As a father or mother, you want to have a healthy child, but have you ever paid attention to your child’s external genitalia? Some parents may say, “My child is still young and I should wait until puberty to consider reproductive issues. In fact, this is a wrong view. Many diseases of the external genitalia need to be treated at a very young age, otherwise they will affect the child’s life. Some boys are even raised as girls. Here I introduce several common pediatric genitourinary diseases: Abnormal penile appearance: Many parents of children with this problem are concerned about the question: Is it normal to have a boy with a small penis at home? Does it need to be treated. Under normal circumstances, children are born with a prepuce (or prepuce), which can be left untreated if there is no infection or narrowing of the urethra within 3 years of age. After the age of 3 or if there is a circumcision with prepuce formation, a circumcision adhesion separation should be performed. It is also necessary to identify whether the circumcision is too long, prepuce, prepuce adhesion, prepuce formation (manifested as swelling of the penis head), occult penis (manifested as small penis shape), etc. The need for circumcision should be decided according to the specific situation. It is not possible to make a generalization. Cryptorchidism: It refers to the failure of the testicles to descend to the scrotum from the lumbar area behind the peritoneum in accordance with the normal development process, also known as incomplete descent of the testicles. In layman’s terms, this means that the testicles cannot be felt in the scrotum of a boy after birth. The scrotum is clinically empty and the testicles cannot be palpated. The scrotum on the affected side is often poorly developed, either unilaterally or bilaterally. The diagnosis is easy. However, many parents of children, including some non-pediatric surgeons, do not have a proper understanding of when to take treatment and wait until the child is preschool age or even older before treating the condition. The latest scientific research confirms that the testes that do not descend to the scrotum are developmentally restricted and that the varicocele, which is closely related to reproduction, will degenerate because the temperature in the groin or abdominal cavity is higher than that in the scrotum, and that this change is reversible until the age of two years, but that the damage will gradually increase and become irreversible beyond that age. Therefore, the latest opinion is that the testes should be introduced into the scrotum within two years of age to ensure further testicular development and subsequent fertility. In addition, for those who are now older and the testicle has not been introduced into the scrotum, surgery should be performed as soon as possible, because prolonged failure to lower the testicle into the scrotum may cause testicular malignancy and affect the opposite testicle due to an immune reaction. Hormone therapy (i.e., HCG injection) can be tried in children under one year of age, but surgery should be performed if hormone therapy is ineffective or if the patient is older than one year. Hypospadias: It is a disorder of embryonic development in which the urethral groove is not completely fused to the distal glans and the urethral orifice is located anywhere between the coronal sulcus and the perineum, accompanied by a hypospadias deformity. The incidence of this disease is 1 in every 500 male births. According to the location of the urethral orifice, it can be divided into coronal groove type, penile body type, penile scrotum type, perineum type and so on. Typically, the urethral orifice does not open at the glans, the penis is recurved, the foreskin is piled up on the dorsal side of the penis, and sometimes there is a combination of scrotal inversion and bilateral cryptorchidism. For severe perineal hypospadias combined with bilateral cryptorchidism, the perineum looks like a girl and is often raised as a girl. There are more than 200 kinds of surgical methods for this disease at home and abroad, which means that there is no uniform method for the treatment of this disease. In our opinion, the surgical procedure should be chosen according to the patient’s specific situation, and the surgeon’s surgical skills should also be taken into account, as not everyone can perform hypospadias surgery by non-pediatric surgeons and urologists, because a failed first surgery will result in many complications and make future treatment difficult. All parents have to do is to visit a pediatric surgery specialist as soon as possible. It is currently believed that the timing of surgery for hypospadias should be completed between 8 months and 2 years of age, that is, before the child is able to understand. This is because the psychological burden of the disease increases as the child grows older. The ideal surgery should achieve an opening of the external urethra to the glans (i.e., an orthodontic opening), full extension of the penis, no urethral stricture or urinary leakage, and a near-normal penile shape. Our department is currently using advanced surgical techniques from the United States (Duckett and Snodgrass methods), which greatly improves the success rate of one-stage completion of surgery and reduces the pain of staged surgery and the burden of sub-operations on the child. Hermaphroditism: This is a condition in which the external genitalia are not male or female. It is divided into true hermaphroditism and pseudohermaphroditism. Changing gender after 18 months of age can have serious psychosocial consequences and should be done as soon as possible after birth to determine the appropriate gender. The sex should be determined according to the anatomy and function of the infant’s sexual organs and gonads, not the karyotype or the ability to bear children. The above-mentioned diseases are common diseases of the pediatric urinary system, and improper treatment will affect the “sexual” well-being of the child for life. Only correct diagnosis and treatment can return a healthy external genitalia and a lifetime of happiness to the affected child.