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Dr. Navitsky
Dr. Navitsky, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1036
Experience:  US Pediatrician licensed in California living abroad.
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My son is 9 and his penis hasnt grown since birth, what can

Customer Question

My son is 9 and his penis hasn't grown since birth, what can we do?
Submitted: 2 years ago.
Category: Pediatrics
Expert:  Dr. Navitsky replied 2 years ago.

Jnavits12 :

Hi there I can talk with you

Jnavits12 :

Have you discussed this with your pediatrician at any point?

Jnavits12 :

I would want to know the measurement from the base of the shaft to the tip of his penis to be able to tell you where this falls according to his age. Really prior to puberty the penis grows quite slowly almost not noticeably...the scrotum will grow more noticeable but the testes inside won't start to grow until puberty starts.

Jnavits12 :

I would then ask you about any secondary sexual characteristics like facial, pubic hair, axillary odor and hair, growth spurts....to be able to tell you if he is totally prepubertal (which according to his age may be so) or if he has started to go through puberty.

Jnavits12 :

There are conditions in which boys have a very small penis that are part of medical disorders ...called microphallus or micropenis....there are often hormonal problems with these kids but there are some treatments available.

Jnavits12 :

There is also a phenomenon nowadays in which there is excess body fat....and the pubic fat pad accumulates this fat and makes essentially the penis hide behind it and appear quite small...simply stretching the fat pad back and feeling the area of where the shaft comes out will give you the true size.

Jnavits12 :

Thus I will wait until you are online and enter the chat to discuss this further. This information I have provided is very basic but I will be happy to give you more information as you need. If you feel that the above information is enough to answer your question please click on the accept button. Thanks!

Jnavits12 :

Hi there I see you are in the chat mode and will wait a response. Here is a chart of stretched penis size depending on age off of Alan Greene's website http://www.drgreene.com/qa/penis-size-defined?pagination=1

Customer :

His shaft to tip is about 1 inch and about a quarter

Jnavits12 :

And this is pulling back totally the skin above the pubic bone area correct...the fat pad?

Customer :

yes

Jnavits12 :

so this is a small penis size for his age which is the 2.5in + or -2 standard deviations of 0.4in. Did you guys ever measure it when he was younger?

Jnavits12 :

Where is he in terms of puberty...any changes yet?

Jnavits12 :

The size you mention however doesn't qualify for a "micropenis" definition which as you can see from the link if you went there already is more than 2.5 S.D. below where it should be for age. This website by the way is put up by a professor at Stanford that I know, have seen in action and respect and I know he maintains it quite well.

Customer :

correction, as I look at a measuring tape I would say its about 1 inch and 3/4 not erected and probably 2 inch and 1/2 erected.

Jnavits12 :

Actually I guess it does as my basic math fails me yet again (always use calculators embarassing personal note!!)...the size that is less than 2.5 S.D. from normal in the 8-11 age group is 1.5in...but if the size is 1 3/4 inch than that would be on the small side but not micro small...these measurements are stretched but not erect.

Customer :

We haven't seen it erected in quite a while. Maybe because he doesn't get that sensation

Jnavits12 :

Well he is also getting to be 9 and may be a bit more shy about letting you see his erections....at school there is now talk about sexual things and genitalia and he may purposely hide them..

Jnavits12 :

So I have has kids in my practise with definition micropenis (which needs to be looked at medically to make sure that there is no hormonal/genetic problem that would be important to know for when they go though puberty and for fertitlity reasons etc...) that have responded very well to testosterone shots....many times however if the boy is totally prepubertal and doesn't fit the definition of micropenis...nothing more than reassurance is given as the penis and testes invariably will grow during this time!

Customer :

I did look for some answer online, no real answers, but wanted to find out what we could ask our son's doctor or if there is anything out there he can take that will not be harmful. My nephews all have larger penis than him and it make me feel like I am at fault.

Jnavits12 :

So what I would recommend you do is if you have access to good medical care take this issue to a pediatric endocrinologist who will take you seriously and really this is a very common issue with boys! Even though your nephews have a larger penis now really what remains to be seen is what they are left with after puberty which may be something different all together. In no way other that contributing your genes that makes your son the child you know and love!!! is this "your fault".

Jnavits12 :

Although an embarrassing topic in pediatrics I would say that I get asked about penis size about once a week

Jnavits12 :

Thus is is a very common concern for parents to have. If you started with your pediatrician what they would do is measure...then look for pubertal signs and either instruct you to wait a bit for puberty to start or send you to see an endocrinologist.

Customer :

What are the options that you have heard of if this was a concern from a pediatricians view?

Jnavits12 :

In terms of taking something "natural" or otherwise to make things grow there is nothing out there....you may come across many devices or treatments offered to adult males which also aren't really scientifically proven. If your son qualifies for a micropenis diagnosis #1 it is important to make sure it is isolated and doesn't mean something more important (for example only problems with insufficient testosterone or inability to react to it....)#2 if can be treated...and the only treatment I have seen employed is that of testosterone shots.

Jnavits12 :

The endocrinologist is the expert in this area and a full evaluation by a pediatric specialist would make sure there is nothing underlying the problem that needs to be attended to and then any treatment that is available, If I were to see him in clinic and measurements were the same as what you gave to me...(sometimes parents mismeasure a bit) then I would refer him on for an evaluation.

Customer :

what would a testosterone shot do for him if this is the case?

Customer :

Are we taking action a bit late? Should we have had him circumcised?

Jnavits12 :

Occasionally we as pedi's can initiate a workup including blood work and a bone age xray...the testosterone shots will help the penis to grow....actually it is much much better he is not circumsized as if anything surgically needs to be done....there is more tissue to work with!! You are not too late...really I would address this before puberty however as after puberty the chances that treatment will help are less

Customer :

what are truly the benefits of having him circumsized

Jnavits12 :

Not every boy does respond to testosterone by the way...but the first thing to complete is diagnosis to make sure that nothing is underlying the small penis size. This to me as a doctor if more important actually then what comes later on. Cicumcision has the only benefit in the US of decreasing the risk of a urine infection in the first year of life...this is about it.

Jnavits12 :

With this comes the risk of infection from the operation...the operation coming out "not so good" (really common!!) as it is done as a newborn for the most part...the pain associated with it...etc...

Customer :

by the way he is taller than some of his cousins and has a foot size of 3, does this tell you something?

Jnavits12 :

In underdeveloped countries there is thought to be maybe a reduced risk in HIV transmission but in the US this really is not a reason to circumcise. If he has had a recent growth spurt then this is the time to look at the penis issue as it can be an early sign of puberty. Sometimes kids with large frames (tall) can make their penis look small just by comparison but you would go on the measurement. His foot size is I think big right I don't know average foot sizes but my almost 8 year old girl is growing in to a 1

Customer :

Ok, so make a visit to his doctor and schedule a visit to examine him on this subject or schedule a check up and then mention this issue we are concern about?

Jnavits12 :

I would make an appt to see the doctor before his checkup just in case time is important and he is starting to grow...and come closer to puberty. Again remember what I said about this being a very common concern and although embarrassing to him you want to make sure nothing is going on and it is a legitimate concern! Your pedi may get a slightly larger measurement than you as they are trained to do it and thus may jsut provide some much needed reassurance that you will see growth when puberty comes.

Jnavits12 :

He at 9 may be starting to wonder why his cousins penis's are bigger and if there is something wrong with him as well.

Jnavits12 :

Thus "looking into it" may give him some piece of mind and the chance to speak about his thoughts if he has any about his penis size.....good to avoid later on complexes :)

Customer :

What is the age range of puberty?

Customer :

In the website you provided, is the sizes given for a non erected penis or an erected penis?

Jnavits12 :

basically it is heriditary and now there are some unknown influences that are making the average age be pushed downwards....so for a boy the average age is around 11. The sizes are for a non erect stretched (by you) penis

Jnavits12 :

In 2012 a boy can start though as young as 9 without it being termed "too young"

Customer :

Ok, thanks for your advise. We will look into this. Blessings

Jnavits12 :

You are welcome...good luck to you! If you feel that the information I have provided has been helpful please click on the green accept button. Thanks and enjoy the rest of your weekend!

Expert:  Dr. Navitsky replied 2 years ago.
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US Pediatrician licensed in California living abroad.