4 common urological problems found in boys

Written by: Miss Marie-Klaire Farrugia
Published: | Updated: 19/06/2019
Edited by: Jay Staniland

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.


Foreskin problems


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.


Undescended testes


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.

Learn more: Types of hydrocele



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.

By Miss Marie-Klaire Farrugia
Paediatric urology

Miss Marie-Klaire Farrugia is a consultant paediatric urologist based at Chelsea and Westminster Hospital and the BUPA Cromwell hospital in central London. She specialises in all areas of kidney, bladder and genital anomalies that babies are born with or develop later in childhood. In particular, she counsels pregnant mothers whose babies are prenatally-diagnosed with a kidney condition, so that the best postnatal plan can be made for the newborn.

Miss Marie-Klaire Farrugia is the clinical lead for paediatric surgery in the North West London Network, and writes guidelines and teaches in the major North West London hospitals. Her research interests include the long-term outcome of prenatally-diagnosed urological problems such as hydronephrosis and posterior urethral valves and vesicoureteric reflux. She is an experienced open, laparoscopic and robotic surgeon and performs neonatal and childhood circumcision; repair of simple and complex hypospadias including staged graft repairs; hernia and hydrocoele repairs; surgery for undescended testes; pyeloplasty; ureteric reimplantation; surgery on duplex kidneys and ureterocoeles; posterior urethral valves; nephrectomy and hemi-nephrectomy; Deflux injection for kidney reflux with urine infections; amongst others.

Miss Farrugia is an executive member of the Society for Fetal Urology and a member of the British Association of Paediatric Urologists, the European Society for Paediatric Urology, the American Association of Pediatric Urologists and the Societies for Pediatric Urology.

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