Penile Growth After Puberty in Patients with a Constitutionally Small Penis

Abstract Purpose To evaluate the possibility of catch-up growth of the constitutionally small penis and the role of androgen supplement therapy through long-term follow-up. Material and Methods A total of 58 patients with constitutionally small penises, without chromosomal anomalies and gene-associated syndromes, intersex, and hypospadias, were included in this study. The average patient age at their first visits was 10 years and the average follow-up period was 2.2 years. Chromosomal study, hormone study (LH, FSH, Testosterone) were conducted to test for chromosomal anomalies in 19 patients whose SPL (Stretched Penile Length) were below 2SD. The size of the testis, SPL, bone age, and hormone level were measured and pubertal development were recorded by Tanner stage. 31 patients had been followed until puberty and mean follow-up period was 3.3 years (0.9-6). For penile growth, 15 patients were injected with 25-50mg testosterone enanthate monthly three times. Results Among the total of 31 patients who reached puberty, 28 (90.3%), including 7 patients who underwent androgen treatment, had a penile growth spurt and became to be within normal range while 3 (9.7%) had a below average for their age. After androgen replacement therapy, rapid penile growth was observed in all patients and the therapeutic effect was sustained after the treatment and SPL was within normal range after puberty. Bone age was measured before and after hormonal therapy and no significant changes were found. At the end of the study, SPL was within the normal range in 21 patients (87%) among 24 patients reached puberty without any previous treatment. Conclusions Catch-up growth of small penis were accomplished in most of children with constitutionally small penis. Androgen therapy could be recommended in selected patients safely to avoid psychological stress.