”Microcephaly is not an independent disease, but it is a real problem that often troubles parents and doctors because small testicles and penis are, on the one hand, one of the main symptoms of male hypogonadism and, on the other hand, an inevitable manifestation of prepubertal and delayed somatic puberty in boys. It is this seemingly normal phenomenon that often conceals a series of serious potential dangers. A large number of medical practices have proven that the diagnosis of hypogonadism in males with small testicles is late. For example, if the testicles are of different sizes due to varicocele, the problem can be solved by performing varicocele surgery. However, for small testes caused by congenital factors, such as the treatment of Crohn’s syndrome, testosterone propionate 50 mg, injected intramuscularly twice a week, or methyltestosterone 5 mg, taken three times a day, can promote the development of male secondary sexual characteristics, promote sexual desire and maintain normal sexual function. Microtestoidism accounts for 20% of male infertility! Patients with microtia can be found by specialists at a glance when they walk on the street. They often have small white faces, no beard, no throat knots, light and tender skin, more subcutaneous fat, wider hips than the average man, and some even have slightly protruding bilateral breasts. Many people are infertile after marriage and go to the hospital for examination before they develop, with small testicles and semen but no sperm. Performance: There are signs in childhood but it is difficult to find out. Patients with microtia are harder to find before puberty, but there are still some signs, such as being thinner and taller than children of the same age, having a timid and fearful personality, and having a more high-pitched voice, which is sometimes felt by classmates. “, “sissy”. This kind of children, when very young, the external genitalia look nothing abnormal, parents can only find out when they look closely, the child’s testicles are particularly small, or in the scrotum can not feel the testicles. When the child reaches the age of 8 or so, the average boy will have an erection in the morning, which is a sign of normal development, but the signs of erection in children with microcephaly are not obvious. When puberty is reached, the abnormal performance is more prominent, and delayed puberty development means that the testicles are still the same size as those of a toddler after the age of 14, and male secondary sexual characteristics are not obvious. The external genitalia are male shaped, the penis is normal or short, and the testicles are small and hard even when they reach adulthood. Causes: Most congenital dysplasia Microtesorism is mostly congenital testicular dysplasia, and the incidence rate of the population is 1 in 1000~1 in 1500, which means that there are at least one or two students with microtesorism in medium-sized elementary and secondary schools, mainly due to sex chromosome abnormalities. A normal male has 46 chromosomes, represented by 46XY. The congenital testicular smallness should be confirmed by a chromosome test at a specialist hospital. It is understood that congenital testicular dysplasia, in adulthood, testicular volume is generally less than 6 ml, slightly worse in intellectual development, school grades in the class is the lower middle class. Among congenital testicular dysplasia, there is a kind of pituitary testicular dysplasia, where the testicles are small and soft in texture, and the intelligence will be better. There are also some patients with microcephaly caused by acquired factors, for example, testicular injury caused by trauma, accident or surgery; mumps with orchitis during adolescence; varicocele; long-term x-ray exposure of the testicles; underwear that is too tight or hot baths that are too frequent; endocrine diseases taking drugs that damage the testicles; long-term heavy smoking and drinking. Trauma-induced testicular nerve dysplasia, adult testicles are only the size of peanut rice or fava beans, with a hard texture and a volume of only about 3~6 ml. Treatment: Lifelong taking of androgens For small testes caused by congenital factors, some androgens can be used to promote the development of male secondary sexual characteristics, so that the genitalia develop normally, pubic hair develops obviously, rich in male characteristics, promote sexual desire and maintain normal sexual function. However, no matter what treatment method is used, it can only promote the development of sexual function and secondary sexual characteristics, and cannot restore fertility. In patients with microcephaly, because the testes can still secrete a certain amount of male hormones, they can still have sexual desire and sexual function, and they can also have normal ejaculation, but there is no sperm or very little sperm in the semen, and 97% of patients are infertile, and they can only borrow sperm to have children later. Assessment of testicular function in adolescent children 1. The length and width of the testicles can be measured with calipers; 2. Testicular volume index (right testicle length x width + left testicle length x width) x l/2 = testicular volume; 3. The volume of testicles is larger in newborns, about 2 ml, and increases from 0.5 cm3 to 1.53 cm3 in young children; 4. About 2 ml before puberty; 5. Greater than 4 ml or length greater than 2.4 cm indicates puberty has been initiated. What is the normal testicular volume The normal adult male testicle is slightly larger on the right side than on the left side, with an average of 3.38×2.27×1.71 cm on the right side and 3.30×2.37×1.78 cm on the left side. The volume can be as large as 25 ml. It is generally accepted that adults with testicular volume less than l0 ml are called microcephaly.