Micropenis Research Articles

Clinical characteristics and genetic analysis in two patients with 3β-hydroxysteroid dehydrogenase deficiency

Objective To analyze the clinical characteristics of two patients with 3β-hydroxysteroid dehydrogenase deficiency and to explore their molecular genetic defects. Methods The clinical features and laboratory data of two patients were collected. The exons of HSD3B2 gene were amplified by PCR and sequenced by Sanger sequencing. Results Patient 1, aged 5 yrs old, was raised as a girl with 46, XY karyotype, presented with hyperpigmentation, female infant vulva, clitoral hypertrophy, and bilateral cryptorchidism; Patient 2, aged 11 yrs old, was raised as a girl at birth but as a boy after 1 yr old for known 46, XY karyotype, presented with hyperpigmentation, micropenis and severe hypospadias. Both patients had markedly elevated adrenocorticotropin and decreased cortisol. Two homozygous missense mutations in HSD3B2 gene were identified: conversions of codon Pro155 to Leu(p.P155L) in patient 1, and codon Ala82 to Thr(p.A82T) in patient 2, both of which were reported for the first time in China. Conclusion The patients with 3β-hydroxysteroid dehydrogenase deficiency in 46, XY karyotype mainly present with male pseudohermaphroditism and adrenocortical deficiency, and the diagnosis should rely on the steroids detection and HSD3B2 gene screening. (Chin J Endocrinol Metab, 2016, 32: 98-102) Key words: 3β-hydroxysteroid dehydrogenase deficiency; Congenital adrenal hyperplasia; Male pseudohermaphroditism; HSD3B2 gene

Epispadias in a Child with Intact Prepuce: A Rare Congenital Abnormality

Epispadias is a rare genitourinary malformation, more so is epispadias with intact prepuce. Incidence of epispadias with intact prepuce is not known however, there are few case reports and a case series. We present a 5-year-old boy brought to our facility by his parent for circumcision. Further evaluation revealed a short penis with broad base and intact prepuce. The preputial slit was dorsally oriented. On retracting the prepuce, there was corona epispadias with wide and healthy urethral plate. No meatal stenosis or chordee noticed. Other findings were normal. He had epispadias repair. The postoperative period was uneventful. Three months after operation, the prepuce was easily retractable over the penis and the penis was cosmetically acceptable.

AB073. Mutations in the type II 3β-hydroxysteroid dehydrogenase gene caused primary adrenal insufficiency & 46,XY disorders of sex development.

Congenital adrenal hyperplasia (CAH) is one of the most common inherited metabolic disorders. It includes a group of autosomal recessive disorders caused by the deficiency of one of the enzymes involved in one of the various steps of adrenal steroid synthesis. 3β-hydroxysteroid dehydrogenase (3β-HSD) deficiency is a rare cause of CAH caused by inactivating mutations in the HSD3B2 gene. Most mutations are located within domains regarded crucial for enzyme function. Our aim is to describe phenotype and to identify mutations of HSD3B2 in two classic β-HSD deficient patients belonging to two apparently unrelated pedigrees. This is a case series study. Family history and clinical manifestations were described. Genomic DNA from these patients was extracted using standard procedures from the peripheral blood leukocytes. Mutation analysis of HSD3B2 was performed using polymerase chain reaction (PCR) and DNA direct sequencing. Vietnamese 46,XY newborn referred at 2.5th month of life with salt loss associated with hyponatremia (123 nmol/L) and hyperpigmentation. The testes were palpable in the scrotum but associated with a severe hypospadias (micropenis 0.5 cm; posterior). At 4 months of age, a second adrenal crisis has occurred with hyponatremia 127 nmol/L and increased 17OH-Progesterone (26.8 ng/mL) in this 46,XY DSD. This clinical and biological data associated with a sibling with female phenotype deceased at 18 months old after adrenal crisis (1st occurred at 7 days of life) suggest the diagnosis of 3β-HSD deficiency. The sequencing of HSD3B2 confirms the diagnosis because he is homozygous for a missense mutation, pAla161Pro. This mutation affects an amino acid conserved in all species and is located in one two alpha-helix involved in the dimerization of the two sub-units of the enzyme. The changing from Alanine to proline could break the alpha-helix. The same mutation has been found in the other Vietnamese family. The 46,XY newborn referred at 3th month of life with severe dehydration associated with hyponatremia (93 nmol/L) and hyperpigmentation. The testes were palpable in the scrotum but associated with a severe hypospadias (micropenis 0.5 cm; posterior). Clinical presentation and increased 17OH-progesterone (9.7 ng/mL) in this 46,XY DSD suggest the diagnosis of 3β-HSD deficiency. The sequencing of HSD3B2 also confirms the diagnosis because he is homozygous for a missense mutation, pAla161Pro. The severity of this mutation correlates well with the phenotype in these patients. Parents of two unrelated pedigrees are not consanguinity. This study contributes to a better understanding of the molecular defects of 3β-HSD and of the phenotypic heterogeneity of CAH related to 3β-HSD deficiency.

Erect penile dimensions in a cohort of 778 Middle Eastern men: establishment of a nomogram.

Accurate data regarding the size of the erect penis are of great importance to several disciplines working with male patients, but little high-quality research exists on the subject, particularly in different ethnic groups and for erect penis size. The aim of this study was to create a nomogram of erect penile dimensions in a large sample of Middle Eastern men. A retrospective cohort study of 778 men (mean age 43.7; range 20-82) attending urological outpatient clinics in Saudi Arabia was conducted. Exclusion criteria were age under 18 years, a presenting complaint of small or short penis, Peyronie's disease or complaint of congenital curvature, clinical hypogonadism, and previous penile surgery or trauma. Three erect penile dimensions following induction of erection using intracavernosal injection of Quadrimix. Mean patient body mass index (BMI) was 29.09 (standard deviation [SD] 5.76). The mean suprapubic skin-to-penile tip erect length was 12.53 cm (SD 1.93); the mean erect length from the symphysis pubis to the penile tip was 14.34 cm (SD 1.86); and the mean erect shaft circumference was 11.50 cm (SD 1.74). A nomogram was constructed and statistical analysis performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.283, P < 0.000) but not from bone to tip, and a weak negative correlation between age and both erect penile length measurements (skin to tip r = -0.177, P < 0.0005; bone to tip r = -0.099, P = 0.006). A nomogram for Middle Eastern men can be used as a standard when advising men with small penis anxiety. The importance of measuring erect size and allowing for infra-pubic fat interference in measurement is emphasized. We envisage that this tool can be used to educate and reassure concerned men about the size of their penises.

The micropenis: about a series of 30 patients

The micropenis: about a series of 30 patients

Ten Years' Experience for Hypospadias Repair: Combined Buccal Mucosa Graft and Local Flap for Urethral Reconstruction

Objectives: To share our experience in hypospadias repair and discuss the clinical implications of our method, which consists of a combined buccal mucosa graft and local flap for urethroplasty. Patients and Methods: 1,394 cases (median age 11.3 years, age range 5 months to 53 years) of hypospadias which were repaired using our method between July 2000 and December 2010 in our department were included in this study. The patients who had a short penis or did not have chordee were excluded from the data. 588 cases (42.2%) had previously undergone surgery in other hospitals but failed; 806 (57.8%) cases had undergone the first treatment in our department. Results: Of the 806 cases which had undergone the first treatment in our department, we successfully reconstructed the urethra for 747 patients (92.3%), and 59 patients had complications (7.7%); of the 588 cases which had previously undergone surgery but failed, we successfully reconstructed the urethra for 522 patients (88.8%), and 66 patients had complications (11.2%). The most common complication was urethra fistula (70; 5%); other complications include necrosis of the skin flap and infection resulting in wound disruption (19; 1.4%), urethral diverticula (11; 0.8%) and urethral stricture (25; 1.8%). Conclusions: Our method appears to be a safe, simple and satisfactory surgical procedure and can provide relatively enough tissue to reconstruct the urethra with a higher success rate.

Children with idiopathic hypogonadotropic hypogonadism: clinical data analysis and mutations analysis of KAL1 and FGFR1 gene

To summarize the clinical features of idiopathic hypogonadotropic hypogonadism (IHH) diagnosed during childhood, and detect mutations in KAL1 and FGFR1, acting as key clues for diagnoses. We collected and analyzed clinical data of 21 cases (including demographic data, chief complaint, history of present illness, family history, physical examination, laboratory tests and imaging studies, etc.) diagnosed with IHH from December 2008 to February 2013. Polymerase chain reaction and gene sequencing was applied to detect mutations on KAL1 and FGFR1. Fifty healthy unrelated individuals were choosen as controls. Of 21 patients with IHH, 19 were males and 2 females, they visited us initially from 8-17 years old, with an average of (13.58 ± 2.38) years old. Sixteen cases were KS patients (76%). One boy reported abnormal sense of smelling but having olfactory perfect picture on MRI; 2/19 male cases had no puberty when they were over 13-14 years old without abnormal external genitalia. 8/19 cases only had small penis, 8/19 had both of cryptorchidism and small penis, and the Case 2 also had hypospadias. One boy had cryptorchidism combined with a normal penis. Only 2 girls diagnosed as IHH who visited us because of no puberty signs when they were 13 and 16 years old, respectively. Other clinical manifestations included: one with gynecomastia, 2 had mental retardation, and one was deaf; one with high palatal arch; one with mirror-movement and one with left renal agenesis but normal renal function respectively. Laboratory tests showed that the basic testosterone (T) is low and with inappropriately low or normal gonadotropin hormones. The results of cases of standard human chorionic gonadotropin (HCG) test of 7 cases out of 19 male children's were normal (testosterone>1 100 ng/L), and another nine cases continued to complete the extended HCG test, and the testosterone levels of two of them (cases 6, 8) were still lower than 1 000 ng/L. Family history: the parents in 9/21 family had delayed puberty, involving only one parent in 6 families, involving both in 2 families and the other one was an uncle having micropenis with a child. Among these 21 cases, only one boy's father had hyposmia and his first emission age was 14-15 years. Eleven patients accompanied abnormal sense of smelling and the olfactory organ abnormalities on MRI, 4 had olfactory organ abnormalities on MRI while they had good smelling function self-reportedly. We got 15 samples (12 KS and 3 nIHH cases) to screen the mutation of KAL1 (14 exons) and FGFR1 (18 exons). A splicing mutation c.1062+1G>A in KAL1 is identified in case 17 with IHH. One novel heterozygous FGFR1 mutation, a single base deletion mutation on the exon 1 c.27delC is identified in case 14. This mutation causes the premature termination codons. This pilot research showed that IHH/KS diagnosis in children depends on clinical manifestation rather than gene analysis. Small penis or cryptorchidism, smelling abnormality and positive familial history may contribute to the KS/HH diagnosis. MRI of olfactory bulb acts as important proof for diagnosis of KS. Mutations in KAL1 and FGFR1 gene are not main causes of Kallmann syndrome.

Where even a long penis can't help: Evidence of long-distance spermcast mating in two acorn barnacles

Free-living barnacles are sessile as adults, mostly hermaphroditic, and generally thought to mate either by pseudo-copulation, using their famously long penises, or by self-fertilization. However, the recent discovery of spermcast mating in a stalked barnacle, Pollicipes polymerus — which has a relatively short penis — raises questions about whether spermcast mating might occur in the more familiar acorn barnacles as well. To assess how widespread spermcast mating is in barnacles with longer penises, we studied two common intertidal acorn barnacles, Balanus glandula Darwin, 1854 and Chthamalus dalli Pilsbry, 1916, whose penises can extend up to seven times their body length. We sampled fertilized isolated individuals, as well as isolated pairs where at least one parent carried fertilized eggs, and genotyped both adults and embryo masses using seven single-nucleotide-polymorphism loci for each species. 100% and 70% of embryo masses in isolated individuals had at least one non-maternal allele in B. glandula and C. dalli, respectively. Even in isolated pairs, 7.7% of B. glandula and 9.1% of C. dalli had alleles not present in either parent. This incidence of spermcast mating is lower, and over smaller spatial scales, than reported for the stalked barnacle, P. polymerus. Nonetheless, these observations provide strong evidence that spermcast mating does occur — at least occasionally — in acorn barnacles too. This possibility therefore needs to be considered in studies of barnacle mating systems, sex allocation and population genetics.

Assessment and management of 46, XY disorders of sexual development

Micropenis is one of clinical manifestations of 46, XY disorders of sex development.Due to the complex etiology, the limitation of diagnostic methods, it is difficult to define the causes in some complicated cases.The abnormality in any part of the hypothalamic pituitary gonadal axis, androgen synthesis and function will influence the development of penis.Based on the statistical data of penis in comparison, trying to find the reference data for clinical application, used in the diagnosis of micropenis.For the patient raise a boy, the treatment including medicine and operation to improve the size of penis.Exogenous androgen and human chorionic gonadotrophin(HCG) treatment are the main methods in present, it can effectively promote the micropenis to increase in size.But it is debatable when to start the treatment, dosage and the duration.The potential side effects are unknown.Operation treatment can improve the hypospadias induced abnormal appearance and reconstruction of urethra.Treatment of gonadotropin can be applied to the patients who want to acquire fertility.For patients reared as female, male gonads must be removed, and estrogen replacement administered after adolescent. Key words: 46, XY disorders of sex development; Micropenis; Etiology; Diagnosis

Sexual Quality of Life After Hormonal and Surgical Treatment, Including Phalloplasty, in Men with Micropenis: A Review

The term micropenis encompasses a range of congenital and acquired conditions that result in an abnormally short penis. Small penis size may persist into adulthood, becoming a major cause of dissatisfaction. To review the literature pertaining to the effects of hormonal and surgical treatment on psychosexual functioning and quality of life (QoL) in individuals with micropenis who were raised male. Long-term psychosexual and QoL outcomes after hormonal and surgical treatment, including phalloplasty. PubMed search for relevant publications (1955-2012) on the role of hormonal and surgical treatment in sexual QoL in adult men with micropenis. Multiple variations in the etiology of micropenis make it difficult to draw firm conclusions that fit all of the patients within this disparate population. However, the literature review supports the conclusions that (i) male gender assignment is preferable for most 46,XY infants with congenital micropenis because of the likelihood of male gender development and genitosexual function; (ii) small penis size persisting into adulthood and dissatisfaction with genital appearance jeopardize sexual QoL; (iii) there is no known intervention, apart from phalloplasty, to guarantee that the penis will become normal in size; (iv) early data suggest that the phalloplasty technique considered the gold standard for gender reassignment in the transgender population can also be transferred to 46,XY patients with micropenis; (v) psychological support should be an integral part of management in order to alleviate the distress and impairment of QoL experienced by these individuals. Further publication of series with large numbers and longer follow-up is needed. Specific outcome kits should be designed to measure more precisely patients' degrees of satisfaction with cosmetic, anatomical, and functional variables. Only if health-care professionals fully appreciate the impact of this condition can optimal care be provided.

A young male adolescent with feminine appearance: diagnosis of 46, XX syndrome neglected for 4 years with gynaecomastia presentation

Gynaecomastia is common in infancy and adolescent boys, but other inciting causes should be kept in mind and necessitate further evaluation should be conducted to determine any underlying conditions. A 22-year-old unmarried male adolescent visited our endocrinology clinic for feminine appearance despite operations for bilateral gynaecomastia 4 years ago. Physical examination showed inverted triangular distribution of pubic hair, sparse beard, small-sized testes, flaccid short penis and surgical scar of the chest wall. Serum hormones study revealed primary hypergonadotropic hypogonadism, and cytogenetic study disclosed female complement (46, XX). The authors recommend that sexual chromosome abnormality should be considered in patients with hypogonadism to avert androgen deficiency-related complications early and that long-term team care should be provided to improve the patient's health-related quality of life.

Evaluation of Surgical Outcome of Penile Augmentation and Lengthening Procedures

Our study included 280 patients complaining of small-sized penis. They were seen in the outpatient clinic of the Andrology Department, Kasr El Aini, Cairo University. Patients were collected from 2002 till 2008 and classified into 4 categories from an etiological point of view. Eleven patients (3.9%) were operated upon according to fine selection criteria; six patients were selected for lengthening procedures, while two patients were selected for increasing girth procedures and three patients for combined operation of lengthening and increasing girth techniques. Seven patients showed subjective satisfaction after lengthening procedures and four patients showed subjective satisfaction after increasing girth techniques. In conclusion, detailed analysis of short penis complaint with a proper diagnosis and patient education are required for accurate management of patients complaining of a short penis.

A Case of Trisomy 9 Complicated With Congenital Diaphragmatic Hernia

We experienced a case with fetal trisomy 9, which was confirmed by genetic amniocentesis at the 28th week of gestation. A pregnancy woman of the 24th week of gestation with congenital diaphragmatic hernia (CDH) and intrauterine growth restriction (IUGR) was referred to our hospital. Magnetic resonance imaging (MRI) scans further depicted the detailed anatomical configurations of congenital diaphragmatic hernia, hydrops fetalis, agenesis of corps callosum, and cerebellar hypoplasia. Genetic amniocentesis revealed trisomy 9, a karyotype of 47, XY, +9 in the cultured amniocytes. At the 32nd week of gestation, intrauterine fetal death was confirmed and a stillborn male infant was delivered with a body weight of 875 g and a length of 39 cm after induction of labor. Macroscopic findings included small palpebral fissures, hypertelorism, micrognathia, low-set ears, hypoplastic phalanges, cryptorchidism, hypoplastic scrotum, micropenis, and rocker-bottom feet. doi: http://dx.doi.org/10.4021/jmc1003w

Checklist of the ancyrocephalids (Monogenea) parasitizing Tilapia species in Cameroon, with the description of three new species

A checklist of the 23 species of Ancyrocephalidae (Monogenea) parasitizing Tilapia species sampled from both sides of the Cameroon Volcanic Line is provided. As already reported elsewhere, Cichlidogyrus aegypticus in Cameroon shows two different shape of its vagina, and C. tilapiae, C. arthracanthus and C. tiberianus were found on a wide range of host species. Among the 23 studied species of Monogenea, three are considered new species and are described herein: Cichlidogyrus berminensis n. sp. from Tilapia bemini, characterized by a short penis with marked narrow heel, a simple and straight accessory piece ending in a large hook, and a medium sized pair of uncinuli I; Cichlidogyrus gillesi n. sp. from Tilapia guineensis, characterized by a large and trapezoid heel of the penis and a S-shaped and wrinkle walled vagina; and Scutogyrus vanhovei n. sp. from Tilapia mariae, characterized by the presence of a distinct swollen portion of the penis. From a parasite's point of view, the CVL has no influence on species dispersion/distribution.

Anatomy and Histology of the Male Reproductive Tract and Spermatogenesis Fine Structure in the Lesser Anteater (Tamandua tetradactyla, Myrmecophagidae, Xenarthra): Morphological Evidences of Reproductive Functions

The anatomy and histology of the male genital tract of the lesser anteater were studied. Fine details of spermatozoa regarding their genesis and morphology were also studied in six adult specimens. The testes lie in the pelvic cavity. The deferent duct emerges from the epididymis and opens into the ejaculatory duct, which drains into the membranous urethra. Accessory glands (prostate, seminal vesicle and bulbourethral gland) are histologically similar to those described in other mammals. The short penis presents an urethral orifice, while the corpus spongiosum becomes thinner at the end indicating the absence of a histologically defined glans. The seminiferous epithelium shows: (1) Sertoli cells with deep nuclear indentations, (2) spermatogonia with crusty-like chromatin, (3) spermatocytes at different stages of maturation and (4) three morphologically distinct stages of spermatid differentiation according to nuclear shape, acrosome development and chromatin condensation. Sperm heads appear oval. The length of the spermatozoa averages 67.33 ± 1.60 μm. Two specimens with inactive spermatogenesis were azoospermic. Their testes and epididymis presented sizes smaller than those with active spermatogenesis. These studies together with others in anteaters may contribute to successful breeding in conservation programmes.

Incidence of reduced penis size among men with recurrent prostate cancer previously treated with surgery, radiation plus androgen deprivation, or radiation alone.

38 Background: The relative incidence of reduced penis size across prostate cancer treatment modalities is not well-known. Methods: The incidence of physician-reported patient complaints about reduced penis size was calculated for 948 men in the COMPARE registry who experienced PSA failure and were assessed a median of 5.45 (2.6-8.9 IQ range) years after prostatectomy or radiation (RT) consisting of either external beam or brachytherapy. Multivariable logistic regression was used to determine factors associated with poorer sexual function and incontinence. Results: Of 948 men, 25 (2.63%) complained of a reduced penis size. The incidence of reduced penis size by treatment was: surgery (19/510=3.73%), RT plus androgen deprivation therapy (ADT) (6/225=2.67%), RT without ADT (0/213=0%). Surgery (p=0.004) and RT+ADT (p=0.016) had significantly more short penis complaints than RT alone. Rates of shortened penis for surgery and for RT+ADT were similar (p=0.47). On multivariable analysis adjusting for age and treatment type, short penis was associated with poorer sexual function (Odds ratio: 2.430, 95% CI: 1.046-5.643) (p=0.0389) and more incontinence (Odds ratio: 4.671, 95% CI: 1.985-10.994) (p=0.0004). Conclusions: Complaints about reduced penis size were more common with RT+ADT or surgery than with RT alone, and were associated with poorer sexual function and incontinence issues.

Epispadias with complete prepuce: A rare anomaly

Epispadias with complete prepuce is a very rare anomaly. It is often associated with late presentation because it is a very rare condition and the penis appears grossly normal, thus, the diagnosis is easily missed during the neonatal period. We report a case of a boy presenting at seven years of age with epispadias and complete prepuce. The diagnosis should be suspected in any child presenting with incontinence, short penis, ballooned prepuce on voiding and absence of penile raphe or frenulum. The established procedures for repair of classic epispadias are equally effective and bladder neck reconstruction may be required to achieve continence.

A Case of Ambiguous External Genitalia in a Thoroughbred Male Horse with the 63,XO/64,XY Mosaic Karyotype

A Thoroughbred colt with ambiguous external genitalia was presented for clinical and histological examinations. The colt had a short penis that faced backward between his hind limbs. The measurements of luteinizing hormone, follicle stimulating hormone, testosterone and ir-inhibin showed a tendency to increase gradually from April. Both the sex-determining region of the Y chromosome and amelogenin gene fragments were detected by the PCR method. A cytogenetic analysis revealed the 63,XO/64,XY mosaic karyotype (ratio 83:17). In autopsy, immature symmetrical subcutaneous testes were found in the inguinal regions. The testes and other accessory sex organs were histologically normal. These results add to our knowledge of chromosomal abnormality and information concerning disorders of sex development in the horse.

Relationship between penile size and somatometric parameters in 2276 healthy young men

The aim of this study was to determine the average penile length of a group of healthy, young Turkish men, and to investigate the relationship between penile length and somatometric parameters in the same group. The flaccid and stretched length and circumference of the penis was measured in a group of 2276 physically normal, young men. The correlation between penile length and weight, height and body mass index (BMI) of the participants was determined by Pearson's analysis. The mean age of the participants was 21.1 ± 3.1 (18-39) years. The mean flaccid, fully stretched and circumferential length of the participants' penises were 8.95 ± 1.04, 13.98 ± 1.58 and 8.89 ± 0.86 cm, respectively. There was a significant relationship between all of these variables (P<0.01). Although weak positive correlations were found between the mean circumference length and BMI, there were no correlations between both the flaccid and stretched lengths and BMI. The penile length must be known to be able to determine the abnormal penile sizes and to make convenient decisions in the counseling and/or treatment of people with short penis concerns. Our study provides mean penile lengths in a large sample of healthy, young Turkish men, and the penile dimensions were found to be weakly correlated with somatometric parameters.

Effect of Penile‐Extender Device in Increasing Penile Size in Men with Shortened Penis: Preliminary Results

It has been suggested that the application of penile-extender devices increases penile length and circumference. However, there are a few scientific studies in this field. The aim of this study was to assess the efficacy of a penile-extender (Golden Erect(®) , Ronas Tajhiz Teb, Tehran, Iran) in increasing penile size. This prospective study was performed on subjects complaining about "short penis" who were presented to our clinic between September 15, 2008 and December 15, 2008. After measuring the penile length in flaccid and stretched forms and penile circumference, patients were instructed to wear Golden Erect(®) , 4-6 hours per day during the first 2 weeks and then 9 hours per day until the end of the third month. The subjects were also trained how to increase the force of the device during determined intervals. The patients were visited at the end of the first and third months, and penile length and circumference were measured and compared with baseline. The primary end point of the study was changes in flaccid and stretched penile lengths compared with the baseline size during the 3 months follow-up. Twenty-three cases with a mean age of 26.5 ± 8.1 years entered the study. The mean flaccid penile length increased from 8.8 ± 1.2 cm to 10.1 ± 1.2 cm and 10.5 ± 1.2 cm, respectively, in the first and third months of follow-up, which was statistically significant (P < 0.05). Mean stretched penile length also significantly increased from 11.5 ± 1.0 cm to, respectively, 12.4 ± 1.3 cm and 13.2 ± 1.4 cm during the first and second follow-up (P < 0.05). No significant difference was found regarding proximal penile girth. However, it was not the same regarding the circumference of the glans penis (9.3 ± 0.86 cm vs. 8.8 ± 0.66 cm, P < 0.05). Our findings supported the efficacy of the device in increasing penile length. Our result also suggested the possibility of glans penis girth enhancement using penile extender. Performing more studies is recommended.