, and 24 ± 2.5 mm. One Fars neonate (0.23%) had micropenis (PL = 21.3 mm). CONCLUSIONS Using -2.5 standard deviations as the cutoff for micropenis, a newborn infant in Golestan Province with a PL of < 23.3 mm had micropenis; however, more investigations are needed to clarify this issue.
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Affiliation(s)
- Ehsan Alaee
- Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
| | | | - Mahnaz Fouladinejad
- Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
- Corresponding Author: Mahnaz Fouladinejad, Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-1715547680, E-mail:
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Jarrett OO, Ayoola OO, Jonsson B, Albertsson-Wikland K, Ritzen EM. Penile size in healthy Nigerian newborns: country-based reference values and international comparisons. Acta Paediatr 2014; 103:442-6. [PMID: 24289753 DOI: 10.1111/apa.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/02/2013] [Accepted: 11/14/2013] [Indexed: 11/27/2022]
Abstract
AIM To establish normal reference values for penile size in Nigerian newborn boys and to compare those values with standards from other populations. METHODS A total number of 261 healthy newborn boys delivered at gestational ages of 28 weeks or more were enrolled in the study. Penile lengths and widths were measured within 72 h of birth. RESULTS The mean (±SD) penile length in the 261 Nigerian males studied was 3.4 ± 0.48 cm, while the mean mid-shaft diameter was 1.2 ± 0.14 cm. Compared with data from other populations, Nigerian newborn boys had similar penile sizes to those reported for US Caucasian boys (mean 3.4 cm), but significantly greater penile sizes than those reported for boys from China and Hong Kong (mean 3.0 and 3.1 cm, respectively; both p < 0.001). There was a slight, but significant, difference in size between Nigerian and Malaysian boys, with Malaysian boys having greater penile sizes (mean 3.5 cm; p < 0.05). CONCLUSION A Nigerian newborn with a penile length of <2.39 cm can be considered to have a micropenis.
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Affiliation(s)
- OO Jarrett
- Department of Paediatrics; University College Hospital and College of Medicine; University of Ibadan; Ibadan Nigeria
| | - OO Ayoola
- Royal Manchester Children's Hospital; Manchester UK
| | - B Jonsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - K Albertsson-Wikland
- Gothenburg Paediatric Growth Research Center; Department of Paediatrics; Institute of Clinical sciences; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - EM Ritzen
- Department of Women′s and Children′s Health; Karolinska Institutet; Stockholm Sweden
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Teckchandani N, Bajpai M. Penile length nomogram for Asian Indian prepubertal boys. J Pediatr Urol 2014; 10:352-4. [PMID: 24145175 DOI: 10.1016/j.jpurol.2013.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/18/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Penile length-for-age nomograms in prepubertal boys may aid in early recognition of endocrine and genetic disorders associated with abnormal phallic size. There are scarce data on the penile length measurements in children beyond the neonatal period and there is a lack of such a nomogram for Asian Indians. MATERIALS AND METHODS Of the boys who were admitted in our ward or seen in the outpatient setting for genitalia-unrelated surgical problems, 20 consecutive boys were included in each of the following ten age slots (total of 200 subjects): 0-1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-7, 7-8, 8-9, and 9-10 years. Their stretched penile length (SPL) measurements were used to establish the normal range (mean ± 2 SD) of penile length-for-age in prepubertal Indian boys. Mean ± 2.5 SD was also calculated to define the cut-offs for micropenis and macropenis, respectively, in each age group. RESULTS A rapid increase is seen in penile length up to 4 years of age. A much slower increase is implied thereafter. CONCLUSION This study provides reference values of penile lengths for Asian Indian boys aged 0-10 years.
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Affiliation(s)
- Narinder Teckchandani
- Dept. of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Minu Bajpai
- Dept. of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India.
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Matsuo N, Ishii T, Takayama JI, Miwa M, Hasegawa T. Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants. Endocr J 2014; 61:849-53. [PMID: 24931740 DOI: 10.1507/endocrj.ej14-0069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.
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Affiliation(s)
- Nobutake Matsuo
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan
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Lee JH, Ji YH, Lee SK, Hwang HH, Ryu DS, Kim KS, Choo HS, Park S, Moon KH, Cheon SH, Park S. Change in penile length in children: preliminary study. Korean J Urol 2012; 53:870-4. [PMID: 23301133 PMCID: PMC3531642 DOI: 10.4111/kju.2012.53.12.870] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 06/21/2012] [Indexed: 12/04/2022] Open
Abstract
Purpose Studies of penile length in children have been rarely conducted. In Korea, great improvements in height and weight have been observed because of economic development over the past 25 years. We investigated the current status of penile length in Korean children and compared the results with those of a previous Korean study conducted in 1987. Materials and Methods The subjects in this study were 233 boys aged 1 to 158 months, each of whom had been brought to outpatient clinics between April and October 2011. Penile length was measured according to the stretched penile length (SPL) technique; testicular size was measured (in ml) by using orchidometry. A comparison of penile lengths between the current study and the 1987 study was made by using Student's t-test. Results SPL increased significantly by 0.7 to 1.1 cm in most age groups (p<0.05). Current anthropometric measures of Korean children such as height, body weight, and testicular size have increased compared with those from 1987. Conclusions Penile length has increased significantly over the last quarter century. Therefore, it is suggested that novel reference values for penile length in prepubertal Korean children be determined in studies with a larger community-based population in order to diagnose and treat size-related penile disorders.
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Affiliation(s)
- Joong Ho Lee
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Fievet L, Harper L, Chirpaz E, Michel JL, Sauvat F. Penile length is comparable in boys with and without hypospadias. J Pediatr Urol 2012; 8:493-6. [PMID: 22030456 DOI: 10.1016/j.jpurol.2011.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION It has been suggested that penile length is negatively correlated to the degree of hypospadias; however, there are no studies in the literature actually comparing penile length in normal patients and patients with hypospadias. MATERIAL AND METHOD Between January and May 2011, we measured penile length in two groups of children aged up to 5 years. The first group comprised all boys admitted for hypospadias (40 patients; 25 distal and 15 proximal hypospadias). The control group comprised 100 boys seen for other surgical procedures excluding those with endocrine disorders. We measured the length of the dorsal aspect of the penis in the flaccid state, without stretching. We then established, using our control group, a range of 'normal' values for penile length in our population and determined whether children with hypospadias were within this 'normal' range. RESULTS Mean penile length in the control group was 4.07 ± 0.92 cm, mean penile length in the hypospadias group was 4.36 ± 0.9 cm (4.48 ± 0.89 cm for distal hypospadias and 4.21 ± 0.79 cm for proximal hypospadias). There was no difference in penile length between the hypospadias group and the control group regardless of degree of hypospadias. CONCLUSION This study indicates that penile length in children with hypospadias whether proximal or distal is within the normal range.
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Affiliation(s)
- L Fievet
- Department of Pediatric Surgery, CHR F Guyon, Bellepierre, Saint-Denis de La Reunion, Reunion
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Affiliation(s)
- Alev Oğuz Kutlu
- Zubeyde Hanim Maternal Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
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Lian WB. Anthropometry in Ethnic Groups and Cultural and Geographical Diversity. HANDBOOK OF ANTHROPOMETRY 2012:2523-2534. [DOI: 10.1007/978-1-4419-1788-1_156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Cinaz P, Yeşilkaya E, Onganlar YH, Boyraz M, Bideci A, Camurdan O, Karaoğlu AB. Penile anthropometry of normal prepubertal boys in Turkey. Acta Paediatr 2012; 101:e33-6. [PMID: 21682766 DOI: 10.1111/j.1651-2227.2011.02386.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The age-related values of penile length must be known to determine abnormal penis sizes and to follow the treatment of underlying diseases. The aim of this study is to evaluate abnormal penile length in Turkish children by establishing novel reference values for Turkish population and to compare the mean penile length and other parameters with alternates from different ethnic populations and geography. METHODS This cross-sectional study was conducted on a voluntary basis between November 2008 and November 2009 from four centres in Turkey and comprised of 1278 healthy volunteered prepubertal children. Complete stretched penile length and penis circumference measurements were used for penile length and penis circumference evaluations, respectively. All measurements were taken twice by only one investigator, and mean values were recorded. RESULTS Penile length and penis circumference for every age group were obtained, percentile curves were established and these findings were compared with the results of previous studies. Significant differences were found between penile length of Turkish children and recently used reference values. CONCLUSION With this study, novel reference values for penile length in prepubertal children were presented to the literature.
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Affiliation(s)
- Peyami Cinaz
- Gazi University Medical School, Department of Pediatric Endocrinology, Ankara, Turkey
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Kutlu AO. Normative data for penile length in Turkish newborns. J Clin Res Pediatr Endocrinol 2010; 2:107-10. [PMID: 21274323 PMCID: PMC3005681 DOI: 10.4274/jcrpe.v2i3.107] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 06/18/2010] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Local normative data for penile size will aid physicians in clinical practice. There are no studies on stretched penile length (SPL) in newborn Turkish boys. OBJECTIVE To establish normative data for SPL of newborn Turkish boys and compare these with data from different countries. METHODS 514 newborn Turkish boys, who were not small for gestational age (SGA) or premature, were included in this cross-sectional study. SPLs of the newborns were measured by the same investigator. The correlations between SPL and gestational age, weight, length, and head circumference were evaluated. RESULTS The 3(rd) percentile value for SPL was found as 3.00 cm in these Turkish newborns. Positive correlations were shown between SPL and height (r=0.240, p<0.001), weight (r=0.251, p<0.001), and head circumference (r=0.235, p<0.001). Multiple linear regression analysis showed that SPL positively correlated with height and head circumference (p=0.021 and p= 0.042, respectively). CONCLUSIONS This is the largest study on SPL in newborns from our country. This normative data can be used in clinical practice for defining micropenis.
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Affiliation(s)
- Alev Oğuz Kutlu
- Zübeyde Hanim Maternal Hospital, Pediatric Endocrinology, Ankara, Turkey.
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Kim SY, Jun JS, Lee SG. Normative data of penile length in Korean newborns. KOREAN JOURNAL OF PEDIATRICS 2008. [DOI: 10.3345/kjp.2008.51.9.944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sang Yeob Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Sung Jun
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Sang Geel Lee
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
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Camurdan AD, Oz MO, Ilhan MN, Camurdan OM, Sahin F, Beyazova U. Current stretched penile length: cross-sectional study of 1040 healthy Turkish children aged 0 to 5 years. Urology 2007; 70:572-5. [PMID: 17905119 DOI: 10.1016/j.urology.2007.04.051] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 03/12/2007] [Accepted: 04/30/2007] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To update the normal stretched penile length values for children younger than 5 years of age. We also evaluated the association between penile length and anthropometric measures such as body weight, height, and body mass index. METHODS The study was performed as a cross-section study. The stretched penile lengths of 1040 white uncircumcised male infants and children 0 to 5 years of age were measured, and the mean length for each age group and the rate of increase in penile length were calculated. The correlation between penile length and weight, height, and body mass index of the children was determined by Pearson analysis. RESULTS The stretched penile length was 3.65 +/- 0.27 cm in full-term newborns (n = 165) and 3.95 +/- 0.35 cm in children 1 to 3 months old (n = 112), 4.26 +/- 0.40 cm in those 3.1 to 6 months old (n = 130), 4.65 +/- 0.47 cm in those 6.1 to 12 months old (n = 148), 4.82 +/- 0.44 cm in those 12.1 to 24 months old (n = 135), 5.15 +/- 0.46 cm in those 24.1 to 36 months old (n = 120), 5.58 +/- 0.47 cm in those 36.1 to 48 months old (n = 117), and 6.02 +/- 0.50 cm in those 48.1 to 60 months old (n = 113). The fastest rate of increase in penile length was seen in the first 6 months of age, with a value of 1 mm/mo. A significant correlation was found between penile length and the weight, height, and body mass index of the boys (r = 0.881, r = 0.864, and r = 0.173, respectively; P = 0.001). CONCLUSIONS The age-related values of penile length must be known to be able to determine abnormal penile sizes and to monitor treatment of underlying diseases. Our study has provided updated reference values for penile lengths for Turkish and other white boys aged 0 to 5 years.
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Affiliation(s)
- Aysu Duyan Camurdan
- Department of Social Pediatrics, Gazi University School of Medicine, Ankara, Turkey.
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Kumanov P, Robeva R, Tomova A. Prevalence of micropenis among boys from different regions of Bulgaria. J Pediatr Endocrinol Metab 2007; 20:791-5. [PMID: 17849741 DOI: 10.1515/jpem.2007.20.7.791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Micropenis is a normally formed penis whose length is more than 2.5 SD below the mean penile length for age. However, the definition of this disorder depends on penile length norms. METHODS Penile length, circumference and anthropometric values of 310 boys under one year of age from five regions in Bulgaria were investigated. RESULTS The mean penile length for all boys was 3.55 +/- 0.46 cm, thus micropenis could be defined as a penile length below 2.40 cm. However, regional differences were observed in penile length and circumference. According to regional mean values and the appropriate definition of micropenis, only two of the children had micropenis. CONCLUSIONS In a prospective study of Bulgarian boys we established wide regional variations of normal penile length. Consequently, the diagnostic and therapeutic approach to micropenis should consider the mono-ethnic inter-regional differences.
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Affiliation(s)
- Philip Kumanov
- Clinical Center ofEndocrinology, Medical University, Sofia, Bulgaria.
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Romano-Riquer SP, Hernández-Ávila M, Gladen BC, Cupul-Uicab LA, Longnecker MP. Reliability and determinants of anogenital distance and penis dimensions in male newborns from Chiapas, Mexico. Paediatr Perinat Epidemiol 2007; 21:219-28. [PMID: 17439530 PMCID: PMC3653615 DOI: 10.1111/j.1365-3016.2007.00810.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Development of the perineum as well as the external genitalia is determined by dihydrotestosterone, resulting in a greater anogenital distance (AGD) in males than females. In animal experiments with hormonally active agents, anogenital distance is used as a bioassay of fetal androgen action. Use of anogenital distance in human studies has been rare. Because anogenital distance has been an easy-to-measure, sensitive outcome in animal studies, we developed an anthropometric protocol for measurement of anogenital distance in human males. In this paper we describe the method for measurement of three anogenital distances, their reliability, and an assessment of predictors for each in the context of an epidemiological study. We compare the reliabilities and predictors to those for stretched penis length and penis width. A cross-sectional study of 781 newly delivered male infants was conducted in 2002-03 in Chiapas, Mexico. Replicate measures were obtained on nearly all subjects. The reliability of the measures of anogenital distance (0.82-0.91) were higher than for stretched penis length (0.78) and width (0.75). Birthweight and gestational length were more strongly related to anogenital distance than to penis length. Anogenital distance was not related to penis length (r = 0.03). Our large study clearly shows that AGD can be measured well in newborn males, and that the measurements were more reliable than those of penis length. Whether AGD measures in humans relate to clinically important outcomes, however, remains to be determined, as does its utility as a measure of androgen action in epidemiological studies.
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Affiliation(s)
| | | | - Beth C. Gladen
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | | | - Matthew P. Longnecker
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
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Fok TF, Hon KL, So HK, Wong E, Ng PC, Chang A, Lau J, Chow CB, Lee WH. Normative Data of Penile Length for Term Chinese Newborns. Neonatology 2005; 87:242-5. [PMID: 15665508 DOI: 10.1159/000083420] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2004] [Accepted: 10/21/2004] [Indexed: 11/19/2022]
Abstract
Careful examination and assessment of penile length in the newborn is important because micropenis is associated with hypothalamic disorders. This prospective cross-sectional study was designed to establish the norm of penile length for term Hong Kong Chinese newborns. 4,628 full-term healthy male newborns were enrolled in the study. Penile length was measured from pubic ramus to the tip of the glans penis by placing the end of a straight edge ruler against the pubic ramus. A gestation-associated graph of 3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles for the penile length was created. The penile length was significantly correlated with gestational age, birth weight and body length. When compared with published data for other populations, Hong Kong newborns have significantly shorter penile length. The norm of the penile length is useful in diagnostic and therapeutics for the ethnic Chinese male newborns.
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Affiliation(s)
- T F Fok
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
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Abstract
AIM To assess the adult stretched penile length (SPL) and sexuality in patients with micropenis who exhibited an inadequate response to exogenous testosterone therapy and were raised as males. PATIENTS AND METHODS Patients with micropenis who had an equivocal response to exogenous testosterone therapy and were raised as males were evaluated at adulthood (>17 yr). RESULTS AND CONCLUSIONS Twenty patients with micropenis, initial median SPL -3.3 SD below the mean (range -5.5 to -2.6) had a suboptimal response to initial testosterone therapy, median SPL post-treatment -2.7 SD (-3.3 to -2.2), and were raised as males. At adulthood, 90% (18/20) had a micropenis, median SPL -3.4 (-5.9 to -2.2). All have a male gender identity, five are undergoing psychiatric counseling (fear of sexual rejection--five patients, one of whom also has suicidal ideation). Eight have not pursued a sexual relationship; 12 are sexually active, one of whom is bisexual.
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Affiliation(s)
- D A Husmann
- Department of Urology, The Mayo Clinic, Rochester, MN 55905, USA.
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Abstract
Adult stretched penile length (SPL) was determined among 22 males who were diagnosed with micropenis. These adult SPL values were compared with SPL at the time of diagnosis, age of diagnosis and etiologic category in 20 men who were diagnosed before puberty. A portion of this group completed a structured questionnaire interview, the Social Adjustment Self Report Questionnaire and the Hopkins Symptom Checklist to assess social and psychosexual milestones and the presence of psychiatric morbidity. Results show that the majority of men who had been diagnosed with micropenis had an adult SPL within 2 standard deviations of the normal adult mean, with only a minority showing values below this. It appeared that men with micropenis might have greater than average interval SPL growth between diagnosis and adulthood; it remains unclear whether this supranormal growth represents a catch-up phenomenon or results from augmentation by intermittent androgen therapy. There was no clear relationship between SPL at diagnosis and SPL in adulthood. The responses to the questionnaires indicated that men who had been diagnosed with micropenis were comparable to control men in regard to gender issues, body image, social fitness, sexuality, work, family adjustment and the presence of psychopathology.
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Affiliation(s)
- Peter A Lee
- Division of Pediatric Endocrinology, Department of Pediatrics, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, PA 17033-0850, USA.
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