Pediatrics, part 75: Reproductive Disorders - Male Reproductive Disorders


Cathy covers a number of male reproductive disorders in pediatric patients, including: cryptorchidism, testicular torsion, epididymitis, varicocele, and phimosis. She explains the pathophysiology, risk factors, signs/symptoms, treatment, complications, and patient teaching for these disorders. At the end of the video, Cathy provides a quiz to test your understanding of key points she made in the video.

  • 00:00 Introduction
  • 00:35 Cryptorchidism
  • 1:30 Testicular Torsion
  • 2:26 Epididymitis
  • 3:37 Varicocele
  • 4:41 Phimosis
  • 6:06 Quiz Time!

Full Transcript: Pediatrics, part 75: Reproductive Disorders - Male Reproductive Disorders

Hi, I'm Cathy with Level Up RN. In this video, I will be covering a variety of male reproductive disorders from our Level Up RN Pediatric Nursing flashcards. This includes cryptorchidism, testicular torsion, epididymitis, a varicocele, as well as phimosis. And then at the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our flashcards, go ahead and pull them out so you can follow along with me.

Cryptorchidism is the absence of one or both testicles from the scrotum. So infants that are born prematurely or with a low birth weight are at higher risk for this condition. In terms of diagnosis, an ultrasound or MRI can be used to confirm the location of the testicle and differentiate cryptorchidism from a retractile testicle, which is one that can move back and forth between the groin and scrotum, or absence of a testicle. Treatment includes surgery to move the testicle into the scrotum. This is called an orchiopexy, and this is typically performed between 6 and 18 months of age. So, of note, cryptorchidism does place the individual at increased risk for infertility as well as testicular cancer.

Let's now talk about testicular torsion. This is where we have twisting of the testicle and the spermatic cord, which causes ischemia and could lead to necrosis or tissue death of the testicle. So risk factors for testicular torsion include a congenital abnormality such as a bell-clapper deformity or some kind of trauma to the area. Signs and symptoms include the abrupt onset of severe unilateral testicular pain as well as swelling, nausea, and vomiting, and inguinal pain. An ultrasound can be used to help diagnose testicular torsion, and treatment includes emergency surgery. So there is a small window, like six hours from the onset of symptoms, where surgery can be performed and the testicle can be salvaged.

Next, we have epididymitis, which is inflammation of the epididymis. And as a reminder, the epididymis is a tubular structure at the back of the testicle where sperm matures. So epididymitis is usually caused by a bacterial infection but may also be the result of trauma as well. Key risk factors include a sexually transmitted infection or a urinary tract infection. Signs and symptoms include the gradual onset of unilateral scrotal pain, as well as swelling, tenderness upon palpation, dysuria, which is painful urination, and discharge from the urethra. Diagnosis of epididymitis includes a urinalysis to check for the presence of bacteria as well as a urethral swab to check for the presence of a sexually transmitted infection. And then an ultrasound may be ordered as well. Treatment includes antibiotics to treat the underlying infection, and then rest, ice, and elevation of the scrotum is recommended as well.

Let's now talk about a varicocele, which is enlargement of the veins in the scrotum due to impaired venous blood flow. So varicocele is the most common cause of low sperm count and decreased sperm motility, which can lead to infertility. So many patients with a varicocele are asymptomatic, but other patients may have signs and symptoms such as a dull ache or feeling of heaviness in the scrotum, and they may also describe their scrotum as feeling like a bag of worms. Diagnosis of a varicocele may include the use of an ultrasound as well as thermal imaging. And then treatment of a varicocele may include analgesics as well as scrotal support to help decrease pain and discomfort if that is present. And then a varicocelectomy is a surgical procedure that removes enlarged veins in order to restore proper blood flow in the scrotum.

And finally, let's talk about phimosis, which is where an uncircumcised individual has excessively tight foreskin that is difficult to retract. So physiological phimosis is an expected finding in babies and young boys. It self-resolves as the child grows, and treatment is typically not necessary. Pathological phimosis, on the other hand, is caused by scarring, inflammation, or infection, and it can cause symptoms such as ballooning of the foreskin during urination, painful urination, as well as skin irritation and bleeding. With physiological phimosis, gentle retraction of the foreskin with bathing and urination can help it become more retractile over time. Treatment of pathological phimosis includes topical corticosteroids as well as circumcision. So as a nurse, it is super important to teach families to never force retraction of the foreskin, which can lead to microtears, infection, as well as paraphimosis. So paraphimosis is where the foreskin becomes stuck behind the head of the penis, which impairs blood flow to the tip of the penis and is a medical emergency.

All right. It's quiz time. And in this particular quiz, I want you to name that reproductive system disorder. You guys ready?

Number one. This disorder may cause the scrotum to feel like a bag of worms.

The answer is varicocele.

Number two. This disorder causes a gradual onset of scrotal pain and is often caused by a sexually transmitted infection.

The answer is epididymitis.

Number three. This disorder is characterized by difficulty with retraction of the foreskin behind the head of the penis.

The answer is phimosis.

Number four. This disorder causes a sudden onset of severe unilateral testicular pain and requires immediate surgical intervention.

The answer is testicular torsion.

Number five. This disorder is a condition where one or both testicles fail to descend into the scrotum.

The answer is cryptorchidism.

All right. That is it for this video. I hope you did great with that quiz, and I hope you found this information to be helpful. Take care, and good luck with studying.


Phimosis is where an [inaudible]. This disorder is a condition where one or both testicles fail to descend. I got all the way to the end of my quiz, and I messed up descend. I could have messed up a lot of different things like cryptorchidism. But nope. I messed up the easiest word in this whole thing.

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