December Week 2: Penile Issues

Article 1: Hypospadias.  Peds In Review.

You are in the newborn nursery examining a full term baby boy delivered last night via NSVD, when you notice the urethral opening is farther down the ventral surface of the penis than the usual location. The remainder of the exam, including testicular examination is WNL.

1. What is this condition called and how do you explain to parents why it happened?

2. What are the three classifications based on location of the urethral opening? What is the significance of the classification system?

3. What are the long term functional consequences if not corrected?

4. When should further testing for other anomalies be pursued?

5. What are the initial recommendations you should give to parents before they are discharged home from the hospital? (i.e: what procedure should they NOT do and why? Follow-up?).

Article 2: The Foreskin. Peds In Review.

You are seeing a 6 month old boy in CYAS clinic for his WCC. He is uncircumcised, and his mother wants to know if she should be retracting the foreskin during baths to clean the penis- she has tried but has noticed that the foreskin seems ”stuck.”

1. Is this normal? What should you advise her on genital care for her son in the first year of life?

2. What is the condition called when you are unable to retract the foreskin? At what age is this no longer considered physiologic and at what age would you consider treatment?

3. What is the initial nonsurgical approach to treatment of this condition?

4. What condition involving the foreskin is considered a urologic emergency? What are the potential consequences if not identified and treated immediately?

5. What is the difference between posthitis and balanitis? What is the treatment for each of these?