Hydrocoele
A hydrocoele is a soft swelling in the scrotum caused by a collection of fluid around the testicle. It does not cause pain. The fluid has been pushed down into the scrotum via a channel connected to the abdominal cavity. A hydrocoele may often be present at birth, and usually disappears after the child is 1 year old. It rarely needs any surgical intervention. If your child has any scrotal swelling, it is advisable to have your doctor check it. Sometimes hernias can be present at the same time as a hydrocoele.
Varicocoele
A varicocoele usually occurs after puberty. It is an abnormal enlargement of the veins around the testicle. It generally presents as a swelling around the testicle, usually the left one. A varicoele feels like a bundle of worms. If not treated sperm production may be affected. Treatment is surgical, and you should consult your doctor if you suspect that your child has a varicocoele.
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This is a condition in which a testicle suddenly becomes twisted, and its blood supply is blocked off. If it is not corrected quickly, the testicle may die.
Cause
The cause of a twisted testicle is uncertain.
Clinical features
Your child may complain of rapid onset of severe pain in the groin and of a sore lower abdomen. Within several hours the scrotum over the affected testicle may become very tender, hot and swollen.
Treatment
You should see your doctor immediately if your child has a swollen or painful testicle. Torsion of the testicle is a surgical emergency and must be operated on immediately if the testicle is to be saved.
The testicle is straightened and sewn into position to prevent twisting from recurring. The other testicle may be sewn into position at the same time, also as a preventive measure.
Prevention
There is no way to prevent this condition from occurring initially.
UNDESCENDED TESTICLE
Cause
In the developing foetus the testicle forms within the abdomen and later moves down into the scrotum. An undescended testicle is one which does not lie fully within the sac of the scrotum. This is a relatively common condition, and 2% of newborn have one or two undescended testicles. Within a year, these usually slip down to lie within the scrotum.
Treatment
If, after a year, this has not occurred, then surgical intervention is usually necessary to prevent damage to the testicle. Consult your doctor if you suspect your child has an undescended testicle.
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Cause
Menstrual cramps are caused by the contraction of the muscles of the uterus, under the influence of hormonal changes occurring at the time of menstruation.
Clinical features
Cramps may begin several hours before the flow of blood appears. They are usually in the lower abdomen and may feel like spasms, occurring frequently and lasting for several minutes at a time. Your daughter may have an associated headache, and even nausea. All these symptoms are usually only present on the first day of the period.
Treatment
A hot water bottle can help ease cramps. Try to encourage your daughter to maintain normal activity if she can. Make sure tampons are changed every 3-4 hours, so that build up of blood (which can lead to severe infection or toxic shock syndrome) does not occur. Sometimes a mild painkiller such as paracetamol may be helpful, but if they become necessary on a continual basis, you should see your doctor. Placing a young girl on the Pill will occasionally improve symptoms of a painful period.
When to see your doctor
• if your daughter’s period pains are significantly interfering with her school attendance;
• if despite the above measures, she has such severe pains that she needs to lie in bed;
• if the pains persist, or she has an offensive vaginal discharge;
• if she has a fever.
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FUSED LABIA
Sometimes baby girls are born with their labia minora (inner lips of the vagina) fused together by a thin membrane. This can also sometimes happen following an infection. The opening of the vagina is sometimes covered over. If you suspect that your daughter has this problem, you should see your doctor to discuss its management.
PENIS, PROBLEMS WITH THE
Hypospadias
Hypospadias is an abnormality of the penis which is present at birth in 1 out of every 350 males. In this condition the opening of the urethra (the tube through which urine is emptied from the bladder) is on the underside of the penis instead of at the tip. If severe, it can be associated with a bent penis (chordee). Surgical repair is essential for hypospadias. Boys with hypospadias should not have a circumcision at birth, because it is sometimes necessary to use this skin to repair the hypospadias. If you notice that your child has hypospadias, it is advisable to seek early medical advice.
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