Pediatric Urinary & Reproductive Health

At Conrad Pearson, we specialize in treating a variety of conditions affecting the reproductive and urinary systems in children and adolescents. Our urologists conduct thorough evaluations for these conditions, providing both medical and surgical interventions to support proper development and function. We also collaborate closely with families to educate them about normal sexual development, address potential concerns, and create personalized treatment plans that promote both physical and emotional well-being. By integrating expertise in pediatric urology with a compassionate approach to sexual health, we help ensure that children and adolescents achieve optimal health outcomes and a positive quality of life.

Pediatric Reproductive Health Conditions We Treat:

Epispadias: A rare congenital condition where the urethral opening is situated on the upper side of the penis or, in females, on the clitoris or within the urethra. This results from improper formation of the urethra during fetal development. The outcome varies based on the condition’s severity and the effectiveness of surgical repair, but many individuals can lead functional and fulfilling lives with appropriate treatment. Symptoms include an abnormal location of the urethral opening, difficulty controlling urination, and potential sexual dysfunction or cosmetic concerns.

Undescended Testicles (Cryptorchidism): a condition where one or both testicles have not moved into their proper position in the scrotum before birth. The testicles usually descend into the scrotum during the later stages of pregnancy, but in some cases, they remain in the abdomen or another location. Treatment options are case dependent but include, observation, hormone therapy and surgical intervention. The exact cause of cryptorchidism is not always known, but it may be influenced by factors such as premature birth, genetics, hormonal imbalances, low birth weight, and maternal health issues. 

Symptoms: absence of testicle(s) in the scrotum, swelling or mass in the groin or abdomen, empty or smaller than usual scrotal sac.

Epididymitis: An inflammation of the epididymis, the duct at the back of the testicle where sperm matures and is stored. Epididymitis can be caused by a range of underlying factors, including infections, trauma, urinary tract issues, and systemic autoimmune disorders.

Symptoms: scrotal pain and swelling, redness and warmth, painful urination, discharge from the penis if infection present.

Testicular Torsion: A medical emergency that occurs when a testicle twists around the spermatic cord, compromising its blood supply. This condition can cause severe pain and, if not treated promptly, may lead to loss of the affected testicle. Testicular torsion can happen spontaneously, or as a result of trauma or injury. Contributing factors include anatomical abnormalities, physical activity or sports, family history, and scrotal trauma.

Symptoms: severe sudden testicular pain, swelling, abdominal pain, high-riding testicle.

Inguinal Hernias: A hernia occurs when an internal organ or tissue pushes through a weak spot in the muscle or connective tissue. Symptoms include swelling of the groin or scrotum, and bulging of the groin region.

Hydrocele: A condition characterized by the buildup of fluid in the sac surrounding the testicle, resulting in swelling of the scrotum. It can occur in newborns or develop later in life. The primary symptom of hydrocele is swelling of the scrotum, which may also be accompanied by painful swelling, heaviness or discomfort.

Circumcision and Circumcision Revision: A surgical procedure in which the foreskin – the skin covering the head (glans) of the penis, is removed. This procedure is often performed on newborns, but it can also be carried out on older children and adults. Circumcision revisions, also known as re-circumcision are performed to address issues or complications that arose from initial circumcision such as inadequate skin removal, infections, functional problems or discomfort, and cosmetic concerns. 

Penile Adhesions and Labial Adhesions: Conditions that occur when there is abnormal sticking or fusion of skin surfaces in the genital area.

• Penile adhesions occur when the foreskin of the penis sticks to the head (glans) of the penis. Penile adhesions can be caused due to incomplete circumcision, inflammation, infection or phimosis (a condition where the foreskin cannot be fully retracted). This condition can cause pain or discomfort, difficulty in retracting the foreskin, swelling or redness.
• Labial adhesions involve the sticking together of the labia minora, the inner folds of the vulva. Labial adhesions can be due to hormonal changes, vulvar irritation or infection and skin conditions such as eczema. These adhesions can cause vaginal discharge, pain or discomfort or difficulty with urination.

Meatal Stenosis: The narrowing of the urethral meatus, the external opening of the urethra where urine exits the body. This condition is seen particularly in those males who have undergone circumcision. Causes of meatal stenosis can vary: some individuals are born with a naturally narrow meatus, while scarring or narrowing can occur after surgery. Recurrent urinary tract infections or inflammation may also lead to narrowing, and injury can result in scarring. 

Symptoms: Difficulty urinating or a weak stream, painful urination, frequent urinary tract infections, dribbling or splitting of urine stream.

Varicocele: A condition where the veins in the scrotum become enlarged and swollen. These veins, known as the pampiniform plexus, become dilated due to improper blood flow. Varicoceles typically develop on the left side but can occur on both sides of the scrotum.

Faulty valves within the veins can sometimes prevent proper blood flow, causing the veins to enlarge. Increased pressure in the veins, due to factors like physical exertion or prolonged standing, can also contribute to this enlargement.

Symptoms: scrotal pain or aching, visible or palpable veins, reduced size or shrinkage of affected testicle

Disorders of Sexual Development: Conditions that involve atypical development of sex characteristics. These disorders can be broadly categorized into three main types based on the level of sexual development affected:

• Chromosomal DSDs:
• Klinefelter Syndrome (47,XXY): A condition where males have an extra X chromosome, leading to symptoms like reduced fertility, small testicles, and learning difficulties.
• Turner Syndrome (45,X): A condition in females where one of the X chromosomes is missing or partially missing, resulting in short stature, infertility, and possible heart defects.
• Gonadal DSDs:
• Androgen Insensitivity Syndrome (AIS): A condition where individuals with XY chromosomes are resistant to male hormones (androgens). Individuals may have typical female external genitalia but no functional ovaries or uterus.
• Mixed Gonadal Dysgenesis: A condition where individuals may have a mix of male and female gonadal tissues, often associated with ambiguous genitalia.
• Anatomical DSDs:
• Hypospadias: A condition where the urethral opening is located on the underside of the penis rather than at the tip.
• Vaginal Agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome): A condition where the vaginal canal is underdeveloped or absent, affecting females.

Symptoms of DSDs vary widely depending on the specific condition and the timing of its onset. Common signs may include:

• Ambiguous Genitalia: Uncertainty about whether the external genitalia are male or female, particularly in newborns.
• Delayed Puberty: Late or absent sexual maturation during adolescence.
• Infertility: Difficulty conceiving, often due to abnormal gonadal function.
• Physical Development: Characteristics that do not align with typical male or female development, such as mixed sexual characteristics or incomplete development of reproductive organs.

If your child is experiencing any of these signs or symptoms, contact us to schedule an appointment. Our urologists can evaluate the situation and create an effective treatment plan tailored to your child’s needs.