Genital pathologies are mainly grouped into 3 subgroups. These consist of penile pathologies, scrotum pathologies and vulva pathologies.
Penis pathologies
Consists of hypospadias, epispadias, buried (buried) penis and rare external genital anomalies (phimosis, paraphimosis, meatal web or stenosis, chordee or curvature, penoscrotal web, penile torsion, penoscrotal transposition and bifid scrotum). Urinary flow and voiding are not normal in these patients because of the missing urethra. Sexual function and fertility are not normal due to penile curvature and sperm flow disorder. A normal penis and urethra anatomy and function may require surgery.
Epispadias is a serious anomaly that can be isolated or accompanied by bladder exstrophy. The urethra develops short and opens to the upper surface of the penis or clitoris, the penis develops a serious curve towards the dorsum, and in girls, the clitoris is in the form of two separate parts. Since both the urethra, genital organ (penis/clitoris) and sphincter are severely damaged, serious and specific surgeries may be required occurs as a result of complications. It is a serious condition with these. Since severely buried penises, with their short and small appearance, cause serious psychosexual problems and sexual discomfort in later ages, they should be corrected around the age of 1 year.
Since circumcision is widely performed, it is unfortunately perceived as a simple procedure. Unfortunately, more importance is still given to the ceremonial aspect of circumcision rather than its medical aspect and surgery. However, circumcision errors that seriously affect future sexual life are still an important social problem.
Scrotum pathologies
Acute scrotum is varicocele and undescended testis.
Acute scrotum is the sudden onset of pain, swelling and redness in the scrotum. When testicular torsion is suspected, surgery may be required as soon as possible. Delay in diagnosis and treatment causes testicular necrosis.
Permanent and progressive damage may develop as the undescended testis is exposed to high temperatures. These increase the risk of infertility and malignancy. You have not descended The distinction between stis and retractile testis is very important; the first requires surgery, while the second one may be sufficient for follow-up. The gold standard treatment for undescended testis is surgery. Testes that do not descend until 1 year of age can be lowered into the scrotum by surgery.
Varicocele can damage testicular cells and impair sperm development and cause infertility in the future. Surgery may be required if there is significant shrinkage in the testis, recurrent severe pain, severe stage varicocele, and impaired sperm analysis in age-appropriate patients.
Vulva pathologies
Vulvar pathologies such as labial fusion (synechia), vaginal discharge, imperforated hymen and absence of vagina are common in girls.
Labial Synechiae (Fusion) is the adhesion of the labia minora, that is, the labia minora, to each other. Usually, a very thin curtain in the form of an onion membrane closes the mouth of the vagina and urethra. UTI, vaginal reflux and incontinence may develop.
Imperforated hymen is when the hymen is closed. In puberty, there is no menstrual bleeding, blood accumulates in the vagina and uterus and infection and mass occur.
Vaginal atresia means the absence of the vagina. It is a serious cause of vaginal obstruction. In the absence of the vagina, the external genitalia, ovaries and tubes are usually developed in the form of a normal girl. Therefore, breast development and other sexual characteristics are completely normal girl-like. In these, there is no lack of sexual stimulation and orgasm occurs. However, most of those who do not have a vagina have a low chance of fertility because the uterus is also malformed. There is no menstruation (bleeding) at puberty; blood accumulates in the uterus and infection and mass occur. These individuals cannot have sexual intercourse and give birth to children.
Sexual Development Problem in Children;
The external genital structure is not exactly male or female but has a different genital appearance.
As a result of genetics, some drugs used during pregnancy, and lack or excess of some hormones secreted after birth and puberty is developing.
Gender, genetic structure and hormones played an important role in the development of sexual identity. However, gender; It may not be compatible with the chromosome structure and sexual organs.
The uncertainty of the sex of a newborn baby is not a surgical but a medical and social urgent problem. Because Genital examination of babies should be done in detail from the moment they are born, and suspicious babies should be taken to the doctor early. p>
Is the doctor's experience important?
Correction of genital organs is technically difficult and risky. If the first operation is unsuccessful, the success of subsequent operations will decrease and even irreversible penile injuries may occur. This can cause serious psychosocial, psychosexual, and sexual dysfunction in later life. For this reason, it is very important to perform genital surgeries by experts experienced in pediatric genital anatomy and surgery of these organs. Thus, the chance of success will be higher. In addition, the number of operations, complication rate and complication severity are significantly reduced; Complications can be dealt with correctly and resolved in a healthy way.
In summary, the genital area should be examined, regardless of the complaint. In boys, the scrotum should be evaluated, the testis should be searched, and the penis should be evaluated in erection. In girls, the vulva should be opened and examined, and the clitoris, urethra and vagina should be evaluated.
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