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"Now that he's 3 we check to see if he's retracted..."  

post #1 of 24
Thread Starter 
I took my ds to a 3yo well child check yesterday. He hadn't been to the doctor since his 2yo well child and I wanted to maintain a relationship with the practitioner. Though I'm not wild about this office, I haven't had a problem with them before and they're totally okay with our family not vaccinating.

At one point the resident says "So, at the 3 yo check up we make sure that his foreskin is retractable."
Me: "Everything I've read says that foreskins retract at different ages and his might not be retractable for years yet and that retracting can cause more harm than good so I'm not comfortable with you touching his penis."
Resident: "That's simply not true. You can gently retract the foreskin to see how far back it will go."
Me: "Why do we need to know this?"
Resident replies something like this: "We need to make sure when he pees he's not ballooning and the pee is getting stuck in his foreskin and going back up his urethra and causing UTIs and causing renal scarring, which is VERY DANGEROUS. We need to make sure everything is okay so he doesn't need a circumcision later."
Me:"I've never noticed any ballooning when he pees. His foreskin never looks infected. He never acts like he's in pain when he pees so I'm sure he's not having UTIs. I don't see any reason to check his foreskin."
Resident: "So, you're refusing to let me exam your son's penis?"
Me: "Yes."

We finish the exam with her. When the MD whose practice we're in comes in she repeats how important it is that they examen his penis. I repeat what I said above. She replies with "You don't have to forcibly retract the foreskin, you can gently retract it. I'm Jewish and I didn't circumcise my son! I went against my religion to not circumcise my son and I still retracted him!" (At this point she's speaking quite loudly)

In the end, I still refused this part of the exam (they wrote this boldly on my son's records). And I left the office feeling really bad about the whole experience.

So, I would love some reassurance that they are off their rocker and there is no need to gently retract my 3yo son's foreskin, especially if he is having absolutely no issues with it.


Weirdly enough, I met up at a park afterwards with some people I knew and was ranting about my experience. One woman asked who my pediatrician was and when I told her she said they used the same doctor and they'd just been there for her son's 4yo exam last month and they office had said NOTHING about retraction. In fact, she can't remember them saying anything about retraction to her even though her 4yo and 6yo son (intact) sons have been going to that office for a few years.
post #2 of 24
Good for you mama. You did the right thing, and I'm proud of you!!
post #3 of 24
You are the one thats correct, not the doctor!

And isnt ballooning a sign that retraction is happening? I thought ballooning wasnt a bad thing?
post #4 of 24
Quote:
Originally Posted by Momalea View Post
So, I would love some reassurance that they are off their rocker and there is no need to gently retract my 3yo son's foreskin, especially if he is having absolutely no issues with it.

You did an amazing job.

Not only is ballooning a NORMAL part of foreskin development (something that not all, but many boys go through) but the average age of retraction in boys is around 12 years old. Yet I know for a fact that some boys dont start retracting till as late as high school age.

So it makes no sense to check at a specific age for retraction, because it does not happen at any specific age for everyone.

Also just think logically here. These doctors are saying the reason they need to check is because of a fear that the urine will go back up in the urethra because the foreskin wont let the pee out. Beyond it being VERY obvious if this ever happened, why is this suddenly a problem at 3? Why is at 2 years its not a problem?

Dont worry about it, use your logic, gain some more info and use that the next time you see that doctor, so she/he will be better informed themselves. Or just find a new doctor.
post #5 of 24
WTG!!!! you did awesome! Could you print out a pamphlet for this doctor?

Quote:
Originally Posted by AGierald View Post
You are the one thats correct, not the doctor!

And isnt ballooning a sign that retraction is happening? I thought ballooning wasnt a bad thing?
you are correct.
post #6 of 24
YEAH MOMMA!!! You did great, and you managed to keep your intelligence about you!! I get flustered and forget all my 'brains'!!!

GREAT JOB!!!
post #7 of 24
Bravo for holding your ground. Please send them a polite letter (I say polite so that they might actually read it and listen) thanking them for their openness to learning more about foreskin care, and include the AAP "care of the uncircumcised penis" which says nothing about age 3, and re-iterate that you want it clearly marked in his chart that unless your son is specifically complaining of a problem, there is no reason for his foreskin to be touched, and it would risk causing harm. I can e-mail the guidelines to you if you don't have a copy, just pm me.
post #8 of 24
Good for you for not backing down!! Maybe the doctor was having an off day, here reaction seems odd. But YAY, for her for keeping her own son intact but boo on her for retracting him.

Ballooning is normal, not retracting at 3 is normal, no need to check for retraction ect basically what everyone else already said.
post #9 of 24
That is such a load of BS about the urine backing up into the penis if the boy isnt retractable. Ballooning is normal and not a cause for any concern at all it is actually a normal part of the seperation process though not every boy experiances it.

This is why I try to remind parents that just because a Dr. has never touched their ds penis before they may start trying to do so when he reaches a certain age. You must always be on your guard.
post #10 of 24
Brave. You are correct and they were just plain wrong. There is no evidence that ballooning causes backup and renal damage. This is just plain ridiculous. I expect the doc is well-intentioned but mis-informed. Either that or she just felt she had to back up her PA. While gentle retraction without tearing probably is harmless, it is entirely unnecessary in an infant. You can have the boy pull back as far as it can go comfortably and rinse underneath beginning when he is four or so. While this is probably completely unnecessary, it does get him into the habit of rinsing, which he will carry into adulthood. The boy is the only one who should be retracting his foreskin.
post #11 of 24
AWESOME job momma!!!!!

That makes me laugh what they said about ballooning. My son balloons every single day of his life and is yet to have a single UTI. Ballooning is totally NORMAL and is a sign that the skin is beginning to separate from the glands. Even the AAP has a document that explains how ballooning is a normal phase. You might want to print off something and mail it to them. It can never hurt to educate doctors about this stuff!

You were awesome and you have nothing to worry about. Only 50% of boys are retractable by age 10. It is completely normal to not become retractable until after puberty.
post #12 of 24
Quote:
Originally Posted by Dave2GA View Post
While gentle retraction without tearing probably is harmless, it is entirely unnecessary in an infant.
Actually it can be quite harmful. I speak from first hand experience. My son experienced premature separation from a ped that tried to gently retract. It was very painful for him.
post #13 of 24
You did the right thing by not consenting to something you are uncomfortable with, period.

Good for you.
post #14 of 24
Here's an article debunking the ballooning b.s. which you could provide her.

http://www.cirp.org/library/normal/babu1/

Gillian
post #15 of 24
Yay, mama! You did great! :

For what it's worth, my son is nearly 11 and when I asked him a month ago, he told me he isn't retracting yet. No biggie. It happens when it happens.
post #16 of 24
Thread Starter 
Wow, thanks for all the support mamas! I am feeling very validated in my choice. I also wanted to say that most of what I know about foreskin care (and not retracting) I learned here on mdc.

I'm thinking of what I want to do next. A polite letter with some printed information, probably. I'm considering if I ever want to return to that practice. Not just because of their views on retraction but because of the way they tried to use fear to influence my medical decision.

I'll do some more reading/printing out guidelines so I have more ammunition when I do go to the next appointment, wherever that may be.
post #17 of 24
Quote:
Originally Posted by Momalea View Post
Wow, thanks for all the support mamas! I am feeling very validated in my choice. I also wanted to say that most of what I know about foreskin care (and not retracting) I learned here on mdc.

I'm thinking of what I want to do next. A polite letter with some printed information, probably. I'm considering if I ever want to return to that practice. Not just because of their views on retraction but because of the way they tried to use fear to influence my medical decision.

I'll do some more reading/printing out guidelines so I have more ammunition when I do go to the next appointment, wherever that may be.
You're awesome Momalea! You have an incredibly strong backbone!
post #18 of 24
Quote:
Originally Posted by Momalea View Post
I'm thinking of what I want to do next. A polite letter with some printed information, probably. I'm considering if I ever want to return to that practice. Not just because of their views on retraction but because of the way they tried to use fear to influence my medical decision.
I think this is an important point. Bullying you and telling you falsehoods to make you afraid and go along is not professional. It would certainly give me pause. I would question how much I could trust their advice in a more dangerous and complicated situation.

If they were being professional they would have allowed for your information and recognized that they needed to do some research to find out what was accepted by their own profession.

Not saying you should leave them....but from now on you should at least recognize that they are not always giving you unbiased or accurate information and that you may need a second opinion.

Regards
post #19 of 24
I will always think there's some sick, underlying obsession with exposing the the glans of an infant/child with regards to retraction and/or circ in general. Even if a child can retract at that age, just what is it they feel the need to "check" for??!! There's a well protected glans there; big deal it's normal. It doesn't mysteriously disappear on an intact boy just because it hasn't been exposed. I just don't get it!!!! :
post #20 of 24
Thread Starter 
Quote:
Originally Posted by Greg B View Post
I think this is an important point. Bullying you and telling you falsehoods to make you afraid and go along is not professional. It would certainly give me pause. I would question how much I could trust their advice in a more dangerous and complicated situation.

If they were being professional they would have allowed for your information and recognized that they needed to do some research to find out what was accepted by their own profession.

Not saying you should leave them....but from now on you should at least recognize that they are not always giving you unbiased or accurate information and that you may need a second opinion.

Regards
Exactly. I felt pretty confident about this issue, but what happens when some medical issue comes up that I'm not educated on? I think I'll always be second guessing what they say. And do I want to work with a practitioner who uses fear to try to convince me to do something I've expressed concern about? No.

Time to find a new office. I will still send them information on retraction, though. It can't hurt and it might help.
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