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Tag: Micropenis

Why is My Penis Small, or is it?

Why is My Penis Small, or is it?

Medically reviewed by James Keith Fisher, MD on February 26, 2019 — Written by Eleesha Lockett, MS

This article is a repost which originally appeared on HealthLine

Edited for content

When Penises Are Small

How do we decide what’s small?

What’s too small? What’s too big? Research suggests that many men desire a bigger penis regardless of whether they think that their penis size is average or not. And, some men believe they have a small penis when it’s actually within the average range.

This article will look at the science behind the average penis size, how to measure your penis, and the conditions that can cause a penis to be or seem smaller than usual.

What’s average?

The average length of a penis is roughly 3.6 inches flaccid and 5.2 inches erect. But how did this become the number?

Research on penis size

There have been several studies over the years that have attempted to give a definite number for the average penis size.

One smaller 2014 study in the Journal of Sexual Medicine looked at the average penis size in 1,661 men. The researchers found that the average erect penis length and circumference of participants was 5.6 inches (14.15 centimeters) and 4.8 in. (12.23 cm), respectively.

Another larger study from 2014 compiled data from over 15,000 men to determine average size. In this study, length and circumference measurements were taken both flaccid and erect. The results determined the average penis length to be 3.6 in. (9.16 cm) while flaccid and 5.2 in. (13.12 cm) while erect. In addition, the average penis circumference was measured as 3.7 in. (9.31 cm) while flaccid and 4.6 in. (11.66 cm) while erect.

It’s important to note that the first study used self-reported measurements, while the second study used measurements taken by a health professional. Both studies have their limitations, but the numbers reported are consistent with similar studies on average penis size.

Perspective

Keep in mind that sizes of “small” and “large” are comparative and that averaging penis size is based on what’s known. Known measurements, even a substantial study where more than 15,000 men were measured, are based on groups. The United Nations reported the world’s male population to be at about 3.8 billion in 2017. That means 15,000 men is only about 0.0004 percent of the world’s male population.

Collectively, average measurements from similar studies set a good average and are important to have, but there’s always more to know.

How to measure your penis

If you’re curious about how to measure the size of your penis, here’s a correct way to get an accurate measurement:

  1. You will need to have either a tape measure or ruler on hand.
  2. To measure the length, start your measurement at the base of the penis, where the penis meets the pubic bone.
  3. Run the ruler or tape measure along the full length of the penis from the base to the tip (glans). Do not measure excess foreskin length.
  4. To measure the girth, wrap a flexible tape measure around the shaft of the penis at the base or around the midpoint between the base and head.
  5. If you are measuring your penis flaccid, be careful not to pull on or stretch it as this can potentially cause injury.

When do penises grow?

Research suggests that there are different periods of penis growth throughout the life cycle. In one study, researchers tracked penis size in more than 3,000 males from birth to 16 years old.

They found that on average, the penis grew rapidly from birth until about 1 year of age. From the ages of 1 to 11, penis growth slowed down to some extent. At about age 11 and entering puberty, the researchers observed another period of rapid growth.

When penises seem small

Most males fall into the range of average penis size. However, some boys and men may have what is known as a micropenis. Also, not all small penises are micropenises.

Micropenis

Micropenis is a condition, most often diagnosed in infants, characterized by a penis that falls below the average size range. The criteria for micropenis in infants is generally a penis size of smaller than .75 in. (1.9 cm), based on the stretched penis length.

According to University of Rochester Medical Center, one of the most common complications of micropenis is lowered fertility due to a decreased sperm count.

A sex hormone imbalance called hypogonadism is a leading cause of micropenis.

Although there are different treatment approaches for micropenis, hormone treatment can be key in treating babies. Early administration of testosterone may even help to increase penis size by 100 percent during the initial course of treatment for an infant.

In cases where hormone treatment doesn’t work, surgery may be an option, while speaking with mental health professional can provide more long-term benefits.

Inconspicuous penis

Inconspicuous penis is an umbrella term for any number of conditions that cause the penis to appear smaller than normal.

The following conditions are all linked to having a smaller than usual penis size.

  • Buried penis. Buried penis is primarily caused by an excess accumulation of skin around the penis. The penis may be buried, or hidden, beneath the abdomen, scrotum, or even thigh. In most cases, the penis is a normal length and functions normally. However, this condition may cause difficulty with sexual arousal and function as well as urination.
  • Webbed penis. Webbed penis occurs when the skin of the scrotum is attached too high on the penis. This can affect the angle at which the penis rests, causing it to appear “webbed” and shorter than normal. Cosmetic surgery is a common treatment approach for this condition.
  • Trapped penis. Trapped penis can occur as the result of a circumcision not healing correctly. With a trapped penis, the scar tissue from the circumcision causes the penis to become trapped beneath the healed skin. This condition can cause serious issues with urinary dysfunction, so steroid therapy or surgery are necessary.

Many of these conditions are uncommon, affecting a small portion of the population. In all cases, however, it’s important to remember that penis size does not necessarily determine sexual attractiveness.

Penis size is only one small element in a list of items sexual partners find attractive — with emotional attractiveness being near the top. Besides, one 2006 study found that almost 85 percent of women are content with the size of their partner’s penis.

The takeaway

Although many men are concerned that their penis is too small, research has shown that most men have an average-sized penis. It’s also important to remember that penises, just like vaginas, come in all different shapes and sizes. There is no one perfect penis, and penis size does not determine your sexual attractiveness or self-worth.

For those who fall outside of typical penis size range for any reason, there are interventions that can help promote a positive and fulfilling sex life. If you are still concerned with your penis size or feel that it’s affecting your sex life, reaching out to a sex therapist can help.  [Editor’s Note: There are plenty of techniques for increasing the size of your penis using manual exercises on PEGym.]

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

How is a Micropenis Defined?

How is a Micropenis Defined?

Medically reviewed by Karen Richardson Gill, MD, FAAP, specialty in pediatrics, on November 28, 2018 — Written by Tim Jewell

This article is a repost which originally appeared on HealthLine

Overview

Micropenis is a medical term for a penis, usually diagnosed at birth, that is well under the normal size range for an infant. In every other way, including structure, appearance, and function, a micropenis is like any other healthy penis.

What causes a micropenis?

Before birth, a male infant’s genitalia develop in response to certain hormones, mainly androgens.

If his body doesn’t produce enough androgens or if the body doesn’t respond normally to androgen production, one result can be a micropenis, also called a microphallus.

Medical disorders that affect the pituitary gland or the hypothalamus, both of which play key roles in hormone production, are associated with micropenis.

While a micropenis can develop on its own, with no other hormone-related conditions, it can occur along with other disorders.

It’s not always clear why some boys are born with a hormone disorder that causes micropenis. Family history of micropenis may raise the risk. A 2011 French study, suggests that fetal exposure to pesticides and other chemicals may increase the chances of micropenis development.

What it is and what it isn’t

Assuming there are no other health concerns, a micropenis functions the same as a normal, healthy penis. The ability to urinate and become erect shouldn’t be affected.

A micropenis is sometimes associated with a lower sperm count, however, so fertility may be reduced.

How is a micropenis diagnosed

In addition to getting a personal and family medical history, the doctor will do a physical examination. That should include a proper measurement of the penis.

To make a thorough diagnosis, the doctor may order a blood test to check for hormone disorders.

If you suspect your baby has a micropenis, consult a pediatric urologist or a pediatric endocrinologist.

A urologist is a doctor who specializes in the health of the urinary tract and male reproductive system. An endocrinologist specializes in hormone disorders.

If you have any concerns about your own genitalia, see a urologist who treats adult patients.

What’s considered a correct measurement?

What defines a micropenis is its stretched penile length (SPL).

Stretched penile length (SPL) for babies

The average male infant’s SPL is 2.8 to 4.2 centimeters (1.1 to 1.6 inches), while the length of a micropenis is defined as less than 1.9 cm (0.75 in.).

An SPL that is somewhere in between 1.9 and 2.8 cm in length may be considered shorter than average, but not a micropenis.

SPL for boys

For prepubescent boys who are 9 to 10 years old, for example, the average SPL is 6.3 cm (2.48 in.), meaning an SPL of 3.8 cm (1.5 in.) or shorter would be considered a micropenis.

An SPL between 3.8 cm and 6.3 cm would just be considered shorter than average.

SPL for adults

In an adult, the average stretched penile length is about 13.24 cm (5.21 in.). An adult micropenis is a stretched penile length of 9.32 cm (3.67 in.) or less.

Group Micropenis SPL measurement
Newborn babies <1.9 cm (0.75 in.)
Older, prepubescent boys <3.8 cm (1.5 in.)
Adult men <9.32 cm (3.67 in.)

 

The proper way to measure for a micropenis is to gently stretch it and measure the length from the tip to the base, closest to the body.

Mistaken for a micropenis

Micropenis is actually a rare condition, affecting an estimated 0.6 percent of males worldwide. But what appears to be a small penis may not technically qualify as a micropenis. It may instead be a condition known as buried penis.

Buried penis

A buried penis is a penis of normal size, but it is hidden or buried under folds of skin of the abdomen, thigh, or scrotum. A buried penis is usually diagnosed in infancy, but it can develop later in life.

The condition may be caused by an abnormality that a boy is born with or it may be due to the buildup of fat in the abdomen and around the genitals in someone with morbid obesity.

As men age, their pelvic floor muscles tend to weaken. This affects how the penis rests and it affects erectile function. Weaker muscles can allow the penis to recede somewhat, leading to a buried penis appearance in some men.

Healthy pelvic floor muscles also contract when a man has an erection, helping to ensure proper blood flow in the penis. Weaker muscles allow blood to escape, making it difficult to maintain an erection.

Webbed penis

Another condition that may be mistaken for micropenis is webbed penis, also known as an “inconspicuous penis.” A baby boy can be born with it or it can develop from a circumcision complication.

With a webbed penis, skin from the scrotum is attached unusually high on the shaft of the penis. The result is that the penis itself looks smaller than normal because just the tip and some of the shaft is visible.

Cosmetic surgery can correct the problem, but that usually is delayed until a boy reaches his teens or adulthood.

Micropenis treatment

Talking with endocrinologists, urologists, and surgeons about treatment options will also help you understand what your options are at any age.

Treating micropenis can be helpful in boosting self-confidence later in life and improving the chances of satisfying sexual activity.

Treatment that begins earlier in life can lead to better results. Your child’s age, medical history, and the extent of the condition will help determine what treatment options make the most sense.

Hormone therapy

Hormone therapy can often be done starting at an early age. It may help stimulate penile growth. It begins with a short course of testosterone treatments to see how the penis responds. The hormone can be delivered through an injection or through a gel or ointment applied directly to the penis.

Testosterone therapy may help stimulate penile growth in infancy, though there is less evidence that it is effective in puberty and adulthood. Other types of hormone treatment may be tried if testosterone is ineffective.

Phalloplasty

Surgery to correct micropenis, a procedure called phalloplasty, is more common in adolescents and adults than in infants and young children. It is usually done if hormone treatments have been ineffective. However, the surgery can be done at a young age.

There are risks, as with any type of surgery. Complications affecting the urinary tract, erectile function, and other function may occur, and may require subsequent procedures. Some also argue that resulting changes to size or length are not significant enough to outweigh risks.

Still, advances in plastic surgerymean that for many boys and men, a surgically modified penis that allows for healthy urinary and sexual function is possible. It is important to work with an experienced surgeon and understand all of the potential risks and benefits of surgery.

Accepting your body

In the media and in society generally, penis size is often mistakenly equated with manliness. In an intimate relationship, having a micropenis can require adjustments and healthy attitudes by both partners.

Providing some counseling at an early age may help a boy cope better as he ages and equip him with strategies to deal with peers and potential partners and achieve a rewarding quality of life.

Therapists along with medical doctors are available for you, regardless of your age, to give guidance during important aspects of dealing with life — emotional, sexual, and biological.

The takeaway

Micropenis has specific medical definition and measurement. Living with a micropenis can be a challenge that may require psychological counseling to help you adjust, whether you want to seek medical treatment or not.

Researching and discussing treatment options with health professionals may lead to positive outcomes.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism

Chonnam Med J. 2011 Apr; 47(1): 39–42.
Published online 2011 Apr 26. doi: 10.4068/cmj.2011.47.1.39
PMCID: PMC3214853
PMID: 22111055

Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism

This article is a repost which originally appeared on PUBMED
Sun-Ouck Kim, Kwang Ho Ryu, In Sang Hwang, Seung Il Jung, Kyung Jin Oh, and Kwangsung Park

Abstract

Penile growth is under androgenic control. Human chorionic gonadotropin (hCG) has a stimulatory effect on testicular steroidogenesis and penile growth. The purpose of this study was to evaluate the effect of hCG treatment on the gonadal response and penile growth in male idiopathic hypogonadotrophic hypogonadism (IHH) presenting with micropenis. A total of 20 IHH patients who met the criteria for micropenis were included in this study. hCG (1,500-2,000 IU) was administrated intramuscularly, 3 times per week, for 8 weeks. Basic laboratory and hormonal indexes (including serum testosterone and LH levels), penis length (flaccid and stretched), and testicular volume were measured before and 24 weeks after hCG treatment. The patients’ mean age was 18.9 years (range, 12 to 24 years). The mean serum testosterone level was significantly increased after hCG treatment (baseline, 2, 4, 12, and 24 weeks: 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively; p<0.05). Mean penile length also increased significantly 24 weeks after treatment (flaccid length: from 3.39±1.03 cm to 5.14±1.39 cm; stretched length: from 5.41±1.43 cm to 7.45±1.70 cm; p<0.001). Mean testicular volumes increased significantly as well (left: from 5.45 cc to 6.83 cc; right: from 5.53 cc to 7.03 cc). There were no remarkable adverse effects of the hCG treatment. The hCG treatment increased the serum testosterone level, penile length, and testicular volume in IHH patients. Our results suggest that hCG treatment has a beneficial effect on gonadal function and penile growth in patients with IHH presenting with micropenis.

Keywords: Human chorionic gonadotropin, Micropenis, Testosterone


INTRODUCTION


Idiopathic hypogonadotrophic hypogonadism (IHH) is associated with deficient pituitary gonadotropin secretion due to impaired secretion of GnRH from the hypothalamus. The deficiency may be isolated or may occur in conjunction with other disorders.1 Men with IHH present clinically with delayed sexual maturation and may have associated midline defects such as Kallman’s syndrome.1 The main goal of treatment in adolescent or young men is to restore serum androgen to normal levels by hormonal application such as testosterone or human chorionic gonadotropin (hCG), thus allowing virilization, penile growth, and puberty to be accomplished, and finally, inducing fertility when appropriate. Normal testosterone levels may be achieved with exogenous testosterone administration. Alternatively, endogenous testosterone secretion can be stimulated by using hCG.2 Penile growth is under androgenic control, but hCG also has a stimulatory effect on testicular steroidogenesis and penile growth. One study reported that the final testicular volume in patients with IHH treated with hCG was substantially greater than that in patients treated with testosterone.3

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.4 Micropenis is one of the presenting symptoms of IHH; however, few studies have evaluated the response to hCG therapy in adolescent or adult men with IHH in terms of micropenis. The purpose of this study was therefore to determine the effect of hCG therapy on the gonadal response and penile growth in men with IHH who presented with micropenis.

MATERIALS AND METHODS

1. Patients

A total of 20 male patients with IHH who met the criteria for micropenis were included in this study. The results were analyzed retrospectively by chart review and were approved by an institutional review board and ethics committee. Patients with cryptorchidism or its absence according to the imaging studies conducted at the initial presentation were excluded. The hCG stimulation test was performed in all patients to exclude primary testicular insufficiency. Additionally, all men had normal basal thyroid and adrenal function. A pituitary mass lesion or a suprasellar tumor was excluded by skull X-ray and by cranial computed tomography.

2. Diagnosis of IHH

The diagnosis of IHH was made on the basis of low or normal serum LH and FSH concentrations associated with low serum testosterone, otherwise normal anterior pituitary function, and no demonstrable lesion on a high-resolution CT scan or MRI of the hypothalamic-pituitary area.

3. Methods

1) Clinical and laboratory assessment

Testis volume was assessed by using the Prader orchidometer. Gonadotrophin (LH, FSH) levels were measured by immunoradiometric assays. Serum testosterone was measured following organic solvent extraction by radioimmunoassay. Basic laboratory and endocrine assessments were performed (including serum testosterone, LH, and FSH levels) and penis length (flaccid and stretched) and testicular volume were measured before and after hCG treatment.

2) Hormonal therapy

The patients were treated by using a standard protocol of 1,500 IU to 2,000 IU hCG administrated intramuscularly, 3 times per week, for 8 weeks.

3) Penile length measurement

Penile length was measured by one doctor (K. Park). A wooden spatula was pressed against the pubic ramus depressing the suprapubic pad of fat as completely as possible to ensure that the part of the penis that is buried in the subcutaneous fat was measured. Measurement was made along the dorsum of the penis to the tip of the glans penis. The length of foreskin was not included.

4. Statistical analysis

The data are given as the mean±SD unless otherwise indicated. Comparisons of data within a patient were evaluated by Student’s t test; comparisons of data from different subsets were evaluated by unpaired t test. Multiple means were compared by ANOVA.

RESULTS

The clinical features of the patients are shown in Table 1. The patients’ mean age was 18.9 years (range, 12 to 24 years). The mean testicular volume of the patients was less than 6 ml (measured by Prader orchidometer) at the time of assessment. The basal serum LH (mIU/ml), FSH (mIU/ml), and prolactin (ng/ml) levels were 0.72±0.53 (reference range, 1.3-13.0), 0.23±0.14 (reference range, 0.9-15.0), and 11.39±1.75 (reference range, 2.0-15.0), respectively (Table 1). There were no remarkable adverse events related to the hCG treatment.

TABLE 1

The basal characteristics of the patients before hCG treatment

An external file that holds a picture, illustration, etc. Object name is cmj-47-39-i001.jpg

SD: standard deviation, *Mean penile length: circumcised length (From Hwang IS, Study on penile length of Korean young adults. Korean J Urol 2005;46:621-5).

1. Increase in serum testosterone after hCG treatment

The mean serum testosterone level was significantly increased after hCG treatment. The serum testosterone levels at baseline and after 2, 4, 12, and 24 weeks of hCG treatment were 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively (p<0.05) (Fig. 1).

An external file that holds a picture, illustration, etc. Object name is cmj-47-39-g001.jpg

FIG. 1

Change in the mean serum testosterone level after hCG treatment. *: p<0.05 vs baseline.

2. Increase in penile length after hCG treatment

Penile length was measured with the penis flaccid and fully stretched. The mean penile length also increased significantly after hCG treatment. The flaccid and stretched length after hCG treatment increased from 3.39±1.03 cm to 5.14±1.39 cm and from 5.41±1.43 cm to 7.45±1.70 cm, respectively (p<0.001) (Table 2).

TABLE 2

Testosterone levels, penile length, and testis volume before and after hCG treatment

An external file that holds a picture, illustration, etc. Object name is cmj-47-39-i002.jpg

3. Increase in testicular volume after hCG treatment

The mean testicular volume measured by orchidometer increased significantly as well after hCG treatment. Testis volume increased from 5.45 cc to 6.83 cc on the left side and from 5.53 cc to 7.03 cc on the right side (p<0.005) (Table 2).

DISCUSSION

In this study, patients with isolated IHH had a good response to hCG therapy in terms of penile growth, testicular growth, and elevation of serum testosterone. Although the present study included relatively severe cases whose initial mean testicular volume was less than 6 mL, the majority of patients achieved a good response. The hCG treatment increased serum concentrations of testosterone, testicular volume, and penile length. Therefore, our results suggest that patients with IHH will have a good response to hCG therapy in terms of testicular growth, improvement in serum testosterone, and increased penile growth, even patients with severe forms of hypogonadotropic hypogonadism.

IHH is a congenital disorder with deficient pituitary gonadal secretion that may occur in conjunction with other disorders.1 The central defect in most men with IHH is the loss of pulsatile secretion of GnRH from the hypothalamus.5-8 The objectives of therapy in adolescent and young adult males are to restore normal serum androgen levels to induce penile growth and puberty, and finally, to induce fertility. Although penile growth is dependent on androgenic control, hCG is also known to have a stimulatory effect on testicular steroidogenesis and penile growth.

Micropenis, a presenting symptom of IHH, 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.4 The most important concern in a patient with micropenis is whether the patient will have sufficient penile growth to allow sexual function as an adult. It is well known that micropenis results from a lack of adequate androgen action during early fetal life that hinders full masculinization of the external genitalia and induces inadequate androgen stimulation for normal penile growth. Among the suggested etiologic factors of micropenis, the most common cause of micropenis is failure of the hypothalamus to secrete gonadotropins or hypophysial dysfunction.9 When treating patients with anterior pituitary or hypothalamic dysfunction, hCG can be used to induce puberty instead of testosterone, which has the additional advantage of producing testicular enlargement and initiating spermatogenesis.10 Few studies, however, have evaluated penile growth in response to hCG therapy in adolescent patients with IHH. In cases of idiopathic IHH combined with micropenis, hCG alone has been reported to increase penile length.2 In the current study, we studied the effect of hCG therapy on the gonadal response and penile growth in male patients with IHH presenting with micropenis. Our results show that hCG treatment can successfully improve penile length in IHH patients.

Normal testosterone levels may be achieved with exogenous testosterone administration. Alternatively, endogenous testosterone secretion can be stimulated by using hCG. Additionally, the final testicular volumes in patients with IHH treated with hCG are substantially greater than in patients treated with testosterone.3 Previously, many other studies reported a good response to gonadotropin therapy in males with IHH. Schopohl et al 11 reported that gonadotropin therapy with 3×2,500 IU hCG as a weekly intramuscular injection restored endocrine and exocrine testicular function to the normal range in male patients with IHH. They showed that the serum level of testosterone, positive sperm count, and testicular volume were increased significantly in the gonadotropin-injected group. Burris et al 12 investigated the effect of exogenous hCG alone in IHH men in terms of serum testosterone, spermatogenesis, and testicular growth. They reported that hCG treatment increased the testicular volume from 5.5 (pretreatment) to 10.8 mL (maximum) during treatment and that all men attained normal serum testosterone levels after hCG treatment. During hCG treatment, 14 of the 22 men had positive sperm appearance in their semen. Ley and Leonard 13 also reported that hCG treatment is sufficient to both initiate and maintain spermatogenesis. Although the studies mentioned above reported the effect of gonadotropin therapy in males with IHH, all studied heterogeneous groups of males with complete or partial gonadotropin deficiency, which may be one reason for the good response to the hCG treatment.

The spectrum of gonadotropin deficiency is manifested by the men’s initial testis volume.14 The initial testicular volume of men with IHH is highly correlated with maximum testicular volume and sperm production.12 A testicular volume of less than 4 mL is considered to indicate complete gonadotropin deficiency, whereas a testicular volume of at least 4 mL is considered to indicate some degree of gonadotropin stimulation.15,16 In this study, we included patients with mean testicular volumes less than 6 mL at the initial diagnosis, and the patients showed a good response to hCG therapy. Therefore, we suggest that hCG treatment may have a beneficial effect on gonadal function in patients with a small testicular volume and on penile growth in patients presenting with micropenis.

A limitation of our study is that we could not measure semen parameters before and after surgery, because most of our patients were of an adolescent age and did not agree to provide a semen sample. Another limitation is the small sample size and the absence of a control group treated with combined human menopausal gonadotropin (hMG) or testosterone. The appropriate timing and dosage of hCG therapy and its mode of action has not been conclusively determined, and controversy currently exists in the literature. Furthermore, our study population was mixed with both adolescent and adult patients, and we could not evaluate the outcomes separately for these different age groups of prepubertal and postpubertal patients. It is uncertain whether the initial gain in penile length will be maintained into adulthood. Further study is needed with a prospective design, large sample size, long-term follow-up in terms of penile growth, and a control group of patients with another treatment modality.

In conclusion, hCG treatment seemed to be effective in IHH, because it successfully increased the serum testosterone level and testicular volume and stimulated penile growth. Our data also imply that hCG treatment for patients with IHH presenting with micropenis results in a satisfactory gain in penile length.

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Articles from Chonnam Medical Journal are provided here courtesy of Chonnam National University Medical School and Chonnman National University Research Institute of Medical Sciences