Etiological evaluation of patients presenting with isolated micropenis to an academic health care center.

OBJECTIVE: To evaluate etiology of the patients with micropenis presenting to a tertiary health care center.

METHODS: In this prospective study all patients who were referred with a diagnosis of micropenis from October 2009 through October 2010, underwent a complete evaluation including measurement of stretched penile length.

RESULTS: In 20 (31 %) among a total of 65 patients, measured stretched penile length was not consistent with the description of micropenis. True presence of micropenis was confirmed in the remaining 45 of total 65 cases (69 %). Etiological cause was determined in 29 patients (44 %) with the most common cause being hypogonadotropic hypogonadism. No etiological cause could be found in 16 patients (25 %).

CONCLUSIONS: In approximately one third of patients the presence of micropenis was not confirmed. The most common causes of misdiagnosis were buried penis due to obesity, erroneous measurement of stretched penile length, and/or lack of knowledge on population standards for penile length. Etiological basis of micropenis is rather heterogeneous. Despite extensive investigations, no causal link was found in around one fourth of cases. Accurate measurement and utilization of internationally accepted standards is utmost important for diagnosis and management of micropenis.