1. Reproductive Health Problems in Pediatric Males

2. 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

3. 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

4. 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

5. 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)

6. 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

7. 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

8. 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

9. Health Problems in Pediatric Females   Adolescent Reproductive Health Problems

10. 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.

11. 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)