Amirkashani Davoud, Abdollahi Sarvi Mostafa, Masoumi Mostafa
Division of Endocrinology and Metabolism, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Front Pediatr. 2025 Apr 30;13:1501259. doi: 10.3389/fped.2025.1501259. eCollection 2025.
Micropenis, defined as a penile length more than 2.5 standard deviations below the mean for age and population, presents significant concerns for patients and parents. Despite current guidelines recommending multidisciplinary management, there is limited evidence on long-term outcomes, particularly in untreated patients.
This prospective cohort study involved 46 male children aged 7-9 years presenting with micropenis at the Ali Asghar Endocrine Clinic from 2015 to 2023. Initial penile size, BMI, and other growth parameters were measured, with biannual follow-ups extending 3 years post-bone fusion to evaluate growth rates and influential factors.
Initial mean stretched penile length (SPL) was 3.22 ± 0.21 cm. Significant increases in penile size were observed across all intervals, with the highest growth rates occurring between the first- and second-years post-fusion. BMI emerged as the most significant predictor of penile growth, while initial SPL was the least influential factor. By the third-year post-fusion, the vast majority of subjects (44) achieved penile lengths within the normal range. Two patients, while showing penile growth over time, remained below the cutoff value defined by reference standards.
Our findings indicate that most untreated micropenis patients reach normal penile size by adulthood, highlighting the importance of monitoring growth rates rather than focusing only on initial penile size. This study provides critical insights for developing guidelines and management strategies for micropenis, emphasizing the necessity of continued follow-up to ensure optimal outcomes.
小阴茎定义为阴茎长度比同年龄和同人群的均值低2.5个标准差以上，这给患者及其父母带来了重大困扰。尽管当前指南推荐多学科管理，但关于长期预后的证据有限，尤其是在未经治疗的患者中。
这项前瞻性队列研究纳入了2015年至2023年在阿里·阿斯加尔内分泌诊所就诊的46名7至9岁患有小阴茎的男童。测量了初始阴茎大小、体重指数（BMI）和其他生长参数，并在骨融合后每半年进行一次随访，持续3年，以评估生长速率和影响因素。
初始平均拉伸阴茎长度（SPL）为3.22±0.21厘米。在所有随访间隔中均观察到阴茎大小有显著增加，其中融合后第一年至第二年的生长速率最高。BMI是阴茎生长的最显著预测因素，而初始SPL是最不具影响力的因素。到融合后第三年，绝大多数受试者（44名）的阴茎长度达到正常范围。两名患者虽然阴茎随时间有所生长，但仍低于参考标准定义的临界值。
我们的研究结果表明，大多数未经治疗的小阴茎患者成年后阴茎大小可达到正常，这突出了监测生长速率而非仅关注初始阴茎大小的重要性。本研究为制定小阴茎的指南和管理策略提供了关键见解，强调了持续随访以确保最佳预后的必要性。
