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GENITAL ABNORMALITIES

GENITAL ABNORMALITIES

Hypospadias

Hypospadias

  1. 1:500 newborns
  2. urethral meatus opens on the ventral side of the penis,proximal to the glans
  3. may be associated with chordee (ventral curvature of penile shaft),undescended testicles, inguinal hernia
  4. if severe, distinguish from ambiguous genitalia, and ruleout other GU abnormalities
  5. do not circumcise; foreskin used for surgical repair

 

Epispadias

Epispadias
o urethral meatus opens on the dorsum of the penis,at points along the glans and shaft

 

Phimosis

 

  1. inability to retract prepuce (persistent > 3 years of age)
  2. may be congenital or a consequence of inflammation
  3. if it is severe, requires circumcision or surgical enlargement of opening

Cryptorchidism

image

  1. arrested descent of testicles in natural path to scrotum (prepubic > ext inguinal ring > inguinal canal > abdominal)
  2. common (30%) in premies, 3-4% of full term babies
  3. most descend by 3 months; no spontaneous descent at > 1 year old
  4. sequelae: trauma (inguinal testes), torsion, malignancy (40x risk),infertility
  5. Differential: retractile, ectopic, atrophic testes, intersex state
  6. undescended testes: may palpate in inguinal canal but unable to milk down into scrotum
  7. retractile testes: parents may have seen them in scrotum, can milk them down with warm hands/warm room
  8. Investigations
    • HCG stimulation test to induce descent, serum testosterone, U/S, CT, surgical exploration, karyotype
  9. Treatment
    • orchidoplexy by age 2 years, HCG sometimes tried
GENITAL ABNORMALITIES GENITAL ABNORMALITIES Reviewed by Radiology Madeeasy on October 05, 2010 Rating: 5
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