Tanner Stage 1

Sexual maturity rating 1

Testes: volume <1.5ml

No pubic hair present

Penis:unchanged from early childhood

Tanner Stage 2

Sexual Maturity Rating 2

• Peroid of incresed testicular volum and growth fo pubic hair
• Scrotum:enlarged, reddened, skin taut and thinner
• Testes: enlarges, volum 1.6-6ml
• Penis: unchanged from Tanner stage 1 or slightly larger
• Small amount of light, downy hair along base of scrotum

Tanner Stage 3

Sexual Maturity Rating 3

• Testes and scrotum further enlarges
• Testes:volume 6-12 ml
• Penis: increased length and circumference
• Moderate amount of curly, pigmented corase pubic hair extending laterally over symphysis pubis
• Voice changes occur, body odor appears

Tanner Stage 4

Sexual Maturity Rating 4

Glans penis has become borader and larger

Scrotum: futher enlarged and darker

Testes: volume 12-20 ml

Penis: Incresed length and circumference

Abundant pubic hair

Tanner Stage 5

Sexual Maturity rating 5

Pubic hair extends to medial surface of thighs

Pensi and scrotum adult size

Testes:volume >20ml

1. Hypospadias
2. Epispadias

1. Abnormal placement of the urethral meatus on teh ventral (underside) surface of the penis, or the meatus on the dorsal side
2. abnormal placemnent of the urethral meatus on teh dorsal side

• Associated with fibrotic chordee and bladder anaomalies

• Delayed separation of the prepuce, or foreskin, fromt eh glans penis and may be the result of an incomplete retraction of foreskin persisting after 5 years of age or the result of chronic inflammation causing a secondary phimosis.
• Requires referral if medical therapy not successful

Paraphimosis

• The inability to retract foreskin of the head of the penis, occurs int eh uncircumcised child or adolescent, and can cause extreme congestion of blood flow to glans penis.
• Medical therapy requires compression aroudn the shaft o the penis to reduce swelling followed by reduction of the foreskin by manual downward pressure of the foreskin over the glans penis.

Cremasteric reflex

• Retraction of the testes that can can be activated by cold, emotion, or touch.
• Trapping the testes int eh scrotal sac before attemptiong palpation

Cryptorchidism

Hydrocele

Testicular torison

Swelling and tenderness fo teh scrotal sac, is a twisting of the testis and spermatic cord taht results in veonous obstruction,edema, and organ compromise, which causes testicular infarction.

Accompained by acute pain and an absent cremasteric reflex.

The Prehn sign, decreased pain with elevation of the scrotum is negative in a child or adolescent presenting with testicular torsion.

Balanoposthitis

Epididymitis

Epispadias

Abnormal placment of urethral meatus on dorsal (top) surface of penis

Meatal Stenosis

Paraphimosis

urethritis