Jodi K. Maranchie, M.D. Craig A. Peters, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

A two year-old boy presented with a two week history of dysuria. His parents reported that he cried inconsolably every time he urinated in his diaper and that the pain awakened him from sleep. They denied any fever, hematuria or history of urinary tract infection. The child had received a course of antibiotics without improvement.

PMH:

1. Former 27 week gestation triplet.
2. History of hyaline membrane disease s/p 10 weeks in NICU.
3. History of chordee release without urethraplasty at one year.

Medications: None

Physical Examination:

1. Abdomen soft and flat. No costo-vertebral angle tenderness.
2. Well healed chordee release scar.
3. Hard nodule at penoscrotal junction.

Urinalysis: microhematuria

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30 Minutes