General evaluation of the genitals and anus of a newborn baby

When observing a newborn baby clinically, it is very important to assess the child’s general appearance, such as posture, behavior, head, eyes, nose, mouth, neck , the child’s ears, chest and abdomen. However, it should be noted that the evaluation of the genitals and the anus is just as important. How can this be done and what possible functions should be considered?

Female genitalia
Usually the labia minora and clitoris are edematous, especially after childbirth. However, the labia and clitoris should be carefully examined to identify evidence of ambiguous genitalia. Usually, in a woman, the urethral opening is behind the clitoris. Any deviation from this may indicate that the clitoris is incorrectly identified as a small penis that can occur in conditions such as adrenal hyperplasia.

A hymenal day is usually visible from the back opening of the vagina. It consists of tissue from the hymen and the labia minora. It usually goes away after a few weeks. Usually, the vaginal vault is not inspected. However, the absence of the Hymenal tag may indicate vaginal agenesis. In this case, further investigation would be necessary.

Vaginal discharge may be noticed during the first week of life. This pseudo-menstrual period is a manifestation of the sudden decrease in maternal hormones and usually goes away after 2 to 4 weeks. Discharge of stool from the vaginal opening indicates a rectovaginal fistula and is always reported. Vernix caseosa can be present in large amounts between the lips.

Male genital
The penis is examined for the position of the urethral opening, which is at the tip. However, the opening can be completely covered by the foreskin or the foreskin. that covers the glans. A tight foreskin is a very common finding in newborns smegma, a cheesy white substance that often occurs around the glans. under the foreskin. An erection is not uncommon in newborns. Small, white, firm lesions, called epithelial beads, can be seen as the tip of the foreskin.

The scrotum may be large, edematous, and sagging in full-time newborns, especially in babies born in a closed position. It is more pigmented in dark skinned breeds. A non-communicating hydrocele usually occurs unilaterally and resolves within a few months. The tests should always be taken from the scrotum. In small newborns, especially premature babies, the testes may be palpable in the groin. The absence of testes can also be a sign of ambiguous genitals, especially in addition to the presence of a small scrotum and a penis. Inguinal hernias may or may not manifest immediately after birth. The examination makes it easier to identify a hernia when the child is crying.

Back and anus
When the child is lying down, the spine is examined. The shape of the spine should be slightly rounded, without any of the characteristic S-shaped curves visible later in life. The openings or abnormal dimensions are noted. A large sac protruding somewhere along the spine, but more often in the sacral area, indicates a type of spina bifida. A small sinus that may or may not be connected to the spine is a pilonidal sinus. It is often covered with a tuft of hair. Although it has no pathological significance, it may indicate the existence of spina bifida occulta or be a gateway into the spine. If the child is still vulnerable, the symmetry of the gluteal folds is carefully determined. Asymmetry is reported and tests for congenital hip dislocation are performed.

Passage of zirconium during the first 24 to 48 hours of life indicates anal potency. If an unperformed anus is suspected, a rectal thermometer or rubber catheter should be inserted into the anal opening. If a thermometer is used, care should be taken to avoid perforation of the mucous membrane. If the child is still prone, the buttocks should be carefully detached to examine the anal area for cracks or small tears in the mucous membrane. Anal fissures are a common cause of constipation because the child does not strain during bowel movements to avoid pain. An asymmetry of the mucous folds around the sphincter also indicates cracks.

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