How is the physical exam for microphallus conducted?

Updated: Nov 30, 2020
  • Author: Karen S Vogt, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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The infant or child with micropenis should be thoroughly examined for dysmorphic features and other congenital anomalies.

This examination should include careful inspection of the face and mouth for cleft lip or palate or other indications of midfacial hypoplasia.

Abnormal growth velocity after the first 6-12 months of life suggests growth hormone deficiency with or without other pituitary hormone deficiencies.

A thorough examination of the genitalia, including proper measurements of the stretched penis length, position of the urethral opening, and location and size of the testes, is important. One or both testes may be abnormally descended because testosterone also plays a role in testicular descent.

The proper technique for measuring the penis is to use a rigid ruler held firmly against the symphysis pubis at a right angle. Firm but gentle traction is placed on the penis to stretch it upward along the ruler to the point of increased resistance. [1]

An alternate, less traumatic method is to use the index finger of one hand as a gauge pressed against the symphysis. As gentle traction is placed on the penis, the index finger of the other hand is used to mark the length on the gauge finger, and a tape measure is used to determine the length.

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