Care for Your Newborn Boy's Genitals

A boy's penis is fully formed at birth, and at that time your pediatric provider (and probably you!) will have inspected things to be sure everything looks normal.

Common, usually minor, findings that are occasionally seen include:

• Undescended testicle(s). Sometimes one or both testicles cannot be felt in the scrotum. However, if they can be felt higher up, nearer to the groin, then typically they can and will descend on their own without any intervention. If your pediatric provider is completely unable to locate one or both, they may still reside in the abdomen and not have made the normal descent into the scrotum in the last trimester. This is called "undescended testicles" or "cryptorchidism."
  • In such cases, pediatricians usually wait and watch. Quite often the testicles descend on their own (3%-5% of boys are born with this; by 3 months only 0.8% still have an undescended testicle without any intervention).
  • If, by 6 months or so, the testicle still is not palpable, the hormone HCG is frequently administered, which often brings on the descent. Additionally, a consultation with a pediatric urologist is often made.
  • As a last resort, a simple outpatient surgical procedure can usually be performed to bring down the testicle from the abdomen and tack it down to the scrotum ("orchiopexy") so it doesn't go up again.

• Malpositioned urinary opening ("hypospadias"). The urinary opening ("meatus") should be at or very near the center of the tip of the penis (the "glans"), but is occasionally found to be away from the center, usually on the underside of the shaft of the penis. This occurs during genital formation in the womb. No one really knows why, although occasionally the father had the same problem.
  • This requires no intervention. The opening may be very near where it should be and cause no real trouble.
  • Should it be quite far from the center of the glans, it may eventually require surgery to bring it into proper position. For this reason, any circumcision is often postponed so the foreskin tissue can be used in the surgical repair.

Tips for Concerned Parents

• Watch for a good strong urinary stream in your newborn. This is the best evidence that the strength of the bladder contractions and the urinary opening (urethra) are in perfect working order.
• Care for your son's uncircumsized penis by gently cleansing with warm water only. There is no need to try to retract the foreskin, which hurts and is unnecessary.