Skip to main content

Conspicuous External Genitals in the Boy

  • Chapter
  • First Online:
Symptoms and Signs in Pediatric Surgery
  • 1898 Accesses

Abstract

Many and diverse pathologies manifest as conspicuous external genitals. The visible genitals may be assigned to a boy or a girl, or assignment occurs first to a wrong sex or is not possible at all (ambiguous external genitals). Therefore, classification in one of the three groups (male or female conspicuous external genitals, and external genitals in disorders of sex development) may be impossible at the first look because effacement of the clinical presentation does not render a correct delineation. In Table 32.1, most relevant pathologies that lead to conspicuous external genitals in the boy are listed and differentiated according to their clinical significance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

General: Differential Diagnosis

  • Colodny A (1987) Urethral lesions in infants and children. In: Gillenwater JY et al (eds) Adult and pediatric urology, vol II. Yearbook Medical Publishers, Chicago

    Google Scholar 

  • Ellis DG, Mann CM Jr (1998) Abnormalities of the urethra, penis, and scrotum. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis

    Google Scholar 

  • Hensle TW (1987) Genital anomalies. In: Gillenwater JY et al (eds) Adult and pediatric urology, vol II. Yearbook Medical Publishers, Chicago

    Google Scholar 

  • Johnston JH (1982) Acquired lesions of the penis, the scrotum, and the testes. In: Williams DI, Johston JH (eds) Pediatric urology, 2nd edn. Butterworth Scientific, London

    Google Scholar 

  • Klauber GT, Saut GR (1985) Disorders of the male external genitalia. In: Kelalis PP et al (eds) Clinical pediatric urology, vol I, 2nd edn. Saunders, Philadelphia

    Google Scholar 

Section 32.1

Section 32.2

  • Aigrain Y, Cheikhelard A, Lottmann H, Lortat-Jabob S (2010) Hypospadias: surgery and complications. Horm Res Paediatr 74:218–222

    Article  PubMed  CAS  Google Scholar 

  • Albers N, Ulrichs C, Glüer S, Hiort O, Sinnecker GH, Mildenberger H, Brodehl J (1997) Etiological classification of severe hypospadias: implications for prognosis and management. J Pediatr 131:386–392

    Article  PubMed  CAS  Google Scholar 

  • Baskin LS, Ebbers MB (2006) Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 41:463–472

    Article  PubMed  Google Scholar 

  • Brock JW III, O’Neill JA Jr (1998) Bladder exstrophy. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis

    Google Scholar 

  • Castagnetti M, El-Ghoneimi A (2010) Surgical management of primary severe hypospadias in children: systematic 20-year review. J Urol 184:1469–1474

    Article  PubMed  Google Scholar 

  • Duckett JW, Baskin LS (1998) Hypospadias. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis

    Google Scholar 

  • Fichtner J, Filipas D, Mottrie AM et al (1995) Analysis of meatal location in 500 men. Wide variation questions need for meatal advancement in all pediatric anterior hypospadias cases. J Urol 154:833–834

    Article  PubMed  CAS  Google Scholar 

  • Fisch M (2004) Concepts for correction of penile hypospadias. Urologe A 43:202–207

    Article  Google Scholar 

  • Ishii T, Hayashi M, Suwanai A, Amano N, Hasegawa T (2010) The effect of intramuscular testosterone enanthate treatment on stretched penile length in prepubertal boys with hypospadias. Urology 76:97–100

    Article  PubMed  Google Scholar 

  • Kelly JH (1998) Exstrophy and epispadias: Kelly’s method of repair. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis

    Google Scholar 

  • Lam PN, Greenfield SP, Williot P (2005) 2-Stage repair in infancy for severe hypospadias with chordee: long-term results after puberty. J Urol 174:1567–1572; discussion 1572

    Article  PubMed  Google Scholar 

  • Manzoni G, Bracka A, Palminteri E, Marrocco G (2004) Hypospadias surgery: when, what and by whom? BJU Int 94:1188–1195

    Article  PubMed  Google Scholar 

  • Markiewicz MR, Lukose MA, Margarone JE 3rd, Barbagli G, Miller KS, Chuang SK (2007) The oral mucosa graft: a systematic review. J Urol 178:387–394

    Article  PubMed  Google Scholar 

  • Mieusset R, Soulié M (2005) Hypospadias: psychological, sexual, and reproductive consequences in adult life. J Androl 26:163–168

    PubMed  Google Scholar 

  • Milla SS, Chow JS, Lebowitz RL (2008) Imaging of hypospadias: pre- and postoperative appearances. Pediatr Radiol 38:202–208

    Article  PubMed  Google Scholar 

  • Muruganandham K, Ansari MS, Dubey D, Mandhani A, Srivastava A, Kapoor R, Kumar A (2010) Urethrocutaneous fistula after hypospadias repair: outcome of three types of closure techniques. Pediatr Surg Int 26:305–308

    Article  PubMed  Google Scholar 

  • Paulozzi LJ, Erickson JD, Jackson RJ (1997) Hypospadias trends in two US surveillance systems. Pediatrics 100:831–834

    Article  PubMed  CAS  Google Scholar 

  • Snodgrass WT (2002) Tubularized incised plate (TIP) hypospadias repair. Urol Clin North Am 29:285–290

    Article  PubMed  Google Scholar 

  • Snodgrass WT (2008) Management of penile curvature in children. Curr Opin Urol 18:431–435

    Article  PubMed  Google Scholar 

  • Thorup J, McLachlan Cortes D, Nation TR, Balic A, Southwell BR, Hutson JM (2010) What is new in cryptorchidism and hypospadias – a critical review on the testicular dysgenesis hypothesis. J Pediatr Surg 45:2074–2086

    Article  PubMed  Google Scholar 

  • Toppari J, Virtanen HE, Main KM, Skakkebaek NE (2010) Cryptorchidism and hypospadias as a sign of testicular dysgenesis syndrome (TDS): environmental connection. Birth Defects Res A Clin Mol Teratol 88:910–919

    Article  PubMed  CAS  Google Scholar 

  • Wilcox D, Snodgrass W (2006) Long-term outcome following hypospadias repair. World J Urol 24:240–243

    Article  PubMed  Google Scholar 

Section 32.3

  • Adan L, Couto-Silva AC, Trivin C, Metz C, Brauner R (2004) Congenital gonadotropin deficiency in boys: management during childhood. J Pediatr Endocrinol Metab 17:149–155

    Article  PubMed  CAS  Google Scholar 

  • Bergeson PS, Hopkin RJ, Bailey RB Jr, NcGill LC, Piatt JP (1993) The inconspicuous penis. Pediatrics 92:794–799

    PubMed  CAS  Google Scholar 

  • Bhangoo A, Paris F, Philibert P, Audran F, Ten S, Sultan C (2010) Isolated micropenis reveals partial androgen insensitivity syndrome confirmed by molecular analysis. Asian J Androl 12:561–566

    Article  PubMed  Google Scholar 

  • Cheng PK, Chanoine JP (2001) Should the definition of micropenis vary according to ethnicity? Horm Res 55:278–281

    Article  PubMed  CAS  Google Scholar 

  • Feldman KW, Smith DW (1975) Fetal phallic growth and penile standards for the newborn male infants. J Pediatr 86:395

    Article  PubMed  CAS  Google Scholar 

  • Grumbach MM (2005) A window of opportunity: the diagnosis of gonadotropin deficiency in the male infant. J Clin Endocrinol Metab 90:3122–3127

    Article  PubMed  CAS  Google Scholar 

  • Lee PA, Houk CP (2004) Outcome studies among men with micropenis. J Pediatr Endocrinol Metab 17:1043–1053

    PubMed  Google Scholar 

  • Lumen N, Monstrey S, Selvaggi G, Ceulemans P, De Cuypere G, Van Laecke E, Hoebeke P (2008) Phalloplasty: a valuable treatment for males with penile insufficiency. Urology 71:272–276; discussion 276–277

    Article  PubMed  Google Scholar 

  • Menon PS, Khatwa UA (2000) The child with micropenis. Indian J Pediatr 67:455–460

    Article  PubMed  CAS  Google Scholar 

  • Paris F, De Ferran K, Bhangoo A, Ten S, Lahlou N, Audran F, Servant N, Poulat F, Philibert P, Sultan C (2011) Isolated ‘idiopathic’ micropenis: hidden genetic defects? Int J Androl 34:e518–e525

    Article  PubMed  CAS  Google Scholar 

  • Summerton DJ, McNally J, Denny AJ, Malone PS (2000) Congenital megaprepuce: an emerging condition – how to recognize and treat it. BJU Int 86:519–522

    Article  PubMed  CAS  Google Scholar 

  • Wisniewski AB, Migeon CJ (2002) Long-term perspectives for 46, XY patients affected by complete androgen insensitivity syndrome or congenital micropenis. Semin Reprod Med 20:279–304

    Article  Google Scholar 

  • Wisniewski AB, Migeon CJ, Gearhart JP, Rock JA, Berkovitz GD, Plotnick LP, Meyer-Bahlburg HF, Money J (2001) Congenital micropenis: long-term medical, surgical and psychosexual follow-up of individuals raised male or female. Horm Res 56:3–11

    Article  PubMed  CAS  Google Scholar 

Section 32.4

  • Bar-Yosef Y, Binyamini J, Matzkin H, Ben-Chaim J (2007) Degloving and realignment – simple repair of isolated penile torsion. Urology 69:369–371

    Article  PubMed  Google Scholar 

  • Fisher C, Park M (2004) Penile torsion repair using dorsal dartos flap rotation. J Urol 171:1903–1904

    Article  PubMed  Google Scholar 

  • Paxson CL Jr, Corriere JN Jr, Morriss FH Jr, Adcock EW III (1977) Congenital torsion of the penis in father-son pairs. J Urol 118:881

    PubMed  Google Scholar 

  • Pomerantz P, Hanna M, Levitt S, Kogan S (1978) Isolated torsion of the penis. Urology 11:37–39

    Article  PubMed  CAS  Google Scholar 

  • Sarkis PE, Sadasivam M (2007) Incidence and predictive factors of isolated neonatal penile glanular torsion. J Pediatr Urol 3:495–499

    Article  PubMed  Google Scholar 

  • Shaeer O (2008) Torsion of the penis in adults: prevalence and surgical correction. J Sex Med 5:735–739

    Article  PubMed  Google Scholar 

Section 32.5

  • Caldamone AA, Chen SC, Elder JS, Ritchey ML, Diamond DA, Koyle MA (1999) Congenital anterior urethrocutaneous fistula. J Urol 162:1430–1432

    Article  PubMed  CAS  Google Scholar 

  • Rattan KN, Kajal P, Pathak M, Kadian YS, Gupta R (2010) Aphallia: experience with 3 cases. J Pediatr Surg 4:E13–E16

    Article  Google Scholar 

Section 32.6

  • Adetayo FO (2009) Outcome of management of acute prolonged priapism in patients with homozygous sickle cell disease. West Afr J Med 28:234–239

    PubMed  CAS  Google Scholar 

  • Cantasdemir M, Gulsen F, Solak S, Numan F (2011) Posttraumatic high-flow priapism in children treated with autologous blood clot embolization: long-term results and review of the literature. Pediatr Radiol 41:627–632

    Article  PubMed  Google Scholar 

  • Corbetta JP, Duran V, Burek C, Sager C, Weller S, Paz E, Lopez JC (2011) High flow priapism: diagnosis and treatment in pediatric population. Pediatr Surg Int 27:1217–1221

    Article  PubMed  Google Scholar 

  • Fall B, Fall PA, Diao B, Sow Y, Dieng E, Sarr A, Ndoye AK, Sylla C, Ba M, Diagne BA (2010) Acute priapism associated with sickle cell disease in Senegal: clinical, therapeutic features and risk factors for erectile dysfunction. Med Trop (Mars) 70:475–478

    CAS  Google Scholar 

  • Hekal IA, Meuleman EJH (2008) Idiopathic low-flow priapism in prepuberty: a case report of literature. Adv Urol 2008:549861

    Google Scholar 

  • Maples BL, Hagemann TM (2004) Treatment of priapism in pediatric patients with sickle cell disease. Am J Health Syst Pharm 61:355–363

    PubMed  Google Scholar 

  • Raveenthiran V (2008) A modification of Winter’s shunt in the treatment of pediatric low-flow priapism. J Pediatr Surg 43:2082–2086

    Article  PubMed  Google Scholar 

  • Sandler G, Soundappan SS, Cass D (2008) Appendicitis and low-flow priapism in children. J Pediatr Surg 43:2091–2095

    Article  PubMed  Google Scholar 

  • Sood R, Wadhwa SN, Jain V (2006) Neonatal priapism associated with spontaneous bilateral pyocavernositis. Ann Acad Med Singapore 35:425–427

    PubMed  Google Scholar 

  • Towbin R, Hurh P, Baskin K, Cahill AM, Carr M, Canning D, Snyder H, Kaye R (2007) Priapism in children: treatment with embolotherapy. Pediatr Radiol 37:483–487

    Article  PubMed  Google Scholar 

  • Volmer BG, Nesslauer T, Kraemer SC, Goerich J, Basche S, Gottfried HW (2001) Prepubertal high flow priapism: incidence, diagnosis and treatment. J Urol 166:1018–1023

    Article  Google Scholar 

  • Winter CC, McDowell G (1988) Experience with 105 patients with priapism: update review of all aspects. J Urol 140:980–983

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kaiser, G.L. (2012). Conspicuous External Genitals in the Boy. In: Symptoms and Signs in Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31161-1_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-31161-1_32

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-31160-4

  • Online ISBN: 978-3-642-31161-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics