Every parent wants their baby to be perfect … and most are. But it’s not uncommon for a baby boy to be born with a problem involving his penis, testicles or scrotum. If this happens to your baby, take heart: A pediatric urologist can make things right.
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“The good news is that these problems generally cause no lasting effects when they are fixed or treated early,” says pediatric urologist Audrey Rhee, MD.
An undescended testicle is the most common urological problem at birth. It is seen most often in preemies, and can affect both testes.
In a full-term baby, undescended testicles usually drop on their own in the first six months of life. If this does not happen, surgery may be needed.
“Undescended testes have an increased risk of developing cancer, so any testicle that has not dropped naturally by the time the child is 1 year old should be surgically corrected,” Dr. Rhee says.
Bringing the testicle down into the scrotum is aesthetically pleasing, which is important as the boy ages. But it’s also a necessary step to prevent cancer.
“After puberty, the boy will be able to conduct regular testicular self-examinations to feel for a lump or swelling that may indicate testicular cancer,” Dr. Rhee says. “He can’t do that if the testicle is in his abdomen or groin.”
An imperfect penis
It might be distressful if your baby has an abnormal penis, but it’s a fixable problem that’s not uncommon.
The most frequently seen abnormality is a trio of deformities called hypospadias. It includes a urinary hole in the wrong position, a bend in the penis, a condition called chordee, and an incomplete foreskin. Chordee can also exist alone.
“These deformities should be corrected, or the boy will be unable to void while standing when he’s older. He may also find intercourse uncomfortable or be unable to get a woman pregnant,” Dr. Rhee says.
Hypospadias is surgically treated in a single procedure best performed between the ages of 6 and 18 months. “At this age, the child is still in diapers, has no genital awareness and is less likely to remember the procedure,” Dr. Rhee says.
Surgery involves correcting the bend and bringing the urinary hole to the tip.
“We encourage parents not to get the baby circumcised until the surgery has been done, as we often use the foreskin in the repair,” Dr. Rhee says.
Epispadias — the opposite of hypospadias — is a much rarer condition in which the urinary hole appears on the top side of the penis. In these babies, the hole is surgically relocated to the tip of the penis.
A swollen scrotum
A swollen, fluid-filled scrotum is known as a hydrocele. When it is present at birth, it usually disappears by age 1.
Older boys also can develop hydroceles from trauma to the scrotum, a sexually transmitted disease or a tumor.
“Any time there is fluid in the scrotum, it should be evaluated with a physical exam, and it may need an ultrasound,” Dr. Rhee says.