WordNet

slight or limited; especially in degree or intensity or scope; "a series of death struggles with small time in between"
a garment size for a small person
the slender part of the back
limited or below average in number or quantity or magnitude or extent; "a little dining room"; "a little house"; "a small car"; "a little (or small) group" (同)little
have fine or very small constituent particles; "a small misty rain"
on a small scale; "think small"
a writing implement with a point from which ink flows
an enclosure for confining livestock
female swan
the male organ of copulation (`member is a euphemism) (同)phallus, member

PrepTutorEJDIC

(大きさが)『小さい』,小形の;(量が)『少ない』,わずかな / 『取るに足りない』,ささいな(trivial) / 《名詞の前にのみ用いて》(仕事・活動などが)『小規模の』,ささやかな / 心が狭い,利己的な / (音・声が)弱い,小さい / (文字が)小型の,小文字の / 《the~》小さいもの;(…の)細い部分《+『of』+『名』》 / 《複数形で》《英》(衣類・ハンカチなどの)小物,小間物 / 小さく,細かく / (声などが)低く,弱く / 小規模に,こぢんまりと
〈C〉(インクを用いる筆記具全体をさして)『ペン』;万年筆,ポールペン,フェルトペン;ペン先 / 〈U〉《the~》文筆,著述 / 〈C〉《単数形で》《文》文筆家 / 《気どって》…‘を'書く,著す(write)
〈C〉(家畜などを入れる)『おり』 / 《集合的に》ありの中の動物 / 〈C〉(監禁・保護に使われる)囲い,幼児用遊びわく(playpen) / (囲い・ありなどに)…‘を'入れる,閉じ込める,監禁する《+『名』+[『up』]『in』+『名』》
刑務所[penitentiaryの短縮形]
陰茎,ペニス

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/19 03:01:05」(JST)

wiki en

Micropenis is an unusually small penis. A common criterion is a dorsal (measured on top) erect penile length of at least 2.5 standard deviations smaller than the mean human penis size,^[1] or smaller than about 7 cm (2 ³⁄₄ in) for an adult when compared to an average erection of 12.5 cm (5 in).^[2] The condition is usually recognized shortly after birth. The term is most often used medically when the rest of the penis, scrotum, and perineum are without ambiguity, such as hypospadias. Micropenis occurs in about 0.6% of males.^[2]

Causes

Of the abnormal conditions associated with micropenis, most are conditions of reduced prenatal androgen production or effect, such as abnormal testicular development (testicular dysgenesis), Klinefelter syndrome, Leydig cell hypoplasia), specific defects of testosterone or dihydrotestosterone synthesis (17,20-lyase deficiency, 5α-reductase deficiency), androgen insensitivity syndromes, inadequate pituitary stimulation (gonadotropin deficiency), and other forms of congenital hypogonadism. Micropenis can also occur as part of many genetic malformation syndromes that do not involve the sex chromosomes. It is sometimes a sign of congenital growth-hormone deficiency or congenital hypopituitarism. Several homeobox genes affect penis and digit size without detectable hormone abnormalities.

In addition, in utero exposure to some estrogen based fertility drugs like diethylstilbestrol (DES) has been linked to genital abnormalities and/or a smaller than normal penis. ^[3]

After evaluation to detect any of the conditions described above, micropenis can often be treated in infancy with injections of various hormones, such as human chorionic gonadotropin and testosterone.

Most eight- to fourteen-year-old boys referred for micropenis do not have the micropenis condition. Such concerns are usually explained by one of the following:

a penis concealed in suprapubic fat (extra fat around the mons pubis).
a large body and frame for which a prepubertal penis simply appears too small.
delayed puberty with every reason to expect good future growth.

Treatment

Hormone treatment

Growth of the penis both before birth and during childhood and puberty is strongly influenced by testosterone and, to a lesser degree, the growth hormone. However, later endogenous hormones mainly have value in the treatment of micropenis caused by hormone deficiencies, such as hypopituitarism or hypogonadism.

Regardless of the cause of micropenis, if it is recognized in infancy, a brief course of testosterone is often prescribed^[4] (usually no more than 3 months). This usually induces a small amount of growth, confirming the likelihood of further growth at puberty, but rarely achieves normal size. No additional testosterone is given during childhood, to avoid unwanted virilization and bone maturation. (There is also some evidence that premature administration of testosterone can lead to reduced penis size in the adult.)^[5]

Testosterone treatment is resumed in adolescence only for boys with hypogonadism. Penile growth is completed at the end of puberty, similar to the completion of height growth, and provision of extra testosterone to post-pubertal adults produces little or no further growth.

Surgery

Because hormone treatment rarely achieves average size, several surgical techniques similar to phalloplasty for penis enlargement have been devised and performed; but they are not generally considered successful enough to be widely adopted and are rarely performed in childhood.

In extreme cases of micropenis, there is barely any shaft, and the glans appears to sit almost on the pubic skin. From the 1960s until the late 1970s, it was common for sex reassignment and surgery to be recommended. This was especially likely if evidence suggested that response to additional testosterone and pubertal testosterone would be poor. With parental acceptance, the boy would be reassigned and renamed as a girl, and surgery performed to remove the testes and construct an artificial vagina. This was based on the now-questioned idea that gender identity was shaped entirely from socialization, and that a man with a small penis can find no acceptable place in society.

Johns Hopkins Hospital, the center most known for this approach, performed twelve such reassignments from 1960 to 1980, most notably^{[citation needed]} that of David Reimer (whose penis was destroyed by a circumcision accident), overseen by Dr. John Money. By the mid-1990s, reassignment was less often offered, and all three premises had been challenged. Former subjects of such surgery, vocal about their dissatisfaction with adult outcome, played a large part in discouraging this practice. Sexual reassignment is rarely performed today for severe micropenis (although the question of raising the boy as a girl is sometimes still discussed.)^[6] (See "History of intersex surgery" for a fuller discussion.)

References

^ Lee PA, Mazur T, Danish R, et al. (1980). "Micropenis. I. Criteria, etiologies and classification". The Johns Hopkins medical journal 146 (4): 156–63. PMID 7366061.
^ ^a ^b ScienceDaily.com (2004). "Surgeons Pinch More Than An Inch From The Arm To Rebuild A Micropenis," 6 Dec. 2004, URL accessed 2 April 2012.
^ Center of Disease Control. "DES Update: Consumers".
^ Ishii T, Sasaki G, Hasegawa T, Sato S, Matsuo N, Ogata T (2004). "Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis". J. Urol. 172 (1): 319–24. doi:10.1097/01.ju.0000129005.84831.1e. PMID 15201804.
^ McMahon DR, Kramer SA, Husmann DA (1995). "Micropenis: does early treatment with testosterone do more harm than good?". J. Urol. 154 (2 Pt 2): 825–9. doi:10.1016/S0022-5347(01)67175-1. PMID 7609189.
^ Calikoglu AS; Calikoglu, A (1999). "Should boys with micropenis be reared as girls?". J. Pediatr. 134 (5): 537–8. doi:10.1016/S0022-3476(99)70236-2. PMID 10228285.

External links

Media related to Micropenis at Wikimedia Commons
Into the Hands of Babes, by Melissa Hendricks, Johns Hopkins Magazine
Gender Self Reassignment in an XY Adolescent Female with Ambiguous Genitalia, from Pediatrics (PDF)
Effect of penile size on nocturnal erections: evaluation with NPTR testing with men having micropenis from the International Journal of Impotence Research

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 男性における原発性性腺機能低下の原因 causes of primary hypogonadism in males
2. 小児における身体的診察：会陰 the pediatric physical examination the perineum
3. 肥満の小児および思春期の臨床的評価 clinical evaluation of the obese child and adolescent
4. Selection of modality for diagnosis and staging of patients with suspected non-small cell lung cancer
5. Procedures for tissue biopsy in patients with suspected non-small cell lung cancer

English Journal

Development of Avian External Genitalia: Interspecific Differences and Sexual Differentiation of the Male and Female Phallus.

Herrera AM1, Brennan PL, Cohn MJ.
Sexual development : genetics, molecular biology, evolution, endocrinology, embryology, and pathology of sex determination and differentiation.Sex Dev.2014 Jul 8. [Epub ahead of print]
Avian genitalia, particularly in waterfowl, are extremely diverse. Penis morphology varies among species, and penis length and elaboration are associated with the frequency of forced extra-pair copulations, yet the developmental mechanisms responsible for this variation are unknown. In addition, fem
PMID 25011524

A clinical study of pingyangmycin sclerotherapy for venous malformation: an evaluation of 281 consecutive patients.

Bai N1, Chen YZ, Fu YJ, Wu P, Zhang WN.
Journal of clinical pharmacy and therapeutics.J Clin Pharm Ther.2014 Jun 13. doi: 10.1111/jcpt.12183. [Epub ahead of print]
WHAT IS KNOWN AND OBJECTIVE: In China, lidocaine together with 2 mg/mL of pingyangmycin (PYM, also known as bleomycin A5) is recommended for the treatment of venous malformations (VMs). The purpose of this study was to investigate whether lidocaine has a synergistic effect with PYM in improving the
PMID 24924412

Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual.

Hasegawa K1, Namba Y, Kimata Y.
Acta medica Okayama.Acta Med Okayama.2014 Jun;68(3):183-90.
Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedi
PMID 24945633

Japanese Journal

For Vol.67, No.5 pp325-331 Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual

Acta Medica Okayama 68(3), 183-190, 2014-06
NAID 120005447132

TPF (Paclitaxel, Cisplatin, 5-fluorouracil)療法を施行した進行性陰茎癌の1例

泌尿器科紀要 = Acta urologica Japonica 60(2), 95-98, 2014-02
NAID 120005465993

Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual

Acta Medica Okayama 67(5), 325-331, 2013-10
NAID 120005341866

「small」

Micropenis
	A flaccid micropenis
Classification and external resources
Specialty	Urology
ICD-9-CM	752.64
OMIM	607306
DiseasesDB	14839
eMedicine	ped/1448
	[edit on Wikidata]

　　[★]

adj.

小さい

関: little、petit、tiny

[pmid7366061-1] Lee PA, Mazur T, Danish R, et al. (1980). "Micropenis. I. Criteria, etiologies and classification". The Johns Hopkins medical journal 146 (4): 156–63. PMID 7366061.

[ScienceDaily04-2] ScienceDaily.com (2004). "Surgeons Pinch More Than An Inch From The Arm To Rebuild A Micropenis," 6 Dec. 2004, URL accessed 2 April 2012.

[3] Center of Disease Control. "DES Update: Consumers".

[pmid15201804-4] Ishii T, Sasaki G, Hasegawa T, Sato S, Matsuo N, Ogata T (2004). "Testosterone enanthate therapy is effective and independent of SRD5A2 and AR gene polymorphisms in boys with micropenis". J. Urol. 172 (1): 319–24. doi:10.1097/01.ju.0000129005.84831.1e. PMID 15201804.

[pmid7609189-5] McMahon DR, Kramer SA, Husmann DA (1995). "Micropenis: does early treatment with testosterone do more harm than good?". J. Urol. 154 (2 Pt 2): 825–9. doi:10.1016/S0022-5347(01)67175-1. PMID 7609189.

[pmid10228285-6] Calikoglu AS; Calikoglu, A (1999). "Should boys with micropenis be reared as girls?". J. Pediatr. 134 (5): 537–8. doi:10.1016/S0022-3476(99)70236-2. PMID 10228285.

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案内

案内

small penis