ANyone know anything about circumferential phimosis?

[MOMYS]

A friend's son was screaming when she picked him up from daycare yesterday (he is 2). They found that his foreskin had rolled back (inside out) when they took off his diaper. She phoned the dr and they diagnosed him with circumferential phimosis. Apparently no-one retracted the foreskin.

Would love to know if anyone knows anything about this condition?

[Raelynn]

Sounds like paraphimosis, where the foreskin gets trapped behind the glans. Were they able to get his foreskin pulled back down? I would be extremely suspicious of a baby in diapers having his foreskin pulled all the way back, I have a hard time believing noone retracted him.

[MOMYS]

The mom had to roll it back down (like I said it wasn't just stuck behind the glans, but also rolled inside out)....

I am pretty suspicious as well, but she is adament (and apparently the dr agrees with her) that no-one retracted the foreskin.

Dr has told her that although it is rare for it to happen "spontaneously" it can happen and it could happen more frequently now that it has happened once. He is being circ'ed next week :-(

[Night_Nurse]

Originally Posted by MOMYS

He is being circ'ed next week :-(

Wow! Just because something happened one time?

[MCatLvrMom2A&X]

Is there any way you can talk some sense into this mother??? I mean seriously the Dr. didnt even know the right word for the condition which is paraphimosis. How can she possibly trust him on the circ thing.


There is no reason to think it would happen again and even if it did just put it back for crying out loud.

That poor little guy.

[Friday13th]

I might be missing something here but this, to me, sounds like saying "your child's eyelid spontaneously flipped inside out...no, really, no one touched it" I'm somewhat unclear on how that could happen.

And even if the child's foreskin was somehow doing this on it's own, why not just flip it back?

[Dave2GA]

It is absolutely absurd to circ him for paraphimosis that has been manually resolved. If it ever happens again he will complain and it can be reduced. Even if manual methods fail an injection with hyaluranadase (sp?) will quickly reduce the swelling so the foreskin can be put back in place. The doc sounds ignorant and ready to cut. Let her know how unnecessary circ is and get her to a competent urologist who isn't a cutter.

[ErikaB]

You say 'he's being circ'ed next week' like you don't have a say. Have you made this decision or has your doctor? Don't second guess your decision to keep your son intact so soon. There is nothing wrong with your son's foreskin. I wouldn't put him under the knife just yet. If this becomes a chronic problem I would consider taking some sort of action. Take a deep breath, think about this some more!

[MCatLvrMom2A&X]

It is the OP's friend not the op ErikaB

[eepster]

Originally Posted by MOMYS

(and apparently the dr agrees with her) that no-one retracted the foreskin.

So, the Dr spent the whole day at daycare with the kid and watch every diaper change closely? Otherwise how exactly does he know that it happened spotaneously.

Seriously, it sounds like one of the daycare workers retracted then lied about it when there was a problem. Switching daycares seems like a less drastic step than cutting off part of his penis, but of course the Dr can't bill for that.

[eepster]

BTW, the last resort, most drastic measure for paraphimosis is a dorsal slit, not circumcision. A dorsal slit shouldn't be taken lightly b/c it does cause some damage, but it isn't full amputation.

[eepster]

Also if it wasn't stuck and she just rolled it back, then it wasn't even paraphimosis, it was mearly a retracted foreskin. Nothing more, nothing less.

Though it's slighty unusual for a child still in daycare to be retractable, it is just an outlier in the normal variation on age of retractibility. Most Drs worry when kids aren't retractable early (not that they should worry, but really you just can't have it both ways.)

[MommytoB]

i'm wondering if the flip back refers to the pucker lip kind of look on the overhang . Was it able to show any part of the meatus during the flip back look.

When my boy was in diapers he gotten those pucker up foreskin lips on his overhang due to foreskin pushing along the diaper and the meatus never showed from it . the pucker lips resolved itself.

I think that's most of the case because if the foreskin was 'retracted the foreskin would get a bit puffy and if the foreskin isn't put behind the glans the foreskin will go naturally over the glans itself so i don't see of the roll issue happening

[MOMYS]

Thanks everyone!

She is going to see the urologist on Monday. I have referred her to this thread, BUT she has kindly told me that they WILL be doing the circ next week.... :-( :-( :-(

[eepster]

How could a mom possibly not be interested in avoiding surgery for her baby? I mean, if a child truely needs a surgery, one tries to be brave and strong, but if there is an alternative doesn't one try to find it first.

I sure tried to find a way out of getting DS's tongue tie surgery, but all the medical proffessionals agreed that being able to feed more efficiently warrented the surgery and that it was severe enough to interfere with speech later.

How can she not want a second opinion. I sent DH to get a second opinion before he had surgery on his finger.

[liseux]

What about steroid cream? Although I would think that would be tough to do with a 2 year old. Poor little guy! I wonder why she is OK with circ when she left him intact in the first place?

p.s. Never mind about the steroid cream, the stretching exercises are way too complex for a 2 yr old & its recommended for adults.

[2lilsweetfoxes]

Originally Posted by liseux

I wonder why she is OK with circ when she left him intact in the first place?

Semi-off-topic, but a lot of insurances and medicaid in a lot of states no longer cover RIC, so parents that do want it done may just not have it done, but when a "medical problem" arises--and they don't realize that there is really no problem whatsoever, they are quick to go ahead and get their son circ'ed.

[eepster]

Originally Posted by 2lilsweetfoxes

Semi-off-topic, but a lot of insurances and medicaid in a lot of states no longer cover RIC, so parents that do want it done may just not have it done, but when a "medical problem" arises--and they don't realize that there is really no problem whatsoever, they are quick to go ahead and get their son circ'ed.

Since I see the OP is in Canada where RIC isn't covered, and I'm guessing her friend is too, I think you may have hit the nail on the head .

[Ron_Low]

Originally Posted by MOMYS

Thanks everyone!

She is going to see the urologist on Monday. I have referred her to this thread, BUT she has kindly told me that they WILL be doing the circ next week.... :-( :-( :-(

Oh, that's disgusting.