Hydrocele

• painfless cystic swelling

• opening of processus vaginalis is narrow of othen closes spont.

• 2 types:

  • slack

    • bilateral (often)

    • disappear within 12mo

  • tense

    • often unilateral

      • often perisst after 1st year

• 90% resolve by 18mo

• referral if present longer than 2yrs

undescended testes

• can still descend up to 3mo after birth

• refer by 6mo with view to correction between 9-12mo

  • definately 2yo

• maximize fertility potential

Hypospadius

• look for other abnormalalites

• refer ASAP if not producing good stresam

• otherwise evaluated by 6mo

  • view to surgery @ 9-18mo

Phimosis

• real phimosis uncommon

• almost all cases tight foreskin resolve naturally

  • can be adherent up to 5-6yo

• if persistent consider VUR

• treatment with corticosteroid cream

  • 0.05% betamethasone valerate qid for 4wk

  • change to higher potency

• persistent difficulty passing urine = referral

Balanitis

• inflammation of foreskin that usually affects glans penis and tissues behind foreskin

• redness or irration of glans and foreskin

• candida = problems

• treatment

  • gentle saline bathing

  • barrier cream

  • hydrocortisoine 1% then antibactieral ointment

  • if yeasts

    • topical antifungal

Labial fusion

• adhesions perineal inflammation

• no treatment if child can void readily and allow natural healing to occur