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Newborn Genitalia Exam
Aka: Newborn Genitalia Exam, Genitourinary Examination in Infants
- See Also
- Circumcision
- Exam: Female
- Breast Buds and Galactorrhea
- Resolves in first month of life
- Consult pediatric endocrinology if persistent
- Labia
- Term infant: Labia majora prominent
- Preterm Infant: Labia minora and Clitoris prominent
- Vaginal Skin Tag or hymenal tag
- Normal and require no treatment
- White mucoid discharge or scant Vaginal Bleeding
- Normal withdrawal from maternal Estrogen in first 3-7 days of life
- Ambiguous Genitalia signs (requires urgent urology/endocrine/Genetics consult prior to gender assignment)
- Fused labia
- Clitoromegaly
- Exam: Male
- Undescended Testes (Cryptorchidism)
- More common in Premature Infants
- Retractile Testes that can be milked into Scrotum do not require additional evaluation (only routine follow-up)
- Communicating Hydrocele
- Processus vaginalis fails to close allowing free passage of peritoneal fluid into Scrotum
- Typically resolves spontaneously within first 1-2 years of life
- Inguinal Hernia
- Complicates Communicating Hydrocele, with bowel passing into Inguinal Canal
- Risk of incarceration and Strangulation
- Hypospadias (with or without Chordee)
- Abnormal ventral placement of the Urethral opening (at the glans, shaft or Scrotum)
- Do not circumcise (foreskin needed for repair)
- Prepuce may adhere to glans (do not retract)
- Chordee
- Ventral penile curvature
- Do not circumcise
- Buried penis
- Penis retracts into fat pad
- Do not circumcise (risk of entrapping glans penis with post-procedure swelling)
- Small Penis (micropenis)
- Suggests low Androgen level or Growth Hormone
- Normal penis length: 2.5 cm to 4.2 cm
- Normal penis diameter: 0.9 to 1.3 cm
- Ambiguous Genitalia signs (requires urgent urology/endocrine/Genetics consult prior to gender assignment)
- Bilateral Undescended Testes
- Micropenis
- Bifid Scrotum
- References
- Fuloria (2002) Am Fam Physician 65(2):265-70 [PubMed]
- Lewis (2014) Am Fam Physician 90(5): 297-302 [PubMed]