Case Study: The Ambiguous Genitalia of a new patient

Introduction
A 35-year-old male, presented to our clinic with concerns about his genital anatomy. Physical examination revealed a diminutive phallic structure measuring only 1.5 cm flaccid and 8 cm erect, placing him in the smallest 1.9% of men. His testicular volume was also abnormally small, ranking in the lowest percentile. This case study documents the patient's unusual genital morphology and explores the diagnostic implications.
Anatomy and Measurements Upon visual inspection, the patient's genital protuberance appeared underdeveloped and infantile in appearance. Measuring only 1.5 cm in length and 0.8 cm in diameter when flaccid, it was barely perceptible against the surrounding pubic fat pad. Even when maximally erect, the phallus only reached a meager 8 cm in length and 1.2 cm in girth, far below average adult male dimensions.
For reference, the average flaccid penis measures 9.16 cm in length and 3.66 cm in circumference, while the average erect penis reaches 13.12 cm in length and 4.24 cm in circumference [1]. The patient's testicular volumes were similarly diminutive at 6 mL and 7 mL, compared to the average adult volume of 18.9 mL [2].

Differential Diagnosis
Given the patient's exceptionally small genital protuberance and hypoplastic testes, the diagnosis of phallic agenesis or ambiguous genitalia with phallic hypoplasia must be considered. His anatomy is more akin to a macroclitoris or pseudopenis than a normal penis