Discovering a problem with your baby can be very distressing. However, many problems are fairly common in babies and children. Top consultant paediatric urologist, Miss Marie-Klaire Farrugia explains the most common urological conditions in boys and how they are treated.
Concern about your child’s foreskin not retracting is a common worry in parents. The foreskin is adherent to the head of the penis in all baby boys, and will begin to retract spontaneously over the next few years – it is fully retractile in about 50% of two year olds, and may take longer in the remainder.
A paediatric urology consultation is warranted if the child develops infection (balanitis) or is having difficulty voiding. A delay in the foreskin retracting may be initially aided with a mild steroid cream. Surgical options include a preputioplasty, whereby the foreskin is 'stretched' but preserved, or a circumcision.
Normally, the testes descend during development in the mother’s womb, but in 3% of newborn boys, the testes have not yet descended. Most of them will descend spontaneously over the first 6 months of life, but if this doesn’t happen, it is important to see a paediatric urologist.
The risks of an undescended testis include loss of fertility, a propensity to twist (testicular torsion) and an increased cancer risk. The paediatric urologist will explain the straightforward surgical procedure to place the testis into the correct position.
Groin and scrotal swellings
Swelling of the genital region may be alarming. The most common cause is a collection of fluid around the testis, in the scrotum, known as a hydrocele. This is harmless and painless, and usually resolves over the first two years of life. A hernia on the other hand, appears as a (sometimes painful) lump in the groin, sometimes extending into the scrotum, and requires a more urgent expert review and repair. Any swelling that becomes acutely red or painful must be seen to urgently.
Hypospadias is a common condition (1:350 male births) where the location of the opening of the urethra (usually found at the tip of the penis), is found elsewhere on the ventral side of the penis. This abnormality is commonly associated with a bend in the penile shaft (chordee) and a hooded appearance of the foreskin. A paediatric urologist will advise on whether surgery is required, and if so the timing and after-care.
If you are concerned about any of the mentioned conditions in your child, or in any other urological condition, make an appointment with a specialist here.