Higuchi Ty, Holmdahl Gundela, Kaefer Martin, Koyle Martin, Wood Hadley, Woodhouse Christopher, Wood Dan
University of Colorado, Aurora, CO.
Department of Pediatric Surgery/Urology, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
Urology. 2016 Aug;94:288-310. doi: 10.1016/j.urology.2016.03.019. Epub 2016 Mar 22.
To provide a comprehensive overview of genital anomalies encountered among adolescents, including late effects of problems addressed earlier in childhood.
The major congenital genital anomalies encountered in pediatric urology were identified. They include hypospadias, exstrophy-epispadias, cloacal malformations, disorders of sexual development, undescended testes, and some acquired penile anomalies seen in adolescence (priapism, adolescent varicocele). Recommendations of the International Consultation on Urological Diseases are provided on various aspects of these conditions, such as postpubertal cosmesis and function, fertility implications, and long-term nephrological considerations (when relevant).
Specific recommendations for care, including strength of clinical recommendation, are provided in this paper. Whereas the basis of this paper is to discuss specific management recommendations as they relate to several heterogeneous conditions, general recommendations include patient-centered discussions regarding operative treatment be deferred until the patient is able to articulate goals and participate in shared decision-making and utilization of multidisciplinary teams for conditions where multiple organ systems may be involved.
Congenital abnormalities of the genitalia are common and widely heterogeneous. Late effects and concerns often emerge after puberty, and patients should be followed throughout their adult lives to address such concerns.
全面概述青少年中遇到的生殖器异常情况，包括儿童早期所处理问题的后期影响。
确定小儿泌尿外科中遇到的主要先天性生殖器异常。它们包括尿道下裂、膀胱外翻-尿道上裂、泄殖腔畸形、性发育障碍、隐睾以及青春期出现的一些后天性阴茎异常（阴茎异常勃起、青少年精索静脉曲张）。针对这些病症的各个方面，如青春期后的美容和功能、对生育的影响以及长期肾脏方面的考虑（如相关），提供了国际泌尿疾病咨询会的建议。
本文提供了具体的护理建议，包括临床建议的力度。虽然本文的基础是讨论与几种不同病症相关的具体管理建议，但一般建议包括以患者为中心的讨论，即手术治疗应推迟到患者能够明确目标并参与共同决策，以及对于可能涉及多个器官系统的病症，利用多学科团队。
生殖器先天性异常很常见且种类繁多。后期影响和问题往往在青春期后出现，应对患者进行终身随访以解决此类问题。
