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Normative data of penile length in Korean newborns

한국인 신생아 음경 길이에 대한 연구

  • 김상엽 (대구파티마병원 소아과청소년과) ;
  • 전재성 (대구파티마병원 소아과청소년과) ;
  • 이상길 (대구파티마병원 소아과청소년과)
  • Received : 2008.03.24
  • Accepted : 2008.07.11
  • Published : 2008.09.15

Abstract

Purpose : As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. Methods : The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. Results : Penile length was $3.02{\pm}0.25cm$ (F=36.467, $R^2=0.180$, P<0.001) when measured with CPLM, and $3.29{\pm}0.26cm$ (F=9.149, $R^2=0.052$, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. Conclusion : In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.

목 적 : 현대사회가 개방적으로 전환되면서 이세의 건강한 내외적 발육발달 뿐만 아니라 음경의 발달, 즉 음경 길이에 대한 관심이 증가하였다. 왜소음경은 음경 길이가 또래의 평균보다 2표준편차 이상 벗어나는 경우로 정의하며 염색체 이상 및 내분비 이상과 관련이 있을 수 있다. 저자들은 한국인 신생아의 음경 길이에 대한 표준화된 자료를 제시하고 왜소음경에 대한 기준을 마련하고자 본 연구를 시행하였다. 방 법 : 2007년 2월부터 2007년 6월까지 대구 파티마병원에서 태어났으며 임신과 분만 시 관련 합병증이 없었던 재태주령 37주에서 42주 사이의 남아 신생아 168명을 대상으로 하였다. 음경 길이의 측정은 CPLM 방법과 syringe 방법을 이용하였으며 동일 검사자가 각 측정방법마다 서로 다른 시간에 두 번씩 측정하였다. 결 과 : 한국인 신생아 음경길이는 CPLM 방법으로 측정 시 $3.02{\pm}0.25cm$, syringe 방법으로 측정 시 $3.29{\pm}0.26cm$로 도출되었다. 재태주령이 길수록 CPLM 방법(F=36.467, $R^2=0.180$, P<0.001) 및 syringe 방법(F=9.149, $R^2=0.052$, P<0.001)에서 음경길이는 유의하게 길었지만, syringe 방법은 CPLM 방법에 비해 재태주령과 음경길이와의 관계를 설명하기에 다소 부족했다. 두 가지 방법을 이용하여 구한 신생아의 음경길이는 통계학적으로 큰 차이는 없었으며 Pearson's 상관관계는 P=0.01 수준에서 두 방법 모두 0.631로 유의하게 나타났다. 결 론 : 본 연구에서는 재태주령이 길수록 음경길이도 길어지며 CPLM 방법으로 2.5 cm 그리고 syringe 방법으로 2.8 cm 미만이면 한국인 신생아에게 있어서 왜소음경으로 추정할 수 있으며 잠복음경일 경우 syringe 방법을 이용하면 도움이 될 수 있다. 왜소음경으로 추정되면 보호자와 충분한 상의 후 외래 추적관찰 및 추가적인 내분비 및 염색체 검사가 필요할 것이다.

Keywords

References

  1. Barthold JS, Kryger JV, Derusha AM, Duel BP, Jednak R, Skafar DF. Effects of an environmental endocrine disruptor on fetal development, estrogen receptor alpha and epidermal growth factor receptor expression in the porcine male genital tract. J Urol 1999;162:864-71 https://doi.org/10.1097/00005392-199909010-00079
  2. Willingham E, Agras K, de Souza AE Jr, Konijeti R, Yucel S, Rickie W, et al. Steroid receptors and mammalian penile development: an unexpected role for progesterone receptor? J Urol 2006;176:728-33 https://doi.org/10.1016/j.juro.2006.03.078
  3. Steinhardt GF. Endocrine disruption and hypospadias. Adv Exp Med Biol 2004;545:203-15
  4. Lovinger RD, Kaplan SL, Grumbach MM. Congenital hypopituitarism associated with neonatal hypoglycemia and microphallus: four cases secondary to hypothalamic hormone deficiencies. J Pediatr 1975;87:1171-81 https://doi.org/10.1016/S0022-3476(75)80132-6
  5. Aaronson I. Micropenis: medical and surgical implications. J Urol 1994;152:4-14 https://doi.org/10.1016/S0022-5347(17)32804-5
  6. Savage MO. Ambiguous genitalia, small genitalia and undescended testes. J Clin Endocrinol Metab 1982;11:127-58 https://doi.org/10.1016/S0300-595X(82)80040-6
  7. Jones KL. Smith's recognizable patterns of human malformation, 5th ed. Philadelphia: WB Saunders Co, 1997;836
  8. Danish RK, Lee PA, Mazur T, Amrhein JA, Migeon CJ. Micropenis. II. Hypogonadotropic hypogonadism. Johns Hopkins Med J 1980;146:177-84
  9. Salisbury DM, Leonard JV, Dezateux CA, Savage MO. Micropenis: an important early sign of congenital hypopituitarism. Br Med J (Clin Res Ed) 1984;288:621-2 https://doi.org/10.1136/bmj.288.6417.621
  10. Lee PA, Mazur T, Danish R, Amrhein J, Blizzard RM, Money J, et al. Micropenis. I. Criteria, etiologies and classification. Johns Hopkins Med J 1980;146:156-63
  11. Lee PA, Danish RK, Mazur T, Migeon CJ. Micropenis. III. Primary hypogonadism, partial androgen insensitivity syndrome, and idiopathic disorders. Johns Hopkins Med J 1980;147:175-81
  12. Lian WB, Lee WR, Ho LY. Penile length of newborns in Singapore. J Pediatr Endocrinol Metab 2000;13:55-62
  13. MacLean HE, Warne GL, Zajac JD. Intersex disorders: shedding light on male sexual differentiation beyond SRY. Clin Endocrinol (Oxf) 1997;46:101-8 https://doi.org/10.1046/j.1365-2265.1997.d01-1742.x
  14. Kaplan SL, Grumbach MM, Aubert ML. The ontogenesis of pituitary hormones and hypothalamic factors in the human fetus: maturation of central nervous system regulation of anterior pituitary function. Recent Prog Horm Res 1976;32:161-243
  15. Klauber GT, Sant GR. Disorders of the male external genitalia. In : Kelalis PP, King LR, Belman AB, editors. Clinical pediatric urology. Philadelphia: WB Saunders Co, 1985:825-61
  16. Gad YZ, Nasr H, Mazen I, Salah N, el-Ridi R. 5 alphareductase deficiency in patients with micropenis. J Inherit Metab Dis 1997;20:95-101 https://doi.org/10.1023/A:1005326027087
  17. Evans BA, Williams DM, Hughes IA. Normal postnatal androgen production and action in isolated micropenis and isolated hypospadias. Arch Dis Child 1991;66:1033-6 https://doi.org/10.1136/adc.66.9.1033
  18. McMahon DR, Kramer SA, Husmann DA. Micropenis: does early treatment with testosterone do more harm than good? J Urol 1995;154:825-9 https://doi.org/10.1016/S0022-5347(01)67175-1
  19. Levy JB, Husmann DA. Micropenis secondary to growth hormone deficiency: does treatment with growth hormone alone result in adequate penile growth? J Urol 1996;156:214-6 https://doi.org/10.1016/S0022-5347(01)66003-8
  20. Schonfeld WA, Beebe GW. Normal growth and variation in the male genitalia from birth to maturity. J Urol 1942;48:759-77 https://doi.org/10.1016/S0022-5347(17)70767-7
  21. Keyes EL Jr. Phimosis-paraphimosis-tumors of the penis. In: Urology. New York: D. Appleton and Co 1919:649
  22. Ozbey H, Temiz A, Salman T. A simple method for measuring penile length in newborns and infants. BJU Int 1999;84:1093-4 https://doi.org/10.1046/j.1464-410x.1999.00366.x
  23. Moon HL. Normal reference value of children in Korea. Seoul: The Korean Pediatric Society 1992:62
  24. Al-Herbish AS. Standard penile size for normal full term newborns in the Saudi population. Saudi Med J 2002;23:314-6
  25. Fujieda K, Matsuura N. Growth and maturation in the male genitalia from birth to adolescence. II. Change of penile length. Acta Paediatr Jpn 1987;29:220-3 https://doi.org/10.1111/j.1442-200X.1987.tb00036.x
  26. Cheng PK, Chanoine JP. Should the definition of micropenis vary according to ethnicity? Horm Res 2001;55:278-81 https://doi.org/10.1159/000050013
  27. Massa GG, Langenhorst V, Oostdijk W, Wit JM. Micropenis in children: etiology, diagnosis and therapy. Ned Tijdschr Geneeskd 1997;141:511-5