| Objective: At present, the time of treatment of micropenis and drug selection are still controversial, and poor efficacy. In this study, using topical testosterone cream and HCG, respectively, to treatment micropenis, then to observe the clinical efficacy and its impact on sex hormone levels , in order to explore an effective means of clinical treatment of micropenis.Methods:choose micropenis reaching the diagnostic criteria [1] [2]excluding merger, concealed penis, buried penis, webbed penis, hypospadias, then measured the size of the penis.They were randomly divided into group HCG and group T. Group HCG,use of HCG 1000IU, im, weekly 2, a total of six weeks; Group T ,use of local testosterone cream, 2 times a day, a total of 8 weeks. Before and after medication 15 days later , indications were detected, which included:①the size of the penis in the resting state of the penis were measured by the length of the penis, penis central diameter with a vernier caliper;②testicular size measured with a vernier caliper, respectively, length, width, thickness, and the formula[3] to calculate their size;③hormone levels measured by radioimmunoassay used to detect the blood T, LH, FSH levels. And at the same time to detect chromosome and the suspected low-pituitary gonadotropin-gonadal lesion dysfunction who scaned pituitary MRI.Results: From April 2008 to March 2009, from 4952 pediatric urology patients, screening 31 cases to meet the diagnostic criteria, 31 cases were of normal growth and development, and no cryptorchidism, concealed penis, buried penis, hypospadias and complications such as hermaphroditism. The youngest 8 months, the oldest 14.0-year-old, with an average age of 6.5±0.9 years. Group HCG of which 16,Group T 15. Between the two groups of age, height and weight comparison there was no significant difference (P> 0.05). Results are as follows:①the size of the penis: between the two groups before treatment the length, the diameter of the penis Central was no significant difference (P> 0.05), but two groups before and after medication in length, central diameter are significant differences in comparison (P <0.05), HCG and T have confirmed significant efficacy. Between the two groups after administration the increase of length and diameter was no significant difference (P> 0.05), confirmed the efficacy of two drugs is similar. Two groups before and after medication the length and diameter are correlation (P <0.05), show that the efficacy of drug to stimulate the penis length and diameter is likely. After medication the added value of the length of the penis was not associated with age (P> 0.05), show that different age have same efficacy.②testicular volume: the two groups of testicular volume before treatment showed no significant difference (P> 0.05). Within the two groups before and after medication comparison of testicular volume were significantly different (P <0.05), but group HCG was significantly higher than group T (P <0.05), confirmed that T and HCG can stimulate testicular growth, but HCG was stronger . After medication the added value of the length of the testis was not associated with age (P> 0.05), show that different age have same efficacy. With 31 cases of testicular dysplasia in 7 cases, 4 cases in group HCG, 3 cases in group T, in two groups testicular volume after treatment are significant growth (P <0.05), showed T and HCG can increase testicular volume for micropenis with testicular dysplasia.③sex hormone levels: the two groups before treatment T, LH, FSH levels showed no significant difference (P> 0.05), but before and after HCG administration T levels were significantly different (P <0.05), confirmed that HCG can stimulate Leydig cell to produce T. Before and after HCG administration LH, FSH levels were not significantly different (P> 0.05), T group before and after medication T, LH, FSH levels were not significantly different (P> 0.05), showed that topical application of testosterone and HCG in the treatment of micropenis on the hypothalamus - pituitary - gonadal axis had no significant inhibitory effect.④chromosome tests: 25 cases in 31 cases of children with a chromosome examination, both 46, xy, show that children no chromosomal abnormalities.⑤MRI examination: lesions of suspected low-pituitary gonadotropin-gonadal dysfunction in 12 cases, including 8 cases of pituitary MRI scan the results were no obvious abnormalities. Show that the small penis in children with pituitary abnormalities were rare.Conclusions: 1. A small penis is not uncommon for clinical, about 6.3‰, Clinical to those found idiopathic. 2. HCG and T treatment of small penis There were significant effects, and its efficacy was no significant difference between the two drugs. 3. HCG and external use of testosterone cream on the hypothalamus - pituitary - gonadal axis had no significant inhibitory effect. 4. Efficacy and age, no correlation, that is, infants and early childhood, youth and pre-adolescent drug delivery can achieve more satisfactory effect. 5. HCG stimulation of testicular growth was stronger than its role in topical testosterone cream. |
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