Children’s Urology Conditions

The most common problems that affect the foreskin in childhood are a tight foreskin and recurrent infections. The foreskin is not fully developed at birth and continues to develop during childhood. By about 5 years of age, however, most boys can pull the foreskin back over the head of the penis. There are 2 principle reasons why there might be difficulty doing this: a narrow opening (known as a phimosis) and attachments between the inside of the foreskin and the underlying head of the penis (referred to as prepucial adhesions). Difficulty in pulling the foreskin back can lead to problems with hygiene and cause infections underneath the foreskin – so-called balanitis.

The most common childhood swelling in the scrotum is a hydrocoele. A hydrocoele is a collection of fluid in the space in front of the testicle. In younger children, it usually forms because of a small persistent channel between the abdomen and the scrotum. In older children, a persistent processus vaginalis is not usually the problem but hydrocoeles can still occur due to a fluid build up in the space in front of the testicle.

The testicles form within the abdomen during the early part of foetal development and then migrate through the inguinal canal to reach the scrotum by the time of birth. If this descent does not occur properly then the testis is referred to as an undescended testis. The testis can stop descending at any point along its path although most commonly they reach the inguinal canal in the groin.