Penis - Paediatrics

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