[tri-med] Re: Anyone have any insight or advice???

----- Original Message -----
From: "Penny Victor"
>>Devon's doctors have
> never mentioned these terms before...although I do think Devon is smaller
> than average...AND he's retracted but that has improved over the years
> too...he actually pokes out a little now some of the time

I think it may be hard to tell because of the retraction sweet. I cant
believe that I am writing all this (call me scarlett!!) but..........
The length of the penis is actually measured from the pubic ramus to the tip
of the glans - so you need to ignore the foreskin in uncircumcised males. It
also needs to be stretched, but not pulled - there is a specific technique
for this that your doctor knows.

Width is not the issue so much as the length. Technically anything less than
2cm (3/4 of an inch) at birth is classified as a micropenis. The "average is
3 - 4 cm. And if its much less then than 2cm thats when they look at why and
will consider gender re-assignment in some cases.

The cause can be for lots of reasons eg hypothalamic dysfunction where there
can also be things like hypoglycemia present or even androgen insensitivity,
that is the body produces male hormones but the body doesn't recognise them.
Micropenis can also be associated with renal problems.

A child with a true micropenis usually has little or no growth without help.
That "help" may be things like testosterone injections. But it really
depends on the cause. So what they have at birth is what they have........

>>and I
> know it doesn't matter...but it's something I've always thought  was a
> little out of the norm on Devon

It actually can matter sweet - depending on what the cause is. It can be
caused by so many things eg GHD, lack of male hormones etc. These hormones
don't just make the penis longer they have other effects like bone density,
sugar levels etc. It might not matter right at the moment but you certainly
dont want to be dealing with osteoporosis later on either.

That is also aside from "functionality". As an OT I have dealt with many
children who have this problem and it does make life difficult. Both
socially - it DOES matter to both little AND big boys when they are standing
at a urinal. And also physically - its hard to manage if there isn't enough
to hold, the smaller length can also predispose them to urinary infections.
I wont even attempt to address sexually :-))

I dont have the exact figures but I will try and get George to fax me a copy
if them today (this is an area he specialises in) but roughly the ranges for
different ages are
Birth - 2.0 - 5.5 cm
Age 1 2.5 - 5.75
Age 2 3.0 - 6.0
Age 3 3.5 - 6.5
Age 4 3.75 - 7.0
Age 5 4.0 - 7.0
and it stays much that size until puberty
(No I will not do the sizes for normal adult!!!!!!!!!!)

Alex is small in this department and not growing as we would expect but
technically he is within limits. He does have scrotal hypoplasia, but the
testes have always been OK. However they have not grown so we are
watching........... He does however have erections so we are not too
worried. The scrotal hypoplasia can be corrected later with plastic surgery
if need be.

You realise that our children will kill us when they get older!!!!!!!!!!!!

Love comforteth like sunshine after rain.
-William Shakespeare

Keep Looking for Rainbows!!!
Karen, Mum to Alex (6, T-18 mosaic)
Sydney, Australia
http://members.optushome.com.au/karens
http://www.trisomyonline.org

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

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