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Thursday, July 24, 2014
Urinary and Genital Disorders (Children)
5 year old boy uncirc. one UTI, urgency
My son is 5 years old, was diagnosed with UTI 1 month ago- treated. Symptoms only involved abdominal pain. These abated but not competely and now have returned with increased urinary frequency and urgency along with erections. When he tries to urinate he complains of frustration with this saying his penis is "fat". He is supposed to have some type of test next week. Any comments are appreciated. He is not circumcised and bowel movements are soft and regular.
If he is uncircumcised and the foreskin does not retract (a term called phimosis) then urine may become trapped under the foreskin and predispose him to infection. One sign of this phenomenon is ballooning of the foreskin during voiding. The condition is treatable with topical corticosteroids to the tip of the foreskin.
The other symptoms are difficult to interpret. It sounds like he should have a renal sonogram. Depending on the result, more invasive testing such as a voiding cystourethrogram may be indicated also. There is a slight chance that he could be having trouble urinating because of a urethral stricture.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University