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Chapter: Medicine Study Notes : Paediatrics

Penis - Paediatrics

Smegma : Yellowish coloured secretion-desquamation which occurs normally and keeps the foreskin separate from the glans.

Penis

 

Smegma

 

·        Yellowish coloured secretion-desquamation which occurs normally and keeps the foreskin separate from the glans

·        May appear like a dermoid cyst underneath the skin

·        Is normal, and will eventually extrude spontaneously

 

Retraction of the foreskin

 

·        By age 4 most boys foreskins will be able to be retracted 

·        May have intermittent pain during separation of the adhesions and the foreskin may be red or swollen for a day or two

 

Phimosis

 

·        Irretractable, scarred foreskin.  May balloon on urination 

·        If mild, application of Betnovate ointment to the tight portion of the foreskin (retract loose bit to access it) is effective 

·        If ongoing problems ® circumcision

·        Paraphimosis: foreskin stuck behind glans ® swollen.  Always put foreskin back after catheterisation

 

Balanitis

 

·        Infection of the foreskin, may remain distal or involve whole penile shaft

·        Can be secondary to phimosis

·        Treat with topical bactrim or oral antibiotics


Hypospadias

 

·        Combination of dorsal hood, proximal urethral opening and chordee (central penile tilt)

·        Presentation varies from mild to severe peno-scrotal type with ambiguous genitalia (check for testis)

·        Correct at 9 – 12 months 

·        ­UTIs

·        ­Infertility as the opening moves closer to the base of the penis

 

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Medicine Study Notes : Paediatrics


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