1. Penile Pain Test usually not necessary Treat constipation Explain erections Schedule Follow up But Mom usually is pretty nerved by situation and wants a quick fix

2. …So how do you deal with the parents frustration… Listen to their concern Explain anatomy Explain literature and past experience Understand their frustration Give alternatives Ensure that child will be fine and that you will be available Answer all questions, stay calm and don’t leave the room until they understand

3. Goal !!!! Prevent unnecessary operations Parents and children are happy

4. Priapism Sickle cell disease –Initiate protocol –Teamwork with Hematology –Start with O2 and hydration –Aspiration if necessary –Transfusion if necessary Urinary Retention and Constipation –Rare –Drainage –Enema –Follow up

5. Hypospadias Incomplete development of anterior urethra Dorsal foreskin hood Ventral Chordee No emergency Does not hurt No dysuria No urinary retention Surgical correction after 7-8 month of age

6. Hypospadias Distal Hypospadias Penoscrotal Hypospadias