Evaluation and Management of Micropenis

Essential Historical Components

• A detailed assessment of developmental milestones is crucial to identify developmental delays that may accompany syndromic causes of micropenis, as recommended by the American Academy of Child and Adolescent Psychiatry 1, 2
• The presence of cryptorchidism, hypospadias, or incomplete scrotal fusion suggests possible disorders of sex development (DSD) or gonadal dysgenesis, according to the American Urological Association 3
• Urinary symptoms such as dribbling, dysuria, frequency, or difficulty with urination should be assessed, as suggested by the American Academy of Child and Adolescent Psychiatry 1, 2

Critical Considerations

• In patients with bilateral nonpalpable testes and micropenis, DSD should be immediately considered, and circumcision should not proceed until evaluation is complete, as recommended by the American Urological Association 3
• A family history of neonatal deaths or ambiguous genitalia in siblings raises concern for DSD or congenital adrenal hyperplasia, according to the American Urological Association 3