Megalopenis
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Megalopenis
Megalopenis has defined objectively as the penile length more than 2 SD above the mean normal length for age. Abnormal largeness of the penis is an anomaly whereby the baby delivered with a large phallus, or it is enlarges rapidly in childhood, this may be a primary rare isolated non syndromic anomalies or due to abnormal high level of production of testosterone.
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Definition: Megalopenis has defined objectively as the penile length more than 2 SD above the
mean normal length for age. (Fig.1 and Tab 1 ) Abnormal largeness of the penis is an anomaly
whereby the baby delivered with a large phallus, or it is enlarges rapidly in childhood, this may be a
primary rare isolated non syndromic anomalies or due to abnormal high level of production of
Nomenclature: Megalopenis, Macrophallus, Penile hypertrophy and Macropenis.
Ethology : Macropenis could be classified as a rare primary anomaly in a normal neonate, and this
very rare condition scantly reported, without any detectable etiology, and a secondary macrophallus
due to high level of production of testosterone e.g., interstitial cell tumors of the testicle,
hyperplasia or tumors of the adrenal cortex, or secondary to other hypothalamic tumour associated
Benign familial infantile seizures with inversion of chromosome 15 are reported to be associated
with macrophallus, and also some cases are reported with heterochrony development where deletion
of chromosomal region 13q21q31 is associated with macropenis 1 .
Also femoral hypoplasia – unusual facies syndrome (FHUFS) which is characterised by bilateral,
mostly asymmetrical, femoral hypoplasia with variable lower limb shortening and nonspecific facial
dysmorphism is commonly associated with megalopenis 2 .
Macropenis is an uncommon finding of Fraser s yndrome, which is an autosomal recessive disease
characterised by cryptophthalmos, syndactyly, malformations of the larynx and genitourinary tract,
craniofacial dysmorphism, orofacial clefting, and mental retardation.
Differential diagnosis : This anomaly should be differentiated from other congenital penile or
urethral anomalies which give false impression of megalopenis and will be discussed later on, like
congenital megalourethra (Fig. 3), megaprepuce (macroposthia), where prepuce is extensively large
and redundant (Chapter … ), neurofibroma, heamangioma (chapter … ) and congenital penile
lymphedema (Fig. 4); in those conditions the penile gigantism is not a true one, as it is affecting
only one component of penile tissue and not the whole penis. Iatrogenic false microphallus or
acquired cases are reported with excessive or overdosage systemic administration of testosterone
hormone or chronic gonadotrophin hormone (HCG) injection, or local application of androgen
creams for cases of hypogonadism, hypospadias or undescended testicles, which are improperly
described in some countries without a proper scientific rational, in such cases the rapid increase in
penile size may be reversible after a couple of months. (Fig 5&6).
Management: Isolated primary cases of megalopenis necessitate investigations to rule out any other
associated anomalies, and to rule out cases secondary to excess androgen production. Ultrasound
and doppler examination may be enough to evaluate the size of corpora, its proper blood supply and
to rule out any additional pathological tissues like neurofibroma or haemangioma, cases secondary
to excessive androgen production i.e interstitial cell tumors of the testicle, are reversible once the
primary pathology eradicated. Iatrogenic megalopenis is also a reversible condition and penis
usually return to normal size once the external androgen administration halted. Family ass urance is
necessary to alleviate their worries and concern. Rarely reduction phalloplasty may be indicated in
Fig 1:Normal penile size according to the age. A verage penis size in correlation w ith age. The
upper and lower graph displays the 2 sigma curves 3 .
Fig 2:Isolated non syndromic megalopenis.
Fig 3: False impression of macrophallus in a case of megalour ethra.
Fig 4: A case of penile lymphedema giving false impression of microphallus, in this case
thickened and oedematous skin extended to scrotum.
Fig 5:Acquired macrophallus after (HCG) injection for undescended testicles in a 18 months
Fig 6:Extensive pubic hair growth and false macrophallus after local testosterone application
T ab 1: Normal penile size from neonate to adulthood.
1. Ü NALPN A, URAN N, GI ̇ RA Y Ö , ER Ç AL D. Inversion of chromosome 15 in a family w ith
benign familial infantile seizures. J Neurol Sci [Turk]. 2008;25:055 – 8.
2. Sabry MA, Obenbergerova D, Al-Sawan R, Al Saleh Q, et al. Femoral hypoplasia-unusual
facies syndrome with bifid hallux, absent tibia, and macrophallus: a report of a Bedouin baby. J
3. W . W eidner, E. W. Hauck : M ä nnermedizin. W . B. Schill, R. G. Bretzel, W . Weidner
(Herausgeber) Urban & Fischer V erlag, S. 448. ISBN 3-437-23260-6
ResearchGate has not been able to resolve any citations for this publication.
Recent molecular cytogenetic studies have elucidated the origin and nature of extra structurally abnormal chromosomes or small supernumerary chromosomes, which are often associated with developmental delay and malformations . The most common of the heterogeneous group of the extra structurally abnormal chromosomes is the inv dup (15), whose presence results in tetrasomy 15p and partial tetrasomy 15q. In the literature, benign familial infantile seizures locus have been found in 19q12-13.1 ve 16p12-q12 chromosomes. In this study, we descript a family which have benign familial infantile seizures accompanied by 15 q21.1, q26.2 inversion, because it has not been declareded before.
A male Bedouin baby with the clinical profile of femoral hypoplasia-unusual facies syndrome is described. The phenotype includes bilateral asymmetrical lower limb hypoplasia/aplasia with short remnants of both femora, absent right tibia, bifid right big toe, dysmorphic facies, thoracic/pelvic abnormalities, macrophallus, and bilateral cryptorchidism. This report re-emphasises the previously described rare association of femoral hypoplasia-unusual facies syndrome with preaxial polydactyly and suggests that the clinical spectrum of the syndrome could be stretched further to accommodate other unusual traits, for example, macrophallus and absent tibia.
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
This book provides comprehensive but concise data for congenital diseases of the penis, explaining the embryological and anatomical background, incidence, historical background, investigation appro aches, imaging and management of each condition.
The book is organised in themed parts, starting from embryology and normal anatomy and examining anomalies for each anatomical part: prepuce, penis, urinary meatus, penile urethra with a final part of acquired penile diseases with congenital background. With clear illustrations in each chapter to explain each condition in detail, online animations for the difficult and complex cases are also provided.
Practitioners in the field of pediatric urology and surgery will find this highly readable book particularly valuable. The author is a pioneer pediatric surgeon with over 30 years’ experience in the field of genitourinary anomalies. ... [more]
1. to document the details of all pediatric surgical training programs in Egypt ( manpower, workload, facilities, etc)
2. to highlight the deferences in training and assessment of paediatric sur gical residents in various programs.
3. to design a unified national pediatric surgical training program ... [more]
Hormone therapy before Hypospadia repair, how, when, what
January 2000 · SAGGI - Neuropsicologia Infantile Psicopedagogia Riabilitazione
So far, the literature has reported only two syndromes characterized by a specific or general breakdown in neuropsychological functions in children with epilepsy who had been showing a normal neuropsychological development. These syndromes are the Landau-Kleffner syndrome (LKS) or "acquired aphasia with epilepsy" and the "epilepsy with continuous spike and waves during slow sleep" syndrome ... [Show full abstract] (CSWS). At the neuropsychological level these syndromes have many features in common, and the only reasons for keeping them separate seem to be the type and severity of associated neuropsychological symptoms.
Introduction: Obesity is a condition in which
body fat has accumulated in the body such
way that health begins to be affected. Scholars
in the early grades by the end of elementary
school, are showing values over average by
comparing acceptable levels. Objective: And
with that, the aim was to verify studies that
show updated data of childhood obesity and
juvenile to mondial level. Materials ... [Show full abstract] and
Methods: for this research sites was used tools
as Scielo, Bireme and Capes’ portal of
journals. Studies have been defined that
broaches obesity in school. Conclusion: It can
be seen that from 2007 to 2014 obesity has
increased in strides, and analyzing studies
cause and effect are carried out to check what
is leveraging this increase.
September 1987 · The Indian Journal of Pediatrics
Hemolytic uremic syndrome is primarily a disease of childhood. Seventy three children presented with clinical signs and symptoms were studied in detail. Seventy four percent of them were under two years of age. Many of these children had clinical evidence of involvement of organs other than the kidney. Mortality among the children studied was 60%. The high mortality is possibly due to involvement ... [Show full abstract] of non renal organs in addition to factors like malnutrition, delay in seeking hospitalization etc. Some of the recent trends in the pathogenesis, pathology and management have been reviewed.
January 1990 · Psychoanalytic Psychotherapy
‘The Gnostic Syndrome’ discusses anorexia nervosa in terms of its poetics and in the context of a developmental object-relations theory. One case is used to illustrate the problems of therapy and the antecedents of the anorexia in childhood and adolescence. The paper forms an investigation into pre-moral states and the interaction of anorexia with character structure.
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A megalopenis is an anomaly of the penis , whereby the penis enlarges rapidly in childhood due to high level of production of testosterone [1] [2] . Also called macropenis, macrophallus, and megalophallus.
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ISBN: 978-3-319-82786-5
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Megalopenis has defined objectively as the penile length more than 2 SD above the mean normal length for age. Abnormal largeness of the penis is an anomaly whereby the baby delivered with a large phallus, or it is enlarges rapidly in childhood, this may be a primary rare isolated non syndromic anomalies or due to abnormal high level of production of testosterone.
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Ünalpn A, Uran N, Giray Ö, Erçal D. Inversion of chromosome 15 in a family with benign familial infantile seizures. J Neurol Sci. 2008;25:055–8.
Sabry MA, Obenbergerova D, Al-Sawan R, Al Saleh Q, et al. Femoral hypoplasia-unusual facies syndrome with bifid hallux, absent tibia, and macrophallus: a report of a Bedouin baby. J Med Genet. 1996;33:165–7.
Weidner W, Hauck EW. Männermedizin. W. B. Schill, R. G. Bretzel, W. Weidner (Herausgeber) Urban & Fischer Verlag, S. 448. ISBN 3-437-23260-6.
Pediatric Surgery, Al Azher University, Cairo, Egypt
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© 2017 Springer International Publishing Switzerland
Fahmy, M. (2017). Megalopenis.
In: Congenital Anomalies of the Penis. Springer, Cham. https://doi.org/10.1007/978-3-319-43310-3_10
DOI : https://doi.org/10.1007/978-3-319-43310-3_10
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Definition The term macropenis (mac·ro·pe·nis) is used to describe an abnormally large penis. Also called macrophallus and megalopenis. Micropenis is the exact opposite of megalopenis. Prevalence 95% of adult males fall within the interval 10.7 cm/4.23 in and 19.1 cm/7.53 in. … Continue reading →
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