title: Bilateral anorchia in infancy: occurence of micropenis and the effect of testosterone treatment.
abstract: OBJECTIVE
  To analyze the clinical and histological findings in boys with bilateral anorchia and the response to testosterone treatment on penis length.
  
  
  METHODS
  Patients were divided into two groups according to the absence (group A, n = 29) or the presence (group B, n = 26) of palpable intrascrotal or inguinal mass at first clinical examination.
  
  
  RESULTS
  A micropenis was found in 46% of patients (n = 24) with a similar proportion in both groups. Testosterone treatment induced a mean penis length gain of 1.9 +/- 1.3 SDS (standard deviation score). However, micropenis persisted in six patients. Histological examination (n = 18) confirmed the absence of any testicular structure with deferent ducts being present unilaterally or bilaterally in all but three patients. In these three patients, a hemorrhagic testis, probably as a result of a mechanical torsion, was found.
  
  
  CONCLUSIONS
  The presence of isolated micropenis in almost half of patients with bilateral anorchia strongly suggests that the testicular damage frequently occurs during the second half of gestation after male sexual differentiation. In most cases, testosterone treatment stimulates the penile growth. Although the pathogenesis of bilateral anorchia may be heterogeneous, our study suggests that gonads may have been functionally abnormal before they disappeared, and suggests that some patients have an intrinsic endocrine disorder.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paediatric Endocrinology Unit and Inserm U457, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Zenaty
authors.forename: F
authors.initials: F
authors.lastname: Dijoud
authors.forename: Y
authors.initials: Y
authors.lastname: Morel
authors.forename: S
authors.initials: S
authors.lastname: Cabrol
authors.forename: P
authors.initials: P
authors.lastname: Mouriquand
authors.forename: M
authors.initials: M
authors.lastname: Nicolino
authors.forename: C
authors.initials: C
authors.lastname: Bouvatier
authors.forename: G
authors.initials: G
authors.lastname: Pinto
authors.forename: C
authors.initials: C
authors.lastname: Lecointre
authors.forename: C
authors.initials: C
authors.lastname: Pienkowski
authors.forename: S
authors.initials: S
authors.lastname: Soskin
authors.forename: M
authors.initials: M
authors.lastname: Bost
authors.forename: A M
authors.initials: AM
authors.lastname: Bertrand
authors.forename: A
authors.initials: A
authors.lastname: El-Ghoneimi
authors.forename: C
authors.initials: C
authors.lastname: Nihoul-Fekete
authors.forename: J
authors.initials: J
authors.lastname: Léger
mesh_terms: D000728:Androgens / Q000172:deficiency / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005058:Eunuchism / Q000151:congenital / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005602:France / Q000453:epidemiology; D005837:Genitalia, Male / Q000002:abnormalities / Q000187:drug effects / Q000254:growth & development / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010409:Penile Diseases / Q000151:congenital / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D013086:Spermatic Cord Torsion / Q000151:congenital / Q000473:pathology / Q000601:surgery; D013739:Testosterone / Q000172:deficiency / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male
chemical_list: D000728:Androgens; D013739:Testosterone