Abstract
The normal length of penis in preterm and term neonates is different among different nations, and is affected by various factors. The present study aimed to determine stretched penile length (SPL) values and cutoff level of micropenis in term and preterm Iranian neonates, for the first time. All male neonates born in two general hospitals of Tehran (Akbarabadi, and Rasoul hospitals), center of Iran, with gestational age of 28-42 weeks were included and their SPL and penile circumference (PC) were examined on the first 3 days after birth by the same physician. Birth weight (BW), and height, gestational age, type of delivery, mother's age, twin/multiple pregnancy, drug, and medical history of mother during pregnancy were recorded and cutoff levels of two variables were calculated based on the collected variables for different gestational ages. Among a total of 587 neonates, 203 neonates were born term and 384 preterm. Mean ± SD of neonates' BW were 2,682.51 ± 739.30 (850-4800) gr. Mean ± SD of their SPL was 22.48 ± 3.34 mm; 25.92 ± 1.54 mm in term and 20.66 ± 2.50 mm in preterm infants (P = 0.001). Mean ± SD of PC was 6.71 ± 1.31 mm; 8.14 ± 0.48 in term and 5.96 ± 0.92 in preterm infants (P = 0.001). SPL and PC were significantly correlated with type of delivery, number of parity, gestational age, BW, and crown-heel length, head circumference (P < 0.001). This study suggested that SPL in male neonates was 22.48 mm and PC was 6.71 mm, both correlated with gestational age and BW. Due to the ethnical variety of this cutoff points and lack of an appropriate study in Iran, these cutoff points can be used by all physicians as a reference for Iranian newborns (term and preterm), in order to prevent misdiagnosis of micropenis and genital disorders.
Highlights
IntroductionOne of the important concerns in neonates’ physical examination is the genital examination, especially penile size that is considered an important representation of hypothalamic or pituitary abnormality (hypogonadotropic hypogonadism); due to the role of androgen exposure in fetal sex development, disorders in genital system may be a sign of disorders of sex development (DSDs) [1]
One of the important concerns in neonates’ physical examination is the genital examination, especially penile size that is considered an important representation of hypothalamic or pituitary abnormality; due to the role of androgen exposure in fetal sex development, disorders in genital system may be a sign of disorders of sex development (DSDs) [1]
Mean ± standard deviation (SD) of Stretched penile length (SPL) and PL were 22.48 ± 3.34 and 6.71 ± 1.31 mm, respectively, in the total population of term and preterm infants
Summary
One of the important concerns in neonates’ physical examination is the genital examination, especially penile size that is considered an important representation of hypothalamic or pituitary abnormality (hypogonadotropic hypogonadism); due to the role of androgen exposure in fetal sex development, disorders in genital system may be a sign of disorders of sex development (DSDs) [1]. In addition to diagnosis of hypothalamic and pituitary defects, measurement of PL is important in procedures, such as circumcision, as well [3]. The accuracy of PL measurement and cutoff for the definition of micropenis are of great importance, commonly missed in early physical examination of the newborn [6]. Stretched penile length (SPL) is basically put on nomograms, designed based on gestational age, weight, and height [7]; PL values are different for preterm infants [8], as well as different ethnicities [9]. The normal length of penis in preterm and term neonates is different among different nations, and is affected by various factors. The present study aimed to determine stretched penile length (SPL) values and cutoff level of micropenis in term and preterm Iranian neonates, for the first time
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