A 1-Day-Old Boy Is Undergoing Routine Evaluation in the Nursery

question 603

Multiple Choice

A 1-day-old boy is undergoing routine evaluation in the nursery.  He was born via vaginal delivery to a primigravida at 38 weeks gestation.  The mother took a daily prenatal vitamin and had routine prenatal care.  Pregnancy was complicated by gestational diabetes, which was controlled by diet.  Labor and delivery were unremarkable.  Birth weight was 3.7 kg (8 lb 2 oz) .  The boy is awake and alert with normal tone and a strong sucking reflex.  The lungs are clear to auscultation, and the heart has a normal rate and rhythm without murmurs.  The abdomen is soft, nontender, and nondistended.  The penis is uncircumcised, and the urethral meatus is visualized at the tip of the glans.  The scrotum is significantly swollen with no discoloration.  Both testicles are palpated within the scrotal sac.  A light shone behind the scrotum transilluminates the swelling.  Which of the following is the most appropriate next step in management of this patient?

• A)Aspiration of fluid
• B)Genetics consultation
• C)Reassurance and observation
• D)Scrotal ultrasound
• E)Surgical intervention