You say that your penis is not short, and clinicians must be defined.
At present, the height growth of patients is initially completed. When the age of bone age is greater than 14 years old, there is no secondary sexual characteristics. Related examination and treatment.
First of all, you should understand the medical history of abnormal organs such as urethral cracking, cryptor test, and small tests in the family. Whether there is a history of marriage with close marriage, whether there is intelligence or abnormalities, or abnormal sense of smell, hearing, visual abnormalities.During physical examination, we pay attention to whether there are abnormal faces and finger toe deformities, and measure the size, location and penis length of the testicles.Those with suspicion of hypothalamus, abnormal pituitary development, or lesions should do imaging examinations such as skull CT and nuclear magnetic resonance.All patients should analyze chromosome nuclear types.Relevant known genes screening and the research of unknown genes have been carried out in developed countries. According to clinical manifestations and various examinations, the screening of the corresponding genes will be determined under what circumstances are the current work that will be carried out in China.
Those who are suspected to have low pituitary dysfunction should check the level of adrenal corticosteroids, thyroidine, and growth hormone levels.The detection of hypothalamic-pituitary-gland axis function is essential for the diagnosis of small penis. It should be tested by testosterone, DHT, LH, and FSH and conducted HCG stimulus tests, GNRH stimulus tests and androgen diagnostic therapy.
1 HCG Stimulation Test
The testicles are composed of pillar cells, interstitial cells and spermatogenic cells.Piltal cells secrete anti -seedling tubular hormones and testosterone secrete testosterone.The HCG stimulus test is used to detect therogen secretion function of Leydig cells.The HCG stimulus test is different at the dosage, number of usage, interval time, and blood collection testing of HCG.Multiple injections are commonly used: HCG 1 500U, muscle injection, once every other day for a total of 3 times.The blood specimen was left in the morning before and after the third injection, and testosterone, DHT.Blood testosterone levels of testicular function can increase by more than 2 times the level of blood testosterone; low or low reactions are primary testicular dysfunction or no testicles; patients with secondary testicular dysfunction depends on the degree of damage to the hypothalamus or pituitary;Those who have delayed physical youth development often have a normal reaction; those with slow response can rise after many HCG excitement, which can rise blood testosterone, which can exclude the function incompleteness of the testicular itself.
2 GNRH stimulus test
This test is used to detect the hypothalamus and pituitary endocrine function, which is of little significance in school age and before.The stimulus can be used in GN-RH or GnRHA (GNRH elements).When the boy's age is greater than 14 years old, first give 11 testosterone 40mg/d, take 7D orally, and then perform the GnRH stimulus test. Generally, the G/KG vein is injected with GNRH according to 2.5 & mu;Detect the peak of the LH and FSH reaction.When LH "5U/L can consider the absence of gonad hormone [9].Now it is more advocated to conduct GNRHA stimulus test.Can be injected with Buccalin 100mg subcutaneous injection [10], 4H uses blood before and after stimulation, and detects the LH and FSH levels.The FSH value is of little significance to diagnosis, and LH "8U/L can diagnose gonad hormone deficiency.This test is 100%sensitivity, 96%specific, simple and easy.KAUSCHANSKY and others performed GNRH (0.1mg/m2), GNRHA (Quperelin, 0.1mg/M2) and HCG (1500U, 1 next day, a total of 32, a total of 3 times.Said) Stimulating test, 13 of them entered the youth development period (group A) one year after the test, and the other 19 cases were still unchanged for 3 to 4 years (group B).Comparing the differences between the two groups of GNRH or GN-RHA stimuli found that after the GNRHA stimulus, the LH value of the group A (20.4 ± 7.5) MIU/ML (range 10.8 ~ 32.6), group B (2.3 ± 2.0) MIU/ML (range 0.7 ~6.9), the range of the LH value of the two groups does not overlap, the LH intercept value is 8miu/ml; and after the Gnrh stimulus, the LH value of the group A (11.4 ± 4.4) MIU/ML, group B (2.7 ± 1.1) MIU/ml, although two twoThe group is relatively statistically significant, but the data overlap is large, which affects the judgment of the results.It is worth noting that before the GNRH stimulus did not use Priming (Priming) and LH, FSH, and testosterone detection were different due to different measurement methods and reagents used, each laboratory should explore according to its own situation.
3 Religion diagnostic treatment
This method is used to detect whether there is an androgen resistance.Muscle injection of propyate testosterone 25mg, once every 3 weeks or Oral Anxiong 40mg daily, for a total of 4 months.If the penis can increase, except androgen resistance can be removed.After treatment, the penis should be at least 2.5cm than before treatment.The study of the hypothalamic-pituitary-gonad axis function of all life found that within 6 months after birth was another time window diagnosis of boys' lack of gonad hormone deficiency.Due to the continuing of the fetal GNRH pulse, the boys fell in FSH, LH, and testosterone after birth, and decreased after 6 months.Early diagnosis provides possible early treatment.
(Editor in charge: Xiaofeng)
