6 Common Baby Genital Problems

Considering all the time parents spend tending to their baby's private parts during diaper changes and baths, it's understandable to wonder whether everything is normal, says Victoria Rogers McEvoy, M.D., assistant professor of pediatrics at Harvard Medical School. While you should always consult with your baby's pediatrician about any concerns you may have, we asked experts for the lowdown on some of the most common genital issues that can affect babies.

Undescended Testicles

The testicles develop in the abdomen and descend into the scrotum in the last few weeks before birth or shortly after birth. Sometimes, though, one or both testicles don't fall into place, which is known as "undescended testicles."

Other times the testes might descend, but the inguinal canal (the passageway between the abdomen and groin) doesn't fully close and the testicles continue to move back and forth between the abdomen and scrotum—a condition called retractile testicles, explains William Reiner, M.D., a professor of pediatric urology at the University of Oklahoma Health Sciences Center, in Oklahoma City. An undescended testicle occurs in nearly 1 in 100 male infants at birth and is more common in preterm infants.

In most cases, testicles move into place within six to 12 months of birth, Dr. Reiner says. If they don't, your pediatrician may suggest hormone therapy or simple surgery.

Inguinal Hernia

In other cases, an inguinal canal can result in another concern: an inguinal hernia. Abdominal tissue, such as a loop of intestine, may move into the opening, causing a painless bulge in the baby's groin area that you may see during a diaper change, says Dr. McEvoy. Inguinal hernias can show up at any age and are more common in males than in females.

Your baby will need minor surgery to close the open passageway in order to avoid developing a strangulated hernia, a condition that occurs when a piece of intestinal content gets stuck in the canal and cuts off the blood supply to that portion of the intestine, says Dr. McEvoy. If this happens, the bulge will look swollen, feel hard, and cause extreme pain. Your baby may vomit, cry inconsolably, feed poorly, or have a fever—and you should take them to the emergency department immediately.

Hydrocele

A hydrocele is yet another problem of the inguinal canal, but this one only affects male infants. "When a boy's inguinal canal fails to close, fluid from the abdomen can collect in the scrotal sac," says Steven Tennenbaum, M.D., a pediatric urologist at Morgan Stanley Children's Hospital of New York-Presbyterian Columbia University Medical Center. It isn't painful, but your baby's testicles may look swollen.

A hydrocele carries the same risk as a hernia. If it hasn't gone away on its own, doctors recommend surgery after the first birthday to drain the fluid and close the passageway.

Urinary Tract Infection (UTI)

A urinary tract infection (UTI) is an overgrowth of bacteria in the urinary tract. In the first year of life, they are more likely in babies with penises, especially uncircumcised penises as the foreskin can trap bacteria. But babies with vulvas can get UTIs too—because the urethra and anus are so close in female anatomy.

Many times, unexplained high fever is the only symptom of a UTI in an infant. But you may also notice odd-smelling urine, unexplained irritability, poor feeding, or vomiting. Notify your pediatrician if you do; if left untreated, a UTI can cause kidney infections which can lead to permanent damage. Thankfully, a course of antibiotics (usually 10 days) easily treats a UTI, says Dr. McEvoy.

Labial Adhesions

The folds of skin in front of the vagina, known as the labia, can fuse together. This fusion can occur after the skin becomes raw and irritated (possibly as the result of a severe diaper rash), says Monique Regard, M.D., a pediatric gynecologist at Maria Fareri Children's Hospital at Westchester Medical Center, in New York. Adhesions can vary in size, are rarely painful, and usually don't stop urine flow.

In most cases, labial adhesions don't require treatment, and you shouldn't try to unstick the skin yourself. They generally resolve on their own and will certainly disappear when estrogen production kicks in during puberty. If your baby has trouble urinating or frequently gets UTIs in addition to labial adhesions, your pediatrician may recommend prescription steroid or estrogen cream or, in rare cases, surgery to separate the adhesions.

Penile Adhesions

Penile adhesions are a possible complication of circumcision. Whenever body tissue is cut, the edges can stick to surrounding areas. Following surgical removal of the foreskin, raw areas of the loose foreskin can stick to the head of the penis. It may look like the head is covered by a thin film or like it was never circumcised.

Penile adhesions are usually painless and release over time as the penis grows, so often no treatment is needed, says Dr. McEvoy. When the adhesions are extensive, a doctor may prescribe a mild steroid cream for treatment.