Microphallus early management in infancy saves adulthood sensual life: A ‎‎comprehensive review

Figure 1  The flow chart of the included studies.

Figure 2 The rate of increase in penile length in both antenatal, postnatal, and adulthood. Micropenis is defined when the penile length is below -2 SD. The figure idea is based on data from Tsang[3]. SD: Standard deviation.

Figure 3 The prenatal and postnatal penile development and its relation to the testosterone surge. Note that any disruption of penile development during the critical window will cause microphallus, which is usually associated with congenital malformation such as hypospadias, while after that causes micropenis. Note the prenatal testosterone surge is associated with rapid penile growth of 0.7 mm/wk. The first postnatal testosterone surge occurs between the second and third month when the testosterone level reaches 260 ng/dL and is associated with rapid penile growth, known as mini puberty at six months of postnatal age. The second postnatal testosterone surge occurs at puberty and continues throughout adulthood. The figure idea and data were obtained from Chitayat and Glanc[10], Blaschko et al[11], Penington and Hutson[13], and Tuladhar et al[15].

Figure 4 Flow chart for hormonal assessment of micropenis. Note that follicle-stimulating hormone, luteinizing hormone, testosterone, and dihydrotestosterone are measured in the basal state in min-puberty (at the age of 6 months) and a stimulated state after human chorionic gonadotropin injection after the age of 6 months. 5αR2D: 5α-Reductase-2 deficiency; AIS: Androgen insensitivity syndrome; CAD: Congenital adrenal hyperplasia; DHT: Dihydrotestosterone; DSDs: Disorders/differences of sex development; FSH: Follicle-stimulating hormone; Hopopit: Hypopituitarism; LH: Luteinizing hormone.

Figure 5  Pseudomicropenis due to a buried penis; the penis is partially or completely concealed beneath the scrotum or excess skin or fat in the pubic area.

Figure 6 A suction 10-mL syringe exerts traction on the infant penis for stretched penile measurement. The idea is adopted from Hatipoğlu and Kurtoğlu[7].