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. Although things usually check out okay, sometimes there are problems. We asked experts for the lowdown on the most common genital issues that affect babies (btw, penis size is not one of them).
What they are: The testicles develop in a boy's abdomen and descend into the scrotum in the last few weeks before birth or shortly after birth. Sometimes, though, one or both of them don't fall into place and are known as "undescended testicles." Other times they might descend, but the inguinal canal (the passageway between the abdomen and groin that exists in both boys and girls) 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., professor of pediatric urology at the University of Oklahoma Health Sciences Center, in Oklahoma City. An undescended testicle occurs in nearly one in 100 boys at birth and is more common in preterm boys.
What to do: 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.
What it is: This is a different complication of an open inguinal canal. Abdominal tissue, such as a loop of intestine, may move into the opening, causing a painless bulge in a girl or boy'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 boys than in girls.
What to do: 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 him to the E.R. immediately.
What it is: A hydrocele is yet another problem of the inguinal canal, but this one only affects boys. "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.
What to do: 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.
What it is: A UTI is an overgrowth of bacteria in the urinary tract. In the first year of life, they are more likely in boys, especially uncircumcised boys (the foreskin can trap bacteria). But baby girls 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. 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 damage.
What to do: A course of antibiotics (usually ten days) easily treats a UTI, says Dr. McEvoy.
What they are: The folds of skin in front of the vagina can fuse together. This can occur after the skin becomes raw and irritated (possibly as the result of a 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.
What to do: In most cases, nothing -- don'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, your pediatrician may recommend prescription steroid or estrogen cream or, in rare cases, surgery to separate the adhesions.
What they are: These are a possible complication of circumcision. Whenever body tissue is cut, the edges can stick to surrounding areas. 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.
What to do: Penile adhesions are usually painless and release over time as the penis grows, so no treatment is needed, says Dr. McEvoy. When the adhesions are extensive, a doctor may prescribe a mild steroid cream for treatment.
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