Micropenis

What is Micropenis?
Micropenis is defined as a Stretch Penile length of <2.5cm in newborns and < 4cm in older children.

What additional signs will tell you that there might be an underlying hormonal problem?
If micropenis is accompanied by bilateral undescended testes and/or hypospadias i.e. the urinary opening instead of being at the tip of the penis is actually on the undersurface of the penis; then a complete hormonal workup is warranted.

When is the best time to show your child about Micropenis?
The best time to evaluate and treat a child for micropenis is between 1-3 months of life if you notice it at birth.

What conditions can mimic micropenis?
In obese boys, the penis may actually be embedded in the suprapubic fat and appear very small. This is a common presentation to endocrine clinics. However, when measured with a scale after displacing the suprapubic fat, the stretch penile length is usually normal. 

Is there any need to panic if the size of the genitals does not grow proportionate to the size of the body in young boys?
Many a time, parents come with the complaint of small genitals in comparison to the child’s age or the growth of the remaining body. This is usually a benign condition as genital growth requires testosterone exposure which does not happen until the boy starts true puberty. The pituitary-gonadal axis is dormant from 6 months of age till the beginning of puberty in boys (9-14years) and no significant testosterone is produced, due to which the genital size pretty much remains the same during childhood. 

Can Micropenis be treated?
After doing a complete hormonal workup to rule out underlying causes, the pediatric endocrinologist may decide to treat Micropenis with either injections or gel formulations of Testosterone under complete medical supervision. The best time to do this is before 6 months of age, before any planned surgery for hypospadias, or during puberty.