Screening for Genitourinary Abnormalities in Adolescent Males

Objectives

After completing this article, readers should be able to:

1. Describe the importance of screening for genitourinary problems in adolescent boys.

2. Delineate the essential components of screening urology in adolescent boys.

3. Explain when and how to perform sexually transmitted infection testing in adolescent boys.

4. Counsel adolescent boys on sexuality-related issues.

Introduction

Pediatricians and other pediatric clinicians are in an ideal position to screen for genitourinary problems in adolescent boys. Much information can be gathered by screening for sexuality-related issues and by investigating specific genitourinary symptoms as they occur. Routine inspection of the genitalia should be considered an essential component of the regular examination for adolescent boys. This article reviews important asymptomatic genitourinary conditions in young men that can be detected in the pediatric office.

Taking the History

The routine history for adolescent boys should address reproductive health-care issues, including questions about the dramatic physical changes, intense emotional feelings, and sexual experiences that occur during puberty as well as any specific genitourinary complaints. These and other sensitive issues should be discussed privately with the clinician, unless the patient specifically requests otherwise. Most parents understand the importance of their adolescent having time alone with the examiner and respect his need for privacy. In certain circumstances and in accordance with state laws (see Guttmacher Institute, www.guttmacher.org), confidentiality and treatment of minors younger than 18 years of age may be permitted without parental or legal guardian consent, although open communication always should be encouraged. For an in-depth discussion on confidential health care for adolescents, the reader is referred to the position paper published by The Society for Adolescent Medicine cited in the Suggested Reading list.

Clinicians can screen quickly for reproductive health care issues in adolescent boys by asking “trigger” questions (Table 1). General questions regarding pubertal changes are a useful lead into a more detailed sexual history. To …