Hypospadius
Correct before 2 years of age. Do NOT circumcise as may need reconstructive surgery
Phimosis
– At 1 year old 50% boys have non-retractile foreskin, by 4yrs 10% and by 16yrs only 1%
– Non-retractile foreskin = balooning on micturition
– Topical corticosteroids can help.
– Encourage patients to maintain good hygiene and gently stretch the foreskin.
Emergency if causes acute urinary retention
Paraphimosis
Foreskin gets stuck in the retracted position.
Look for a hair tourniquet.
May be secondary to masturbation
Needs analgesia to reduce
Balanoposthitis
Balanitis = cellulitis of the glans
Posthesis = cellulitis of the foreskin
Can be irritant, bacterial or fungal.
Management
Needs warm baths
Rule out diabetes
Clotrimazole or antibiotic ointment
Normally get oral amox or trimeth too
References
http://emupdates.com/2009/04/01/900-balanitis-vs-balanoposthitis-causes-of-balanoposthitis-rx-conditions-prevented-by-circumcision/
http://www.wikem.org/wiki/Phimosis
http://emupdates.com/2009/04/01/899-management-of-phimosis-paraphimosis-causes-consequences-treatment/
http://www.bmj.com/content/346/bmj.f3678?sso=
http://www.emrap.tv/index.php?option=com_content&view=article&id=106
http://www.wikem.org/wiki/Balanoposthitis
http://www.amazon.co.uk/Illustrated-Textbook-Paediatrics-STUDENTCONSULT-Online/dp/0723435650
