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Archives de pédiatrie
Volume 21, n° 6
pages 665-669 (juin 2014)
Doi : 10.1016/j.arcped.2014.03.016
Micropénis
Micropenis
 

C. Bouvattier
 Endocrinologie pédiatrique, faculté de médecine Paris 11, centre de référence des anomalies du développement sexuel, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France 

Résumé

Le micropénis est défini par la détection d’un pénis de structure normale avec une longueur<2,5 DS en dessous de la moyenne pour l’âge. Il est lié à des défauts de sécrétion ou d’action de la testostérone. L’évaluation de la fonction gonadotrope et testiculaire pendant la mini-puberté est souvent très utile. Le micropénis doit être traité pour assurer des mictions normales, des rapports sexuels normaux et une bonne image de soi. Indépendamment de la cause sous-jacente, un traitement par testostérone IM devrait être essayé chez les patients ayant un micropénis pour évaluer la capacité du pénis à y répondre. Le gel de dihydrotestostérone est efficace chez les enfants prépubères et présentant une insensibilité aux androgènes. Les enfants ayant un hypopituitarisme congénital répondent facilement à un traitement hormonal approprié. Une prise en charge psychologique est souvent nécessaire.

The full text of this article is available in PDF format.
Abstract

Micropenis represents a clinical sign that should be diagnosed at birth (or in utero) by the detection of a normally structured penis with a length 2.5 SD below the mean for age. Micropenis can be classified as due to deficient testosterone secretion or action. Evaluation of the gonadotropic and testicular function during the mini-puberty is often helpful in evaluating the etiology. Management of micropenis should focus on achieving a suitable penis length, in order to allow an adequate urination, normal sexual intercourses and a good self-body image. Irrespective of the underlying cause, a short course of T should be tried in patients with micropenis to assess the ability of the penis to respond to it. Topical 5a-dihydrotestosterone gel has also been reported to be effective. Children with hypopituitarism and GH deficiency respond to appropriate hormonal therapy. Psychological counseling is helpful and often necessary.

The full text of this article is available in PDF format.


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