The Child with Testicular/Inguinoscrotal Issues

Question 1

When is the peak incidence of presentation for a child with a torted hydatid of Morgagni? What is the treatment?

Answer 1

• 11 - oestrogen surge triggers
• Blue-dot sign
• Surgical excision of appendage

Question 2

What are the signs/symptoms of epididymo-orchitis?

Answer 2

• Insidious onset, fever, vomiting, dysuria, pyuria, red/tender/swollen hemiscrotum. Marked tenderness on posterolateral aspect of testis
• May indicate urological abnormality in children with is, as normally uncommon

Question 3

How common are undescended testes? What are the complication risks if left untreated?

Answer 3

• Occur in 2% and more commonly in prems
• Complications
  
  • Infertility
  • Testicular tumours (3.8 times more likely)

Question 4

What is hypospadias? What does management involve?

Answer 4

• Ventral urethral opening and deficient foreskin here. Chordee (ventral angulation of the shaft)
• Management
  
  • Circumcision contraindicated - foreskin required for repair of hypospadias
  • Correction of chordee and hypospadias - 9-12 months. Allows normal sexual function in later life

Question 5

What is phimosis? What is the management?

Answer 5

• Scarring of preputial orifice causing narrowing, urinary obstruction, ballooning of foreskin on micturition
• Management
  
  • Normal in first year of life
  • Mild - topical steroids
  • Severe - preputioplasty