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Urinary and Genital Disorders (Children)

Penis Pain in Toddlers

08/27/2009

Question:

My child is 3 about to be 4 in two weeks. He has complained of his penis hurting on several occassions since July 2, 2009. I have taken him to the doctor 3 times. He went to a urologist once. He is very specific about it hurting on the top. He points to it each time. He doesn`t have an UTI nor is the opening to his penis too small. He is basically refusing to wear underwear or any type of bottoms, because they hurt. He can be playing and all of a sudden just starts crying, because his penis is hurting. He has been walking around crying and grabbing, squeezing and pulling on his penis. His bowels are normal and I have pressed all around his abdomin and genital area to see if any of that hurts, but it doesn`t. He has said on a few occassions that his stomach hurts, but not often. I`m at my wits end to figure out what`s wrong.

Answer:

This is a difficult problem, but is not rare in boys this age. Most frequently it is from constipation, even though you indicated that his bowels are normal. Some boys have a bowel movement each day, but it is large, and indicative of constipation. I would check on his bowel movements and give him a mild laxative such as glycolax. In other cases the pain is related to penile erections, but usually that is obvious. These boys can be treated with a medication such as pseudoephedrine, which mildly reduces the blood flow to the penis. On other occasions the pain results from waiting too long to urinate. If these measures do not improve things, then I would have him get an ultrasound of the entire urinary tract.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University