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Cryptorchidism
- One or both of the testes absent from the scrotum
- Risk factors
- Premature birth
- Low birth weight
Clinical Presentation
- Routine pediatric exam
Labs, Studies and Physical Exam Findings
– Provider is unable to palpate one or both testicles
– U/S
- MRI
Treatment
- Initially watchful waiting. The majority will descend by 12 months.
- Should be addressed before 12-24 months due to concern about infertility in the future
- hCG injections cause a rise in testosterone and is often an effective treatment
- Surgery
- Orchiopexy should be considered if testis have not descended by 6 months to 1 year.
Peyronie Disease
- Scar tissue within the penis creating a deformity in the shape of the erect penis.
- This condition can make sexual intercourse painful and difficult.
Labs and Studies
- U/S may be used to confirm diagnosis
Treatment
- Mild condition may not be a problem and may resolve on its own
- Steroid injection to break up scar tissue.
- Surgical removal of scar tissue
Vesicoureteral Reflux
- Urine moving backwards through the renal system
- Bladder –> Ureter –> kidney
- Under normal conditions there is valve where the ureter meets the bladder
Clinical Presentation
- Urinary tract infections
- Dilation of kidneys
Labs and Studies
- U/S
- Urinalysis with cultures
- Voiding cystourethrography (VCUG)
- The bladder is filled with contrast dye. The patient voids while being observed with fluoroscopy. (Think barium swallow for the urinary tract)
Treatment
- Mild disease may resolve with time and growth
- Prophylactic antibiotics to prevent infections
- Surgical correction may be warranted if recurrent infections or severe disease
