Conversation: The conversation between human and AI assistant.
[|Human|] Hi my name is Annette. I have a 2 year old little boy who is complaining of genital pain. He seems to get some relief when he pees, but at the sametime i see him really pushing to pee. He pushes so hard that the tip of his penis turns blue, then when he stops pushing it goes back to normal. He is not complaining of pain when he pees and he has no redness swelling or even fever. He is playful and acting normal and then all of a sudden he grabs his genitals and says it hurts.
[|AI|]  A careful examination to the tip of penis can exclude metal stenosis which is the presence of small opening of the urethra, which can cause pain among urination or struggling with it.another condition which can cause this is crystalloid which is the presence of crystals in the urinary tract, and once it's inside the urethra it's painful through urination or just after urination, and it causes obstruction to urinary flow .the other common cause of this problem is cystitis which is a lower urinary tract infection .the last two conditions can be excluded by doing a routine urinalysis and 24 hour urine collection for calcium, creatinine, urine acid and oxalate. I hope this helps