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Hypospadias is a congenital defect of the penis in which the urethral orifice is located on the ventral aspect of the glans penis or, more proximally, on the shaft or scrotum. Some type of hypospadias occurs in approximately 1 in 200 boys. The defect can be minimal or so severe that the sex of the newborn is difficult to determine. Many boys with hypospadias also have a congenital curvature of the penis that needs correction. Corrective surgery is done preferably between the ages of 6 and 12 months. The aim of surgery is to obtain a functionally and cosmetically normal penis while limiting the psychological burden on the child as much as possible. The common surgical procedures include: meatal advancement and glanuloplasty (MAGPI), the tubularised incised plate (TIP) technique according to Snodgrass, and vascularised foreskin flap-plasty. Urethral surgery for hypospadias is accompanied by a relatively high number of complications and should therefore be carried out by surgeons with sufficient experience.

In one boy aged 7 years with a micropenis, and in 3 boys aged 6, 4 and 5 years with delayed speech and language development and behavioural problems, Klinefelter's syndrome was diagnosed. In the first case the diagnosis was immediately suspected because of the micropenis. The other three boys were diagnosed after long observation. One of them was suspected of having a chromosomal abnormality because of behavioural problems together with a typical, female fat distribution pattern. If a delayed speech and language development and behaviour problems are present, Klinefelter's syndrome should be considered, especially if tallness and (or) small genitals are present.

The term 'micropenis' is applied if the measured penile length is more than 2.5 standard deviations below the mean for the age; in neonates born at term this means a penile length of less than 2 cm. Micropenis is the consequence of a defect which develops after the 14th week of pregnancy. The cause may be hormonal (hypothalamo-hypophysial (hypogonadotropic hypogonadism), testicular (hypergonadotropic hypogonadism) or end organ resistance), but also iatrogenic (medication during the pregnancy). In addition, micropenis occurs as a part of a number of syndromes. The diagnostic investigation comprises history-taking, physical examination, specific hormonal testing and, if considered necessary, chromosomal and imaging examinations. In the treatment of micropenis, a trial treatment with testosterone plays an important part.

There are three degrees of impotence or diminished ability to have an erection: (a) there is no erection at all; (b) erection only occurs prior to ejaculation; (c) there is a short-lived erection at the beginning of ejaculation and occasionally also during the final stage of ejaculation. There are differences of degree in erection, ranging from the absence of erection to normal erection. When abnormalities such as those referred to under (b) and (c) are observed in young male swine, the mating pattern may be restored to normal as time goes on.