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Reproductive Health Problems in Pediatric Males Adolescent Reproductive Health Problems Penile Problems • Congenital anomalies are almost always corrected – in infancy or early childhood • Hypospadias – most common penile deformity – Common congenital deformity in which urethra opens on the underside of the penis or perineum • Correctible • Psychological problems dev. during sensitive growth periods if not corrected Adolescent Reproductive Health Problems • Uncircumcision – dev. problems related to tight foreskins that cannot retract over the enlarging glands – Cause: poor cleaning to area. Risk for frequent infections exists • Penile carcinoma – Associated with HPV type 16 & 18 – Highly transmittable STD in U.S. among males, cancer is rare Adolescent Reproductive Health Problems • Penile trauma – Burns or accidental injuries – Frenulum (fold on lower surface of glans connecting with the prepuce) is torn after forceful retraction of the foreskin; unusually rough masturbation or coitus – Spontaneous healing occurs Testicular Tumors • Not a common condition but are usually malignant in adolescence. • Most common solid tumor in males ages 15-34 • A heavy, hard, painless, palpable testicular mass found located anterior or lateral • Ultrasonography and direct biopsy are indicated • Orhiectomy with poss. removal of adjacent lymph nodes – Chemotherapy & radiation done if metastasized • Educate adolescents to perform monthly testicular self-examination (TSE) Repro. Health Problems • Varicocele - a cystic accumulation of blood in the spermatic cord. • Characterized by trotuous elongation and dilation of the spermatic cord superior to the testicle. • Pt may experience discomfort during sexual stimulation • Upon examination, feels like a “Bag of worms” which significantly reduces when pt lies down Epididymitis • Inflammation of the epididymis caused by – bacteria or virus – • Chlamydia trachomatis & Neisseria gonorrhoeae – chemical irritant - urine – localized trauma • Unilateral scrotal pain, redness & swelling. • Urethral discharge, dysuria,fever, pyuria (pus in urine) • TX: analgesics, scrotal support, bed rest, antibiotic Testicular Torsion • A condition in which the testicle (normally attached or encased to the scrotum by a small ligament) becomes loose, causing twisting of testicles impeding blood flow. • Emergency condition, requiring immediate surgery. • Results in partial or complete venous occlusion • Swollen, acute or insidious pain, red, warm, edema, N/V & abdominal pain. • Crucial in recognizing symptoms • Must refer to immediate medical evaluation Health Problems in Pediatric Females Adolescent Reproductive Health Problems Adolescent Pregnancy • Rates of adolescent births still remain high in the U.S. than other developing countries. • 7 out of 10 adolescent mothers complete high school but are less likely to to to college. • The less familiar an adolescent is with her partner, the less likely it is that they will use contraception during intercourse. • Social factors: low socioeconomics, poverty • Maternal success: participation in programs for pregnant teens, social support systems and a sense of control over one’s life. Adolescent Pregnancy • Medical aspects. • Risk for complications exist when there is a lack of adequate care – Premature labor, low-birth infants, high neonatal mortality, iron deficiency anemia, fetopelvic disproportion, prolonged labor. • Infants at risk – bacterial infections within the uterus are associated with early preterm delivery (<30 wks)