- Most childhood problems settle with age. The usual advice is reassurance and a date to come back.
- Two do not wait. An undescended testis should be fixed by 12 to 18 months. Sudden testis pain is a same-hour emergency.
- Never force a boy's foreskin back. Forcing causes the tightness it is meant to prevent.
Sudden pain in the scrotum, including pain that wakes a boy from sleep, must be seen within the hour — a twisted testis has about six hours. Also go straight away for fever in a baby with no obvious cause, a child not passing urine, or a newborn boy whose stream is only a dribble.
Bedwetting
Wetting the bed is normal in young children. It is not naughtiness and not the child's fault. Punishment makes it worse and slows things down.
- Up to age 5: Normal. No tests, no treatment.
- Age 5 to 7: Common. Reassurance and simple measures are usually enough.
- Age 7 and above: Worth seeing someone, especially if it is most nights.
- At any age: See someone for daytime wetting too, for a child who was dry for six months and started again, for straining or a weak stream, for repeated infections, or for great thirst and very large volumes.
The check starts with a urine test, a diary, and looking for constipation — a full bowel presses on the bladder and is the most commonly missed cause. Treatment starts with drink timing, a toilet routine and treating constipation. An alarm is the most effective long-term option for a motivated child and family. Desmopressin helps for short needs like a school trip. Full guide for parents →
Undescended Testis — Timing Matters
At birth one or both testes may not have come down. Many drop on their own in the first three to six months. After that it is unlikely, and this is where timing counts.
- Surgery should be done by around 12 to 18 months.
- A testis left outside sits at a higher temperature, which affects sperm production later.
- Cancer risk is higher lifelong, and stays somewhat higher even after surgery — which is why it is brought down where it can be examined.
- A retractile testis, which can be coaxed down and stays a moment, is normal. It needs watching, not surgery. Telling the two apart needs examination.
- Both testes missing in a newborn needs checking now, not at the next visit.
Foreskin Questions
One of the commonest reasons parents come, and usually nothing needs doing.
- A foreskin that does not pull back is normal in babies and young children. It separates over years. Most boys manage it by the early teens.
- Never force it. Forcing tears the skin, and the tear heals with a scar. That scar is what later needs surgery.
- White lumps under the foreskin are shed skin, not pus.
- Ballooning while passing urine is common and usually settles. Worth checking if the stream is weak or infections happen.
- Come in for repeated soreness, a white scarred ring, pain passing urine, or infection.
Urine Infection in Children
Treated differently from adults, because it can be the first sign of a problem in the plumbing. In babies the signs are vague — fever with no cause, feeding poorly, irritability, vomiting, or not gaining weight.
- A properly collected sample before antibiotics matters. Bag samples are easily contaminated and often have to be repeated.
- An ultrasound of the kidneys and bladder follows a confirmed infection.
- Reflux: Urine flowing back up towards the kidney — is looked for after repeated infections, or if the scan is abnormal. Many mild cases settle as the child grows. Finding it lets us protect the kidney meanwhile.
- Constipation and holding habits are very common causes, and treating them prevents more infections than repeated antibiotics do.
Most visits end with reassurance and a date to come back. Where timing matters, it matters in months — not years.
Other Reasons to Come
- Hypospadias: The opening on the underside rather than the tip. Assessed in infancy. Do not have a circumcision done first: The foreskin may be needed for the repair.
- Hydrocele in a baby: Common, and usually gone within the first year. Worth checking if it lasts longer, or changes size through the day.
- Swollen kidney seen on a pregnancy scan: Most settle, but a scan after birth and a follow-up plan are arranged.
- A weak stream in a boy: Always significant. Checked, not watched.
- Daytime wetting or holding in a child who was previously dry.
What to Bring
- Immunisation and growth records.
- Any pregnancy scans that mentioned the kidneys.
- All urine reports and cultures, and the antibiotics given.
- Ultrasound or other scan reports.
- For bedwetting, two weeks of dry and wet nights, and a note on bowel habit.
- Whether anyone else in the family had the same as a child — bedwetting and reflux both run in families.
This page provides general information only. It is not a substitute for medical advice, diagnosis or treatment. Consult a qualified urologist for assessment appropriate to your situation.