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absent penis Article Abstract
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Published: January 04, 2008
It's a boy!"
When we first glimpse our children in the delivery room, their sex is one of the immediate things we notice. How disconcerting to parents when a boy's penis seems to disappear, either at birth or shortly thereafter. The good news is that the outlook is bright. Sometimes surgery is needed, sometimes medical treatments. When a penis appears absent or too small, we call the condition inconspicuous penis.This is seen in a great many boys. Several very different situations are lumped into this category.
A webbed penis is a normal-sized penis where the skin of the scrotal sack extends part way up the shaft of the penis. Boys can be born this way, or the condition can result from an over-exuberant circumcision where adhesions form between the scrotal skin and the penile skin. Webbed penis usually causes no problems (unless a routine circumcision is later performed). It is unlikely to get better as the child grows. Results with surgery, however, are excellent.
A concealed penis is a normal-sized penis that lays hidden in the pubic fat pad. This condition is also called buried penis or hidden penis. Some children are born this way, and for some it happens after circumcision. It is common in infants, and occasionally seen in older children and obese adolescents. If the penis can be easily exposed by gently pulling on it or by pressing down on the surrounding fat pad, then the situation will usually correct itself over time. Sometimes surgery is needed for concealed penis.
A trapped penis is a normal-sized penis that is partially stuck in the pubic fat pad. Children are not born with trapped penis; circumcision causes it. Routine circumcision of a webbed penis or circumcision when there is significant scrotal swelling (from a hydrocele or hernia) can lead to trapped penis. Scarring or adhesions trap the recessed penis in the fat pad. This condition can predispose children to urinary tract infections or urinary retention. Surgery is usually wise.
All of the above conditions have a penis of normal size. In determining size, the "stretched penile length" is far more important than the "relaxed length." To evaluate penis size, stretch the penis gently and measure from the bone at the base all the way to the tip. Be sure to depress the surrounding fat pad to get all the way to the base. Here are the normal values: Average Stretched Penile length
(Adapted from Feldman KW, Smith DW. Journal of Pediatrics. 1975; 86:395):
Age Mean +/- 1 SD (inches) Mean - 2.5 SD (inches) 0-5 months 1.5 +/- 0.3 0.75
6-12 months 1.7 +/- 0.3 0.9
1-2 years 1.9 +/- 0.3 1.0
2-3 years 2.0 +/- 0.4 sp; 1.1
3-4 years 2.2 +/- 0.4 1.3
4-5 years 2.2 +/- 0.4 1.4
5-8 years 2.4 +/- 0.4 1.5
8-11 years 2.5 +/- 0.4 1.5
Adult 5.2 +/- 0.6 3.7
Micropenis is a penis that is more than 2.5 standard deviations below the average size for age. In a newborn, a stretched penile length less than ¾ inch (1.9 cm) is micropenis. Micropenis is a hormonal problem that takes place sometime after 14 weeks gestation when the penis has already formed. If the penis grows when a 3 month-trial of testosterone is given, the outlook is good for normal adult penis size and function.
Absent penis, or penile agenesis, is very rare, occurring in fewer than 1 in 20 million boys.The scrotum and testicles usually form normally, but the penis doesn't form at all. .Consulting a urologist is all the more appropriate when new concerns arise as the boy grows.
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