Help - Need referral in Massachusetts

[familyguy5]

Help!!

I am in desperate need of your help. My son was diagnosed with Balanitis this morning, and his pediatrician is referring us to a Urologist to discuss our options, including their recommendation of circumcision. My wife has been in a state of panic due to what the Pediatrician is telling her could happen, fear is the ultimate motivator. I am in desperate need of a pediatric urologist in the Boston area that is familiar with intact children and knows how to treat a simple infection and/or irritation.

Please help if you can, or if possible refer me to someone that can.

thanks,

g

[latinalonestar]

Originally Posted by familyguy5

Help!!

I am in desperate need of your help. My son was diagnosed with Balanitis this morning, and his pediatrician is referring us to a Urologist to discuss our options, including their recommendation of circumcision. My wife has been in a state of panic due to what the Pediatrician is telling her could happen, fear is the ultimate motivator. I am in desperate need of a pediatric urologist in the Boston area that is familiar with intact children and knows how to treat a simple infection and/or irritation.

Please help if you can, or if possible refer me to someone that can.

thanks,

g

No need to fret here. Circumcision is not the answer! This doctor def. doesn't have a clue about intact boys. Let me get some links for you and I will be back.

[latinalonestar]

1. Did your pedi do a culture to determine whether bacteria or yeast is present? This is done by simply swabbing the tip of the foreskin.
2. Did your pedi try to retract. You should read the stickies above b/c no one should ever try to retract your son. Retraction is a HUGE no, no.
3. Can you describe the symptoms to us?

Here are some links you need to read:

http://www.mothering.com/articles/ne...uncircson.html

http://www.nocirc.org/publish/pamphlet7.html

if bacteria is present and there is significant swelling then an oral suspension of antibiotics and an antibiotic cream and a steroidal cream is all that is needed. A urologist is certainly NOT needed. You've just run into a doc that doesn't have a clue about the intact boy. Let me look to see if there is a foreskin-wise pedi in your area...

[familyguy5]

Thanks for the help. I was not at the appointment today, but we have a follow-up tomorrow with the pediatrician tomorrow that I will not miss. I asked my wife this morning whether they did a culture, and she said that they could not since there was no discharge. My wife knows to remind the Dr not to retract. I plan to bring a print out of the Dr Fleiss article with me to hand to the doctor, but I know that the urologist will simply state that circumcision will cure everything and likely prevent any future problems like acne and heartbreak ...

My 5 year old son mentioned that his penis hurt last night. When I looked at it, I could see that the glans was swelled a bit, maybe 25% larger than normal. There was also some redness on the outside of the foreskin where I could see the veins/Arteries (I always forget which are which). His skin does not retract at all yet, so the tip of the foreskin is closed over tight.

I knew that I should have found a more appropriate pediatrician last year when we were told that our other son's foreskin should be completely retractable by the age of 6 or 7, and if not, a circumcision is in order, like it is the equivalent of getting a vaccine. Unfortunately I never followed through with a new Dr, and now my wife is only interested in hearing the opinion from a trained doctor. There is not much that I can say to put her mind at ease.

[latinalonestar]

Important thread to read:
http://www.mothering.com/discussions...d.php?t=764732

Okay, now I know this doctor is a real lemon (don't mean to offend). A culture can be done with/without any discharge. Bacteria doesn't need discharge to be present, especially since discharge could be trapped due to the swelling. If there is any type of infection a swab to the tip of the foreskin will reveal it. The fact that she didn't do one is absurd.

The penis is very vascular so sometimes and irritation can cause an alarming amount of swelling and/pain. (much like when you get a sore in your mouth)

My advice is to give him a nice warm bath, 1/8 cup baking soda can be added to soothe the glands. This could simply be some separation discomfort as some of the areas may have come loose. If he has any discomfort during urination, he can pee in a cup of water. This will take the sting off if the urine is touching his glands.

My son's foreskin separated at once and there was quite a bit of swelling initially. Remember that a foreskin can become separated but not yet retractable b/c the opening has not widened. The opening will widen with the increased hormones of puberty.

Please keep checking back, give our old timers a chance to see this.

[familyguy5]

Thanks again. I am not really concerned about my son, and I plan to have a long discussion with the doctor tomorrow about her lack of knowledge. My real problem is that my wife needs to be reassured by a medical professional. She keeps telling me that the doctors are the experts and no matter what I say she will not be convinced.

[latinalonestar]

Originally Posted by familyguy5

Thanks again. I am not really concerned about my son, and I plan to have a long discussion with the doctor tomorrow about her lack of knowledge. My real problem is that my wife needs to be reassured by a medical professional. She keeps telling me that the doctors are the experts and no matter what I say she will not be convinced.

Tell your wife that she will be hard pressed to find a doctor here in the states that is an expert on foreskin. They don't even teach the normal development of the foreskin in med schools! NO JOKE! In order to become educated a doctor would have to take it upon him/herself to learn about the foreskin. Most of us here have done a considerable amount of research about the intact boy. We know more about this than probably 95% of doctors.

If you contact DOC (doctors opposing circumcision) the will be happy to send this doctor a packet of information! www.doctorsopposingcircumcision.org

[NaturalMindedMomma]

At any rate, go to the follow up, give the DR H-E double hockey sticks and the get a new PEDI. I wish I had the name of a specialist who is intact friendly but I feel bad for you.

[Nate'sMama]

I have a friend who was sent by a pedi to a urologist after scaring them with circumcision for their 8yo. Urologist told them to go away He's in Waltham.
I will get you the name...

[latinalonestar]

Also take that pamphlet: Avoiding Circumcision after the Neonatal Period. Tell her that unless her patient has gangrene, frostbite, malignancy or a serious trauma (disfiguring accident) then she should not be recommending a circumcision for ANY reason.

And print out the info from the thread about separation too...

[Fellow Traveler]

Originally Posted by familyguy5

Thanks again. I am not really concerned about my son, and I plan to have a long discussion with the doctor tomorrow about her lack of knowledge. My real problem is that my wife needs to be reassured by a medical professional. She keeps telling me that the doctors are the experts and no matter what I say she will not be convinced.

Ah, you said your son isn't retractable yet, this could be a separation thing. Read the link provided by LatinaLonestar http://www.mothering.com/discussions...d.php?t=764732

How long has this been going on?

[Night_Nurse]

Originally Posted by familyguy5

... She keeps telling me that the doctors are the experts and no matter what I say she will not be convinced.

Just please gently remind her that yes, while doctor's are "experts" and are very educated, many US doctors have not been trained on proper care and function of the foreskin. Also please remind her that doctors aren't infallible and they all make profit on diagnosing problems and performing surgeries (I've yet to find a doctor who thinks circumcisions are such a great thing for boys that he or she will perform them for free). So while there is nothing wrong at all with getting a second (or third) medical opinion, just keep in mind that it's only an "opinion", albeit one of someone with a medical degree.
I'm just a big skeptic of surgery for minor difficulties, especially since I've seen surgeries, including circumcisions, gone very wrong.

[Greg B]

You mihgt try showing her this, written by doctors:

http://www.doctorsopposingcircumcisi...tatement0.html

That site may also have other good information more specific to your situation, but the Genital Integrity Statement covers it as well.

Best wishes

[familyguy5]

I really appreciate all of your responses. One thing that I just thought of is that the Dr prescribed an antibiotic without doing any cultures. If there is no bacterial infection, will this cause any problems, or possibly make matters worse?

thanks again,

greg

[Fellow Traveler]

Originally Posted by familyguy5

I really appreciate all of your responses. One thing that I just thought of is that the Dr prescribed an antibiotic without doing any cultures. If there is no bacterial infection, will this cause any problems, or possibly make matters worse?

thanks again,

greg

Well there is both good and bad bacteria and I think that if you use an antibiotic without need, you risk a yeast infection. Perhaps someone can verify that concern.

[Frankly Speaking]

FamilyGuy, there is some very good information here and not a whole lot I can add.

Balanitis is simply a catch all term for infection. It is like saying "He has an infection." Of course, you already suspected that. I sometimes suspect doctors use these terms to confuse parents or impress them with their use of big words or maybe even scare them.

These infections may be any one of dozens and until the doctor knows which specific one is the cause, he can't reliably treat the infection. A culture will positively identify the specific bacteria or fungal (yeast) that is causing the problem. There does not need to be any visible discharge to collect samples for a culture. Two cotton tipped swabs are simply rubbed around the foreskin opening and the bacteria will be transferred to a growing medium. One of these swabs are for bacterial infections and the second is for fungal infections. The doctor sends the swabs off to a laboratory and the results will be back in about two days.

The myth of the infected foreskin and no other option but surgery is false. What drives this myth is the belief that boys can have foreskin infections that can be cured no other way other than circumcision surgery. The truth is that bacterials and fungals can not discern or discriminate between male and female cells. This means that the infections boys get are the same exact infections girls get. These infections respond to the exact same medications the exact same way in either sex. When was the last time you heard of a girl losing her genital parts because of an infection? It just doesn't happen and neither should it happen with boys. Even with surgery, there would still be the infectious agent present and to keep it from returning, a medication has to be administered to wipe it out.

However, there is another possibility. That is that your son is begining the process of separation for eventual retraction. The symptoms of this exactly mimick the symptoms of an infection. In the case of irritation associated with separation, the symptoms will subside within 24 to 36 hours with no treatment at all. You might want to delay begining treatment until the following morning or later to see if the symptom improve. If treated promptly, (within a couple of weeks or so) these infections are just minor skin irritations and pose no threat to the child's long term well being.





Frank

[latinalonestar]

Originally Posted by familyguy5

I really appreciate all of your responses. One thing that I just thought of is that the Dr prescribed an antibiotic without doing any cultures. If there is no bacterial infection, will this cause any problems, or possibly make matters worse?

thanks again,

greg

If you prescribe an antibiotic without doing a culture then you could be making the problem worse if the infection is actually a yeast infections. Remember that antibiotics cause and/or worsen yeast infections. This is b/c yeast infections are an over growth of candida due to a lack of good bacteria. The antibiotics kill all the bacteria, good and bad.

Yeast tends to be peely looking.

If the infection is thought to be bacterial then a culture can be taken and treatment can begin however if the culture comes back showing there is not infection present or showing that it is yeast, then treatment should be stopped immediately. Also, if it is a bacterial infection you will want to start your son on some probiotics to try to ward off a secondary yeast infection from the antibiotics. My son always gets a probiotic anytime he is on antibiotics for any reason. Secondary yeast infections after courses of antibiotics are not uncommon.

My guess is that this is just a bit of separation trauma but it would be wise to do a culture just to be sure. Have them swab the tip with NO retracting of course. When my son had some swelling from separation that desonide cream did wonders.

[MCatLvrMom2A&X]

If only Dr. where educated on the intact penis there would be no need for this part of the forum.

I would not do the abx yet if you havnt started. You said you where going back with him tomarrow I would insist on a culture then making sure no retraction takes place. If anything is there it will be transfered to the swab without discharge.

If it is yeast and you try to treat with abx he will get worse not better. Do you happen to have any OTC yeast creams around like monistate or something for jock itch? If you do put some of that on there and if it is yeast you will see improvment pretty fast if it isnt yeast then you wont cause any harm by trying it.

I am curious is your dw not happy with your ds being intact or has she just been thrown off by your ds having issues?

I almost want to think that maybe he dosnt have an infection at all but is just going through seperation but only because that 9 times out of 10 that is what is wrong and not an infection at all.

[familyguy5]

MCatLvrMom2A&X,

The more that I read about it, the more I think that the swelling is due to separation. When I am at the doctor tomorrow, I am going to ask about the four causes that I can think of, and see how we can diagnose which is the culprit. I am assuming that she will stare at me blankly.
Here are my thought of the possible causes:
1. Separation
2. Bacteria
3. Fungus
4. Irritant

As for the Dr, the entire practice seems to be Circ crazy. I should have known better when, 8 years ago when we interviewed the Dr, she stated that we should cut to match daddy. Every time there is a spec or anything out of the ordinary with my son's peni, the doctor says that we will likely just need a circumcision, like it is no big deal.

I am tired of hearing that they should be retractable by 7, or that they have phimosis every time they are examined. I need to find a friendly doctor in the area, but I have not yet had any luck.

[tennisdude23]

I just wanted to add this link. Really, there are few grounds for a circumcision medically wise. Aside from cancer the only disease to my knowledge that could warrant a circumcision is Balanitis Xerotica Obliterans (BXO), which is very rare and is not the same condition as Balanitis.

http://www.cirp.org/library/disease/balanitis/