6 Big Urological Issues for Little Boys

There’s a lot of information out there about erectile dysfunction, prostate cancer, and other urological problems that occur in adult men. But baby boys, young boys, and teens have a unique set of urological problems all their own. The good news is that these concerns will generally have no lasting effects—if they are fixed or treated early.

The most important thing a father can do for his kids is to be a good role model. Your children are watching you and imitating what you are doing. If you are unashamed to tell your kids you are going to the doctor to make sure you are healthy, or because you have pain, they will do the same.


Undescended Testicles

premature baby

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The most common problem pediatric urologists see is an undescended testicle that is present at birth. It is more common in preemies than in full-term babies and can affect both testes.

In most cases, an undescended testicle drops by the age of six months. If it does not, it should be surgically retrieved by the time the child is one year of age.

Undescended testes haven an increased risk of developing cancer. The testicle is brought down into the scrotum so that a boy can conduct self-examinations to watch for signs of testicular cancer, such as a swelling or lump.


Penile Abnormalities

Likewise, it is not uncommon for baby boys to be born with a penile abnormality. Such deformities should be corrected if the penis is not functional, if the boy will be unable to urinate while standing when he’s older, or if he is likely to find intercourse uncomfortable or be unable to get a woman pregnant.

The most common penile abnormality is a trio of deformities called hypospadias. Problems include a urinary hole in the wrong position, a bend in the penis (cordee), and an incomplete foreskin. Cordee can also exist on its own.

Hypospadias is surgically treated in a single procedure. In accordance with the American Pediatric Association’s recommendation, the surgery should be done between the ages of six and 18 months when the child is still in diapers, is not likely to remember the procedure, and has no genital awareness.

The procedure involves correcting the bend and bringing the urinary hole to the tip. Parents are encouraged to not get the baby circumcised until the surgery has been done, as the foreskin is often used in the repair.

Epispadias is a much rarer condition. Whereas in hypospadias, the urinary hole appears on the underside of the penis, in epispadias it appears on the upper side. Surgery is used to relocate the hole to the tip of the penis.



Some baby boys are born with a fluid-filled scrotum called a hydrocele. It usually disappears by the age of one.

Older boys can also develop hydroceles from trauma to the scrotum, a sexually transmitted disease, or a tumor. Any time there is fluid in the scrotum, it should be evaluated with ultrasound by a physician.


Testicular Torsion

As a boy goes through puberty, his testicles become heavier. In some boys, this can cause the testicle to twist and cut off its blood supply.

Symptoms include a sudden onset of pain, swelling, and redness in the scrotum. Unless blood flow is quickly restored, the boy can lose his testicle. This is an urgent situation that requires an immediate visit to the emergency department.



When the tube that stores and carries sperm (epididymis) becomes inflamed, the result is pain in the testicles. It can happen to any man, but usually occurs in young men ages 14 to 35.

The most common causes of epididymitis are a sexually transmitted disease, trauma, or not peeing often enough, which can cause a kidney infection that backs up throughout the genitourinary system.

The appropriate treatment for epididymitis depends on the cause—an infection is treated with antibiotics, while a traumatic injury should be evaluated by a physician to prevent the testicle from rupturing.


Testicular Cancer

Testicular cancer is almost exclusively a disease found in young men. This is why we advocate teaching boys to exam their scrotum every month from ages 15 to 35.

A swelling or lump in either the testicle or scrotum or a feeling of pain, discomfort, or heaviness should be brought to the attention of a physician. The good news is that 95 percent of all testicular cancers are cured, and the cure rate is higher—98 percent to 100 percent—when the cancer is caught early.

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