Microphallus Follow-up

  • Author: Karen S Vogt, MD; Chief Editor: Stephen Kemp, MD, PhD   more...
 
Updated: Aug 3, 2011
 

Further Inpatient Care

In the newborn nursery, any infant with microphallus should be closely monitored for hypoglycemia. Hypoglycemia should prompt evaluation for other pituitary hormone deficiencies.

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Further Outpatient Care

Monitor infants with isolated micropenis for subsequent growth and development problems. If any problems arise, evaluate and treat appropriately.

  • Many children with micropenis, especially those with gonadotropin deficiency, do not have spontaneous or complete puberty. In these cases, testosterone is used to initiate puberty, with the dosage gradually increased to an adult replacement dose in a manner that mimics natural puberty.
  • In those with hypogonadotropic hypogonadism who desire fertility, hCG and recombinant FSH can be given to promote testosterone secretion and spermatogenesis at the appropriate time by a specialist in reproductive medicine.
  • Appropriate counseling should be provided.
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Prognosis

The prognosis of boys with micropenis secondary to gonadotropin or testosterone deficiency is usually good. These individuals generally respond well to testosterone therapy and function normally as adults. However, despite the potential for near-normal adult phallic size and sensitivity, infertility is generally expected.[2, 13]

Prognosis is much more guarded in children with androgen insensitivity, especially with significant genital ambiguity.

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Patient Education

Provide parents with a clear picture of the cause of their child's problems, including expectations from treatment. In situations in which gender assignment is being contemplated, the parents should play a key role in the decision process.

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Contributor Information and Disclosures
Author

Karen S Vogt, MD  Pediatric Endocrinologist, Department of Pediatrics, Division of Endocrinology, Walter Reed Army Medical Center

Karen S Vogt, MD is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, Endocrine Society, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Bourgeois, MD  Director of Pediatric Undergraduate Medical Education, Associate Professor, Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, Texas Tech University School of Medicine

Michael J Bourgeois, MD is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Arlan L Rosenbloom, MD  Adjunct Distinguished Service Professor Emeritus of Pediatrics, University of Florida College of Medicine; Fellow of the American Academy of Pediatrics; Fellow of the American College of Epidemiology

Arlan L Rosenbloom, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Epidemiology, American Pediatric Society, Endocrine Society, Florida Pediatric Society, Pediatric Endocrine Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London)  Professor and Chair, First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Greece; UNESCO Chair on Adolescent Health Care, University of Athens, Greece

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) is a member of the following medical societies: American Academy of Pediatrics, American College of Endocrinology, American College of Physicians, American Pediatric Society, American Society for Clinical Investigation, Association of American Physicians, Endocrine Society, Pediatric Endocrine Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Merrily P M Poth, MD  Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences

Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

Stephen Kemp, MD, PhD  Professor, Department of Pediatrics, Section of Pediatric Endocrinology, University of Arkansas for Medical Sciences College of Medicine, Arkansas Children's Hospital

Stephen Kemp, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Association of Clinical Endocrinologists, American Pediatric Society, Endocrine Society, Phi Beta Kappa, Southern Medical Association, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

References

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