title: Penile hemodynamics in hypogonadal men with micropenis.
abstract: OBJECTIVE
  To document the penile vascular and erectile response to intracavernous injection (ICI) of vasoactive agent in hypogonadal men with micropenis.
  
  
  METHODS
  A total of 15, previously untreated, hypogonadal men with micropenis (stretched penis length less than 2.5 SD below the mean of the normal population) underwent a detailed urologic and endocrinologic evaluation. Their mean age was 21.2 +/- 4.2 years. Penile hemodynamics were assessed by color Doppler ultrasonography before and after ICI of 5 microg of prostaglandin E(1) combined with manual genital self-stimulation.
  
  
  RESULTS
  Endocrinologic evaluation revealed that hypogonadism was hypogonadotropic in 10 (66.7%) and hypergonadotropic in 5 (33.3%). Karyotype analysis showed 46XY in all. Their mean stretched penile length was 6.2 +/- 1.4 cm (range 3 to 7.5) and increased to a mean of 6.96 +/- 1.5 cm (range 4 to 8.5) after ICI. The serum free testosterone levels ranged from 0.2 to 3.2 pg/mL (mean 1.9 +/- 0.92). None had had any previous sexual experience, and 14 (93.3%) reported a history of nocturnal erections. Penile color Doppler ultrasonography demonstrated a normal penile vascular system in 7 (46.7%) and penile arterial insufficiency in 4 (28.6%). All 11 of these patients (73.3%) achieved an adequate erectile response to ICI combined with manual stimulation. Mixed vascular disease was observed in the remaining 4 patients (28.8%), and they did not have a sufficient erectile response to ICI. Color Doppler ultrasonography revealed similar results in the hypogonadotropic and hypergonadotropic men.
  
  
  CONCLUSIONS
  Our data suggest that the erectile response to ICI combined with manual genital self-stimulation is effective in most hypogonadal men having a micropenis with low serum androgen levels.
authors.affiliation: Department of Endocrinology, Cerrahpaşa Faculty of Medicine, Cerrahpaşa, Turkey.
authors.forename: P Inar
authors.initials: PI
authors.lastname: Kadioğlu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tefekli
authors.forename: Bülent
authors.initials: B
authors.lastname: Erol
authors.forename: Oner
authors.initials: O
authors.lastname: Sanli
authors.forename: Muammer
authors.initials: M
authors.lastname: Kendirci
authors.forename: Eşref
authors.initials: E
authors.lastname: Ozer
authors.forename: Ustün
authors.initials: U
authors.lastname: Korugan
authors.forename: Ateş
authors.initials: A
authors.lastname: Kadioğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D010410:Penile Erection / Q000187:drug effects / Q000502:physiology; D010413:Penis / Q000002:abnormalities* / Q000098:blood supply* / Q000187:drug effects; D010812:Physical Stimulation; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D013739:Testosterone / Q000097:blood; D018615:Ultrasonography, Doppler, Color
chemical_list: D013739:Testosterone; D000527:Alprostadil