University of Texas Southwestern, Department of Pediatric Urology, United States.
J Pediatr Urol. 2013 Dec;9(6 Pt B):1188-91. doi: 10.1016/j.jpurol.2013.05.004. Epub 2013 Jun 12.
There are no reports of systematically-measured penile dimensions in boys with varying extents of hypospadias. To determine reference values, we prospectively measured maximum glans width in patients undergoing distal and proximal hypospadias repair as well as newborns undergoing elective circumcision.
The maximum glans diameter was measured in consecutive boys aged 0-24 months presenting for newborn circumcision (controls), or repair of distal (distal shaft or glanular) and proximal (proximal shaft to perineal) hypospadias. Patients with proximal hypospadias and glans diameter <14 mm received intramuscular testosterone 2 mg/kg injection once monthly for 2-3 treatments, with measurements recorded prior to the first injection, and again intra-operatively 3-4 weeks after the final injection.
Data were obtained in 240 controls, 188 boys with distal hypospadias, and 39 boys with proximal hypospadias. Median ages were 1, 9 and 9 months, respectively. Males undergoing newborn circumcision were younger than both cohorts of hypospadias patients (p < 0.0001), but no difference in age was noted in those with distal and proximal hypospadias (p = 0.194). Average maximum glans diameters were significantly different: 14.3, 14.8, and 12.9 mm, respectively, for controls, distal and proximal hypospadias (p < 0.0001). Despite mean older age, 46 (24.5%) boys with distal hypospadias and 24 (61.5%) with proximal hypospadias had small glans diameter <14 mm. Increasing age was not correlated with increasing glans size in patients with distal or proximal hypospadias (r = -0.136, p = 0.062 and r = -0.089, p = 0.580) at 3-24 months of age.
Some boys with distal and the majority of those with proximal hypospadias have a glans width less than that of the average normal newborn. Glans size does not correlate with age in patients with hypospadias between 3 and 24 months old, supporting the decision to operate as early as 3 months in some centers.
目前尚无关于不同程度尿道下裂患儿阴茎尺寸的系统测量报告。为了确定参考值，我们前瞻性地测量了接受远端和近端尿道下裂修复以及行选择性包皮环切术的新生儿的最大龟头宽度。
连续测量了 0-24 个月龄因新生儿包皮环切术（对照组）或远端（阴茎干或龟头）和近端（阴茎近端至会阴）尿道下裂修复而就诊的男孩的最大龟头直径。近端尿道下裂且龟头直径<14mm 的患者接受肌内注射 2mg/kg 睾酮，每月 1 次，共 2-3 次，在首次注射前和最后 1 次注射后 3-4 周内进行测量。
240 例对照组、188 例远端尿道下裂患儿和 39 例近端尿道下裂患儿纳入研究。中位年龄分别为 1、9 和 9 个月。行新生儿包皮环切术的男性比尿道下裂患儿各队列均年轻（p<0.0001），但远端和近端尿道下裂患儿之间的年龄无差异（p=0.194）。平均最大龟头直径明显不同：对照组、远端和近端尿道下裂患儿分别为 14.3、14.8 和 12.9mm（p<0.0001）。尽管平均年龄较大，但 46 例（24.5%）远端尿道下裂患儿和 24 例（61.5%）近端尿道下裂患儿的龟头直径<14mm。远端或近端尿道下裂患儿的年龄与龟头大小无相关性（3-24 个月时 r=-0.136，p=0.062 和 r=-0.089，p=0.580）。
一些远端尿道下裂患儿和大多数近端尿道下裂患儿的龟头宽度小于正常新生儿的平均值。3-24 个月尿道下裂患儿的龟头大小与年龄无相关性，支持一些中心在 3 个月时就进行手术的决策。
