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      Normative penile anthropometry in term newborns in Kumasi, Ghana: a cross-sectional prospective study

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          Abstract

          Background

          Genital measurements are a useful adjunct in the early detection of various endocrine conditions including hypopituitarism and disorders of sexual differentiation. Standards for genital sizes have been published but racial/ethnic differences exist. This study was done to establish norms for genital sizes in term Ghanaian male newborns.

          Methods

          This was a cross-sectional study of all apparently well full-term newborns of postnatal age < 48 h and birth weight between 2.5 and 4.0 kg delivered at Komfo Anokye Teaching Hospital within the study period. Anthropometric and genital parameters were documented for study subjects as well as parental socio-demographic indices.

          Results

          A total of 644 male newborns were recruited between May and September 2014. The mean penile length (MPL) was 3.3 ± 0.5 cm and the mean penile width (MPW) was 1.05 ± 0.1 cm. An inverse relationship was found between maternal age and MPL (correlation coefficient −0.062, 95% CI −0.121 to −0.002; p = 0.04). MPL was also significantly different ( p = 0.04) by mode of delivery, with babies delivered by caesarean section having the lowest MPL. MPL correlated positively with both gestational age ( p = 0.04) and birth length ( p < 0.001), while MPW correlated proportionally with birth weight and length ( p < 0.001 for both).

          Conclusions

          Using the conventional definition of micropenis as stretched penile length (SPL) < 2.5 standard deviation (SD) below the mean and macropenis as an SPL > 2.5 SD, a Ghanaian term newborn may warrant investigation if he has an MPL < 2.1 cm or > 4.4 cm.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13633-017-0042-1) contains supplementary material, which is available to authorized users.

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          Most cited references42

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          Phenotypical, biological, and molecular heterogeneity of 5α-reductase deficiency: an extensive international experience of 55 patients.

          In 46,XY disorders of sex development, 5α-reductase deficiency is rare and is not usually the first-intention diagnosis in newborn ambiguous genitalia, contrary to partial androgen insensitivity syndrome. Yet the cause of ambiguous genitalia may guide sex assignment, and rapid, precise diagnosis of 5α-reductase deficiency is essential. The aim of the study was to describe relevant data for clinical diagnosis, biological investigation, and molecular determination from 55 patients with srd5A2 mutations identified in our laboratory over 20 yr to improve early diagnosis. The study was performed at Montpellier University Hospital. We studied a cohort of 55 patients with srd5A2 gene mutations. Genetic analysis of srd5A2 was conducted. Clitoromegaly (49.1%) and microphallus with various degrees of hypospadias (32.7%) were frequent phenotypes. Female external genitalia (7.3%) and isolated micropenis (3.6%) were rare. Seventy-two percent of patients were initially assigned to female gender; five of them (12.5%) switched to male sex in peripuberty. Over 72% of patients were considered for 5α-reductase deficiency diagnosis when the testosterone/dihydrotestosterone cutoff was 10. In 55 patients (with 20 having a history of consanguinity), we identified 33 different mutations. Five have never been reported: p.G32S, p.Y91H, p.G104E, p.F223S, and c.461delT. Homozygous mutations were present in 69.1% of cases, compound heterozygous mutations in 25.5%, and compound heterozygous mutations alone with the V89L polymorphism in 5.4%. Exons 1 and 4 were most affected, with 35.8 and 21.7% mutant alleles per exon, respectively. In the largest cohort to date, we demonstrate a wide spectrum of phenotypes and biological profiles in patients with 5α-reductase deficiency, whatever their geographical or ethnic origins.
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            Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men.

            To systematically review and create nomograms of flaccid and erect penile size measurements.
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              Fetal plasma testosterone correlates positively with cortisol.

              Fetal exposure to testosterone has been implicated in programming childhood behaviour, but little is known about the determinants of fetal testosterone concentrations. To investigate the relation between fetal testosterone and maternal and fetal cortisol. Clinically indicated blood samples taken from 44 human fetuses (mean gestational age 27 weeks, range 15-38), together with paired maternal samples, were analysed for testosterone and cortisol concentrations. Male fetuses had significantly higher concentrations of testosterone than females. Female but not male fetal concentrations rose significantly with gestational age. Fetal testosterone correlated positively with both fetal cortisol and maternal testosterone concentrations. Multiple regression showed that maternal testosterone and fetal cortisol were independently correlated with fetal plasma testosterone in both sexes. Unlike the norm in the adult, where testosterone production is often inhibited by cortisol, in the fetus there is a positive link between the two.
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                Author and article information

                Contributors
                sbasafoagyei@gmail.com
                ekameyaw@yahoo.com
                jchanoine@cw.bc.ca
                sbnguah@yahoo.com
                Journal
                Int J Pediatr Endocrinol
                Int J Pediatr Endocrinol
                International Journal of Pediatric Endocrinology
                BioMed Central (London )
                1687-9848
                1687-9856
                26 January 2017
                26 January 2017
                2017
                : 2017
                : 2
                Affiliations
                [1 ]ISNI 0000 0004 0466 0719, GRID grid.415450.1, Department of Child Health, , Komfo Anokye Teaching Hospital, ; Kumasi, Ghana
                [2 ]ISNI 0000 0001 2288 9830, GRID grid.17091.3e, Endocrinology and Diabetes Unit, British Columbia’s Children’s Hospital, , University of British Columbia, ; Vancouver, BC Canada
                Article
                42
                10.1186/s13633-017-0042-1
                5270225
                8d7ec20b-50ea-411a-890a-b42c36f467e7
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 August 2016
                : 19 January 2017
                Funding
                Funded by: European Society for Paediatric Endocrinology
                Funded by: Global Pediatric Endocrinology and Diabetes
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Pediatrics
                penile length,penile width,genital size,ghana,micropenis,macropenis
                Pediatrics
                penile length, penile width, genital size, ghana, micropenis, macropenis

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