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Diagnostic tests for diagnosing cause of small penis

First of all we take detailed history then do thorough examination of whole body system including genitalia. On history & examination we get certain clue for likelihood of some of the above causes. Then we perform those relevant tests in that particular patient. Thus by doing some of below mentioned tests diagnosis of cause of small penis is made.
The following are the list of investigations; need to be done in the cases of underdeveloped small/ or thin penis

These tests includes:

In biochemistry liver function or kidney function tests are done.

Dynamic test: To judge functional capacity of testis whether testis has the capacity to function normally or not. In this test we inject single injection of gonadotropin as intramuscular injection then three day later the rise in concentration of male hormone is seen to assess whether testis has capacity to function normally or not.

Chromosomal analysis is done to see the genetic structure of testis, because there are many chromosome disorders, which lead to small penis.

Capacity of generation of active testosterone i.e. DHT is tested. This DHT generation test is abnormal in some cases of small penis / thin penis /underdeveloped penis.

Tests to locate testis as ultrasonography or C.T. Scan abdomen is needed if testis is not palpable.
MRI / CT SCAN head: if suspecting hypogonadotropic hypogonadism.

Serum inhibin is tested which tells that whether testis is functioning or not.

Serum Iron, T.I.B.C. & ferritin concentration tested for hypogonadism due to hemochromatosis.

Combined Pituitary hormone tests are performed when suspecting pituitary disorder.

Molecular genetic studies done in some special cases.

Serum estrogen increased whenever testicular function is decreased.

Serum DHT is low in some conditions when generation of dihydrotestosterone is decreased.

Assessment of androgen receptor is done when needed
Dynamic tests as:
HCG test,
Response to antiestrogen clomiphene
LH, FSH rise in response to gonadotropin releasing hormone tests.
All above tests need to be interpreted by expert of hormone diseases with good experience. Based on above test results diagnosis of cause of small /or thin penis is made. Once the cause is found then treatment becomes very easy with good results.

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