Medical Information Center    
Common Genital Problems in Boys
Concern
& Care
关爱
   
   
Joe Williams, MSIII Haiyan Chen,MD, Yingshan Shi, MD
The page started on 05/09/09, updated on 05/27/2009
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
This page is under construction.
For Infants and Young Boys
Ambiguous Genitalia
Circumcision
Disorders of the Foreskin
Penile Adhesions
Phimosis and Paraphimosis
Inflammation of the Penis
Disorders of Penile and Urogenital
Penile Torsion
Micropenis
Concealed and Webbed Penis
Hypospadias and Chordee
Disorders of Testicle
Undescended Testis and Cryptorchidism
Testicular Torsion
Other
Hydrocele
Inguinal Hernia		  For Male Teens
kidshealth.org Testicular Exams
familydoctor.org Genital Problems in Male
pamf.org/teen Common topics related to male health
nlm.nih.gov Penis Disorders
nlm.nih.gov Testicular Disorders
Disorders of Penile
Concealed Penis
Disorders of Testicle
Testicular Torsion
Testicle Trauma
Testicular Cancer
Other
Inguinal Hernia
Epididymitis
Varicocele
Gynecomastia (Enlarged Breasts) nlm.nih.gov/medlineplus mayoclinic.com
 

 
General Information
nlm.nih.gov/medlineplus Male reproductive anatomy
kidshealth.org a cartoon illustration of male reproductive system.
uchicagokidshospital.org Anatomy of the Urinary System
kidshealth.org a review of male reproductive system, including normal function and common problems.
familydoctor.org Genital Problems in Infants
uchicagokidshospital.org Overview of Genitourinary Disorders
organizedwisdom.com an overview about genital abnormalities
uchicagokidshospital.org Glossary
uchicagokidshospital.org Online Resources – Genitourinary and Kidney Disorders
  Penile Anomalies eMedicine
For Providers
Penile Problems The Canadian Journal of CME
 

Ambiguous Genitalia in Genetic Males
Newborns’ genitalia are abnormal which can vary from the more obviously apparent to the almost invisible. Seek medical advice  when you concern about the appearance of your baby’s external genitalia.
Features in genetic males (babies with one X and one Y chromosome)
Penis: Small (<1.9 centimeters)
Urethral opening: above or below the penis, nearer to the scrotum (hypospadias)
Scrotum: small
Often with undescended testicles

  Links for Parents
Ambiguous Genitalia Medline
Ambiguous genitalia: boy or girl? Mayo
Ambiguous Genitalia UC
Sexual Differentiation Urologyhealth
Ambiguous Genitalia Urologyhealth
Ambiguous Genitalia emedicine
 

Circumcision
Circumcision is a surgical procedure in which the skin covering the end of the penis (foreskin) is removed. Existing scientific evidence show some potential medical benefits of newborn male circumcision, however these benefits are not sufficient to recommend route newborn circumcision. There are potential benefits and risks. The parents should determine what is in the best interest of the child.

  Links for Parents
Should have our son circumcised? AAP
Weighing the pros and cons Mayo
Newborn Circumcision ACOG
About Circumcision KH Statistics CDC
Circumcision UC Circumcision lpch.org
Care for the uncircumcised penis AAP
For doctors
circumcision medlineplus
circumcision Medem.com
 
Disorders of the Foreskin - Penile adhesions
Some of the loose foreskin attaches itself to the head of the penis (glans), which occurs after circumcision. 		  Links for Parents
Penile adhesions Yahho.com
Penile adhesions parenting.ivillage.com
 

Disorders of the Foreskin - Phimosis
An ring of tissue prevents retraction of foreskin behind the glans penis. At birth phimosis is normal. At age 3-5 yr the foreskin becomes retractable among 90% uncircumcised boys.
Causes: Inflammation and scarring at the tip of the foreskin. Forcefully retracted foreskin can result in a scar that prevents subsequent foreskin retraction.
Symptoms:Irritation, bleeding, dysuria, blooming of the foreskin upon voiding, urinary retention.
Prevention: Never forcefully retract foreskin
Treatment for Persistent phimosis:
Topical steroid to loosen the adhesive ring with success rates 67-95% reported.Betamethasome dipropionate 0.05% cream only on the contracting band or ring twice a day for 4 weeks. Circumcision if foreskin ballooning during voiding or phimosis > age 10 years old.

Disorders of the Foreskin -Paraphimosis
Foreskin cannot be pulled back over the glans after retracted and trapped behind the corona (or crown) of the penis, which can cause severe swelling, pain, and venous congestion in the foreskin and the glans distal to the corona.
Treatment
Most resolved by manual reduction: Lubricate the foreskin and glans, then compress the glans and push it through the phimotic ring beyond the coronal sulcus.
Urgent urologic consultation to reduce under general anesthesia.
Emergency circumcision under general anesthesia in rare cases.

  Links for Parents
Phimosis & Paraphimosis Univ. Chicago
Paraphimosis medlineplus
Phimosis and Paraphimosis Aetna
Phimosis and Paraphimosis lpch.org
Phimosis and Paraphimosis CH
Phimosis and Paraphimosis merck.com
 

Disorders of the Foreskin - Inflammation of the Penis (Balanitis)

  Links for Parents
Balanitis medlineplus
Balanitis dermnetnz.org
Balanitis eMedicine
Balanitis Aetna InteliHealth
 
Hydrocele

  Links for Parents
Hydrocele medlineplus
Hydrocele childrenshospital.org
Hydrocele mayoclinic
Hydrocele Univ. of Chicago
Hydrocele lpch.org
Hydrocele urologyhealth
 

Penile abnormalities- Penile Torsion
Rotational defect of the penile shaft which usually turn to the left side. Penile development is normal in the most cases, but also occurs with hypospadias in some boys.
Correction is unnecessary if the rotation < 60 degrees from the midline.

  Links for Parents
Penile Anomalies eMedicine
stacommunications.com Penile Problems
 

Penile abnormalities- Micropenis
Stretched penile length measurement: the distance from the penile base under the pubic symphysis to the tip of the glans.
Newborn penis Mean length: 2.8 to 4.2cm (3.5 ± 0.7cm) Diameter: 1.1 ± 0.2 cm
Micropenis < 1.9 cm in length (Normally formed penis <2.5 SD below the mean in length)
Causes
Idiopathic micropenis(no specific causes founded).
Hormonal abnormality: Hypogonadotropic hypogonadism or Hypergonadotropic hypogonadism (primary testicular failure)
Treatment: All need to referral to pediatric endocrinologist and urologist.
Karyotype, anterior pituitary function, testicular function, or/and brain MRI

   Links for Parents
Micropenis Univ. of Chicago Micropenis lpch.org
Micropenis hsv.edu
For doctors
Micropenis emedicine
 
Penile abnormalities - Concealed and webbed penis
Concealed (hidden or buried) penis: Normally developed penis buried by the suprapubic fat pad, congenital or occur following circumcision. May cause urinary retention.
Webbed penis: Scrotal skin extends onto the ventrum of the penis. Penis tends to retract into the scrotum. In rare cases, the distal urethra is hypoplastic, necessitating urethral reconstruction.		  Links for Parents
Inconspicious penis drgreene.com
For doctors
Buried penis emedicine
Inconspicuous penis AAP
 
Penile abnormalities - Epispadias

   Links for Parents
Epispadias medlineplus
Epispadias urologyhealth
Epispadias University of Maryland
Epispadias emedicine
 
Penile and urethral abnormalities - Hypospadias, chordee

  Links for Parents
Hypospadias and Chordee Cincinnatichildrens.org
Hypospadias medlineplus
Hypospadias UC Comer Children Hosp
Hypospadias lpch.org
Hypospadias urologyhealth.org
Hypospadias repair emedicine
Chordee hmc.psu.edu
Chordee Wiki Doc
 
Testicle abnormalities- Undescended testis or cryptorchidism

  Links for Parents
Undescended Testis medlineplus
Undescended Testis Univ. of Chicago
Undescended Testis lpch.org
Undescended Testis Kidshealth
Undescended Testis urologyhealth
Undescended Testis Familydoctor.org
Undescended Testis medem.com
 
Testicular Torsion

  Links for Parents
Testicular torsion and repair medlineplus
Testicular torsion Univ. of Chicago
Testicular torsion lpch.org
Testicular torsion Univ. Boston
Neonatal testicular torsion urologyhealth
 
Epididymitis

   Links for Parents
Epididymitis MayoClinic
Epididymitis MedlinePlus
Epididymitis Univ. of Maryland
Epididymitis eMedicine
 
Testicular Trauma

   Links for Parents
Testicular Trauma urologyhealth
Testicular Injuries Kidshealth
 
Testicular Cancer


   Links for Parents
The Testicle tcrc.acor.org
Testicular Cancer in Children urologyhealth.org
Risk factors Cancer.org
Found Early Cancer.org
Testicular self-exam Kidshealth.org
Testicular self exam tcrc.acor.org
www.nlm.nih.gov for doctors
 
Inguinal Hernia

  Links for Parents
Inguial Hernia niddk.nih.gov
Inguinal Hernia Univ. of Chicago
Inguinal Hernia childrenshospital.org
Inguinal Hernia lpch.org
Inguinal Hernia kidshealth.org
Inguinal Hernia medem.com
 
Epididymitis


   Links for Parents
 
Varicocele

   Links for Parents
Varicocele MedlinePlus
Varicocele urologyhealth.org
Varicocele eMedicine
Varicocele kidshealth.org

Helpful resources and websites
General information
http://kidshealth.org/misc/movie/bodybasics/male_repro.html a cartoon illustration of male reproductive system.
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1113.htm Male reproductive anatomy medlineplus
http://www.uchicagokidshospital.org/online-library/content=P03116 Anatomy of the Urinary System
http://kidshealth.org/parent/general/body_basics/male_reproductive.html a review of male reproductive system, including normal function and common problems.
http://familydoctor.org/online/famdocen/home/tools/symptom/536.printerview.html Genital Problems in Infants
http://www.uchicagokidshospital.org/online-library/content=P03103 Overview of Genitourinary Disorders
http://organizedwisdom.com/helpbar/index.html?return=http://organizedwisdom.com/Absent_Penis&url=www.emedicine.com/ped/topic2798.htm eMedicine an overview about genital abnormalities
http://www.uchicagokidshospital.org/online-library/content=P03086 Glossary
http://www.uchicagokidshospital.org/online-library/content=P03102 Online Resources – Genitourinary and Kidney Disorders
http://emedicine.medscape.com/article/1016681-overview eMedicine, Penile anomalies
http://www.stacommunications.com/journals/cme/2002/09-sept/penisproblems.pdf The Canadian Journal of CME, Penile Problems for provider

For Male Teens
http://kidshealth.org/teen/sexual_health/guys/testicles.html Testicular Exams
http://familydoctor.org/online/famdocen/home/tools/symptom/539.printerview.html Genital Problems in Male
http://www.pamf.org/teen/health/malehealth/ Common topics related to male health
http://www.nlm.nih.gov/medlineplus/penisdisorders.html Penis Disorders
http://www.nlm.nih.gov/medlineplus/testiculardisorders.html Testicular Disorders

Ambiguous Genitalia
http://www.nlm.nih.gov/medlineplus/ency/article/003269.htm Ambiguous Genitalia
http://www.mayoclinic.com/print/ambiguous-genitalia/DS00668/DSECTION=all&METHOD=print Ambiguous genitalia: boy or girl?
http://www.uchicagokidshospital.org/online-library/content=P03079 Ambiguous Genitalia
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=110 Normal and Abnormal Sexual Differentiation
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=31 Ambiguous Genitalia
http://emedicine.medscape.com/article/1015520-overview Ambiguous Genitalia and Intersexuality

Circumcision
http://www.aap.org/publiced/BR_Circumcision.htm Should we have our son circumcised? AAP: American Academy of Pediatrics
http://www.mayoclinic.com/print/circumcision/PR00040/METHOD=print Mayo: Circumcision for baby boys: Weighing the pros and cons
http://www.acog.org/publications/patient_education/bp039.cfm Newborn Circumcision; ACOG: The American College of Obstetricians and Gynecologists
http://kidshealth.org/parent/system/surgical/circumcision.html KH: About Circumcision
http://www.uchicagokidshospital.org/online-library/content=P03080 Circumcision UC: The University of Chicago Comer Children Hospital
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/circmcsn.html lpch.org Circumcision
http://www.aap.org/publiced/br_uncircumcised.htm Care for the uncircumcised penis AAP
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions.htm Statistics CDC
For doctors
http://www.nlm.nih.gov/medlineplus/circumcision.html medlineplus
http://www.medem.com/medlib/article/ZZZ6HG9QE8C Medem.com

Foreskin abnormalities-Penile adhesions
http://answers.yahoo.com/question/index?qid=20090330083103AAESR8W Yahho.com
http://parenting.ivillage.com/newborn/ncare/0,,3qhh,00.html parenting.ivillage.com

Foreskin abnormalities-Phimosis and Paraphimosis
http://www.uchicagokidshospital.org/online-library/content=P03104 Phimosis and Paraphimosis UC
http://www.nlm.nih.gov/medlineplus/ency/article/001281.htm Paraphimosis medlineplus
http://www.intelihealth.com/IH/ihtIH/WSIHW000/24479/10520.html Phimosis and Paraphimosis Aetna InteliHealth
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/pandp.html Phimosis and Paraphimosis lpch.org
http://www.childrenshospital.org/az/Site1447/mainpageS1447P0.html Phimosis and Paraphimosis CH: childrenshospital.org
http://www.merck.com/mmhe/sec21/ch238/ch238c.html Phimosis and Paraphimosis merck.com

Inflammation of the Penis (Balanitis)
http://www.nlm.nih.gov/medlineplus/ency/article/000862.htm medlineplus
http://dermnetnz.org/site-age-specific/balanitis.html dermnetnz.org
http://emedicine.medscape.com/article/777026-overview eMedicine
http://www.intelihealth.com/IH/ihtIH/WSIHW000/24479/10515.html Aetna InteliHealth

Hydrocele
http://www.nlm.nih.gov/medlineplus/ency/article/000518.htm medlineplus
http://www.childrenshospital.org/az/Site867/mainpageS867P0.html childrenshospital.org
http://www.mayoclinic.com/print/hydrocele/DS00617/DSECTION=all&METHOD=print mayoclinic
http://www.uchicagokidshospital.org/online-library/content=P03090 Univ. of Chicago
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/hydrocel.html lpch.org
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=95 urologyhealth

Penile Torsion
http://emedicine.medscape.com/article/1016681-overview eMedicine, Penile anomalies
http://www.stacommunications.com/journals/cme/2002/09-sept/penisproblems.pdf The Canadian Journal of CME , Penile Problems for provider

Penile abnormalities- Micropenis
http://www.uchicagokidshospital.org/online-library/content=P03096 UC
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/mcrpenis.html lpch.org
http://www.healthsystem.virginia.edu/uvahealth/peds_urology/mcrpenis.cfm hsv.edu: healthsystem.virginis.edu
For doctors
http://emedicine.medscape.com/article/923178-overview emedicine

Penile abnormalities - Concealed and Webbed Penis
http://www.drgreene.com/21_1125.html drgreene.com
For doctors
http://emedicine.medscape.com/article/442617-overview emedicine
http://pediatrics.aappublications.org/cgi/reprint/92/6/794.pdf AAP

Penile Epispadias
http://www.nlm.nih.gov/medlineplus/ency/article/001285.htm medlineplus
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=92 urologyhealth
http://www.umm.edu/ency/article/001285all.htm University of Maryland Medical Center
http://emedicine.medscape.com/article/1297912-overview emedicine

Penile and urethral abnormalities - Hypospadias and Chordee
http://www.cincinnatichildrens.org/health/info/urinary/diagnose/hypospadias.htm Hypospadias and Chordee Cincinnatichildrens.org
http://www.nlm.nih.gov/medlineplus/ency/article/001286.htm medlineplus
http://www.uchicagokidshospital.org/online-library/content=P03087 UC Comer Children Hospital
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/hsp.html lpch.org
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=96 urologyhealth.org
http://emedicine.medscape.com/article/1297569-overview Hypospadias repair, emedicine
http://www.hmc.psu.edu/childrens/healthinfo/c/chordee.htm hmc.psu.edu Chordee
http://www.wikidoc.org/index.php/Chordee Chordee, Wiki Doc

Testicle abnormalities- Undescended Testis or Cryptorchidism
http://www.nlm.nih.gov/medlineplus/ency/article/000973.htm medlineplus
http://www.uchicagokidshospital.org/online-library/content=P03081 UC Comer Children Hospital
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/cryptorc.html lpch.org
http://kidshealth.org/parent/newborn/problems/crypto.html Kidshealth
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=178 urologyhealth
http://familydoctor.org/online/famdocen/home/men/reproductive/637.html Familydoctor.org
http://www.medem.com/medlib/article/ZZZA1ZDDDDC medem.com

Testicular Torsion
http://www.nlm.nih.gov/medlineplus/ency/article/000517.htm medlineplus Testicular torsion and repair
http://www.uchicagokidshospital.org/online-library/content=P03115 UC Comer Children Hospital
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/testor.html lpch.org
http://www.childrenshospital.org/az/Site1701/mainpageS1701P0.html childrenshospital.org
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=107 urologyhealth Neonatal testicular torsion

Testicular Trauma
http://urologyhealth.org/adult/index.cfm?cat=10&topic=135 urologyhealth
http://kidshealth.org/teen/exercise/safety/testicular_injuries.html# Kidshealth

Testicular Cancer
http://tcrc.acor.org/testicle.html The testicle
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/testicular cancer.gov
http://www.urologyhealth.org/pediatric/index.cfm?cat=04&topic=137 Testicular cancer in children
http://www.cancer.org/docroot/cri/content/cri_2_4_2x_what_are_the_risk_factors_for_testicular_cancer_41.asp?sitearea=ped Cancer.org American Cancer Society Risk factors for testicular cancer
http://www.cancer.org/docroot/cri/content/cri_2_4_3x_can_testicular_cancer_be_found_early_41.asp? Cancer.org American Cancer Society Can Testicular Cancer Be Found Early?
http://kidshealth.org/teen/sexual_health/guys/tse.html How to perform a testicular self-examination
http://tcrc.acor.org/tcexam.html tcrc: The Testicular Cancer Resource Center How to do a testicular self examination
http://www.nlm.nih.gov/medlineplus/testicularcancer.html for doctors

Inguinal hernia
http://digestive.niddk.nih.gov/ddiseases/pubs/inguinalhernia/ NIH
http://www.uchicagokidshospital.org/online-library/content=P03092 Univ. of Chicago
http://www.childrenshospital.org/az/Site1018/mainpageS1018P0.html childrenshospital.org
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/inghern.html lpch.org
http://kidshealth.org/teen/exercise/safety/hernias.html kidshealth
http://www.medem.com/medlib/article/ZZZZE8BFDDC medem.com

Epididymitis
http://www.mayoclinic.com/print/epididymitis/DS00603/DSECTION=all&METHOD=print MayoClinic
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/001279.htm MedlinePlus
http://www.umm.edu/ency/article/001279all.htm University of Maryland
http://emedicine.medscape.com/article/777181-overview eMedicine

Varicocele
http://www.nlm.nih.gov/medlineplus/ency/article/001284.htm MedlinePlus
http://urologyhealth.org/pediatric/index.cfm?cat=01&topic=510 urologyhealth
http://emedicine.medscape.com/article/438591-overview eMedicine
http://kidshealth.org/teen/sexual_health/guys/varicocele.html kidshealth

Others
Bladder anomalies (exstrophy, cloacal exstrophy, epispadias complex)
Disorders of sexual differentiation (intersex, clitoromegaly, urogenital sinus, cloaca)
Duplication anomalies (ureteral, bladder, kidney)
Hydronephrosis
Renal abnormaliities (duplex kidney, UPJ obstruction, multi-cystic dysplastic kidney, horseshoe kidney)
Tumors (Wilms' tumor, rhabdomyosarcoma, testicular tumors)
Ureteral abnormalities (vesicoureteral reflux (VUR), ureterocele, megaureter)
Urinary tract stones
Posterior urethral valves
Neurogenic bladder
Enuresis (bedwetting) http://www.funandeducation.org/Health/heathinfo/gu/bedwetting.htm

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