Growth and Development of Male External Genitalia: A Cross-sectional Study of 6200 Males Aged 0 to 19 Years | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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December 6, 2010

Growth and Development of Male External Genitalia: A Cross-sectional Study of 6200 Males Aged 0 to 19 Years

Author Affiliations

Author Affiliations: Clinical Center of Endocrinology and Gerontology, Medical University, Sofia (Drs Tomova, Robeva, and Kumanov), and Medical University, Plovdiv (Dr Lalabonova), Bulgaria; Department of Endocrinology, Diabetes, and Metabolism, Cedars Sinai Medical Center, Los Angeles, California (Dr Deepinder); and Reproductive Research Center, Cleveland Clinic, Cleveland, Ohio (Dr Agarwal).

Arch Pediatr Adolesc Med. 2010;164(12):1152-1157. doi:10.1001/archpediatrics.2010.223

Objective  To provide estimates of normal variations in penile measurements and testicular volumes, and to establish reference ranges for clinical use.

Design  Cross-sectional, population-based study.

Setting  Schools, kindergartens, and child care centers in different parts of Bulgaria.

Participants  A population of 6200 clinically healthy white males aged 0 to 19 years.

Interventions  The study physician chose schools, kindergartens, and child care centers randomly and examined children at random until he reached the required number. Each of the 20 age groups (age range, 0-19 years) had an equal number of males (ie, 310).

Main Outcome Measures  The mean (SD) values and fifth, 50th, and 95th percentiles of height (Siber Hegner anthropometer), weight (beam balance), testicular volume (Prader orchidometer), penile length (rigid tape), and penile circumference (measuring tape) from birth to 19 years of age.

Results  Testes did not show any increase in size until the onset of puberty at age 11 years, whereas penile growth was gradual after birth. However, both penile and testicular development demonstrated peak growth from 12 to 16 years of age, which coincided with the maximal male pubertal growth spurt. Data indicate an earlier pubertal development for this study population than that for a similar population several decades ago. Significant differences between urban and rural populations regarding penile length were also noticed.

Conclusions  Our study provides the contemporary reference range values for height, weight, testicular volume, and penile length and circumference of males aged 0 to 19 years. Our data show that, even by the end of 20th century, there is still some acceleration of male pubertal development. For the first time are reported somatic differences in genitalia within a population between urban and rural representatives.