Differential Diagnosis for Pain and Type of Penis, Pain with Urination in Toddler
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is a common cause of pain with urination in toddlers, and given the age group, it's plausible that the pain is referred or associated with the genital area due to the proximity and the child's limited ability to localize pain accurately.
Other Likely Diagnoses
- Phimosis: In toddlers, especially those who are uncircumcised, phimosis (a condition where the foreskin cannot be fully retracted over the glans penis) can cause pain, especially during urination if it leads to urinary retention or difficulty urinating.
- Balanitis: An inflammation of the glans penis, which can be caused by infection or irritation, leading to pain and discomfort, potentially worsening with urination.
- Urethral Stricture or Meatal Stenosis: Although less common, these conditions can cause obstructive symptoms and pain during urination.
Do Not Miss Diagnoses
- Testicular Torsion: Although this condition typically presents with acute testicular pain and swelling, it's a surgical emergency. If missed, it can lead to loss of the testicle. The pain can sometimes be referred or difficult for a toddler to localize.
- Epididymitis: Inflammation of the epididymis, which can cause severe pain and is a significant condition that requires prompt treatment to prevent complications.
- Appendicitis: While less common in this presentation, appendicitis can sometimes cause pain that is perceived in the genital area, especially if the appendix is retrocecal. It's a surgical emergency.
Rare Diagnoses
- Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can cause renal involvement leading to urinary symptoms, including pain with urination, along with the characteristic purpuric rash.
- Interstitial Cystitis/Painful Bladder Syndrome: A condition characterized by chronic pain perceived to be from the bladder, often accompanied by at least one other urinary symptom like pain with urination, but it's rare in toddlers.
- Genitourinary Trauma: Accidental or non-accidental injury to the genital or urinary tract area can cause pain and difficulty with urination, though this would typically be associated with a clear history of trauma.