4-year old just diagnosed with phimosis today. Please help? - Page 3

[eepster]

Originally Posted by AleksFeodoraSnyder

We and the doctor suspected UTI because there was blood in his urine. He cried when he went pee, he lifted his legs with pain.

Now he hates diaper changes and has a pink occationally inflamed forskin tip. (he doesn't appear to be in pain).

The UTI was diagnosed with a culture from a sample of urine retrieved from a catheter.

He is in daycare, i don't know if someone has retracted his forskin there. I haven't nor has my husband retracted his forskin.

Catheters have a high rate of false positives, and can acctually cause UTIs.

All the symtoms you describe (including fighting diaper changes, though for 20 mo that's pretyy much normal) can be attributed to occasional retraction by the daycare staff. I would be nonacussatory, so they don't just get defensive and deny any wrong doing.

I would print out literature about not retracting intact boys and go over it with everyone at the daycare.

He has plenty of pee and poopey diapers.

Then the urine is getting out and isn't obstructed.


As long as your DS doesn't have any new problemms come up, then I would attribute his past symptoms to probable forced retraction and seek no further medical "treatment."

[Yulia_R]

Originally Posted by AleksFeodoraSnyder

Re: Rigid band. In my son the tip looks like the sides of the opening are fused/glued with a line of discolored tissue, and then a little bit of of puffed skin at the end. It's not totally fused to the end. What kind of medical article do you know of that shows what you are describing?
A.

I have never manipulated my son's foreskin (and no one ever should), so I don't know how the opening itself looks like (if you pull the foreskin up). But the way you described the foreskin tip sounds normal to me.

You need to make SURE that no one in day care EVER pulls his foreskin back, not even a little bit.

As a pp said, even IF your son has true phimosis, it can NOT be diagnosed until AFTER the puberty. Even scar tissue (such as circumcision adhesions) retract on their own 85% of the time.

If your son fails to retract after he is 16-18 years of age steroid cream can be used along with stretching exercises. It should take care of it. If not (which is rarely the case) a simple dosal slit will fix the issue. For now you have nothing to worry about. Just make sure no one ever retracts him (except the boy himself), not even a little bit.

[rhiandmoi]

Originally Posted by Yulia_R

Also ask your doctor if a little girl came in with a UTI would he blame it on "her urine being trapped in vagina"??? or would he just tell her parents that UTI do happen, give her antibiotics, warn the parents to not let her have bubble/soapy baths and that would have been all there is to it?

Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.

[chaoticzenmom]

That sounds normal to me. Have you looked at pictures of intact penises? Google intact penis and click on images...maybe there will be some reassurance there.

As for the UTI...Does he have one now? Are you using soap or bubbles in his bath?

My new baby has a different looking penis. I was a little concerned because I couldn't find his peehole. I knew he was peeing, I just didn't see any hole. Well, he peed during a change and he definitely has a peehole, but looking for it, it was as tiny as a pinhole. ( The only reason I even looked for a peehole was because his penis was kind of different looking to me. It has some strange lines on the shaft that lead me to believe that it would probably be a buried penis if we had had him circ'd. That's another post though.)

If it were my son, I'd leave it alone and stop seeing any dr's temporarily. Take soap out of the bath, give some cranberry juice on a regular basis and see what happens. Even if he has kidney reflux, that's supposed to clear up on it's own by age 6 (from what I've read) and would be a kidney problem and not a foreskin problem. Also, ballooning is normal. I have 3 intact sons and they're all so different, It would be hard to find anything about them that I considered "normal."

[chaoticzenmom]

I didn't clarify that the pinhole sized hole on my son's penis got much, much larger when he peed, but then went back to practically unfindable.

[AleksFeodoraSnyder]

What kinds of literature can i show my Dr. and my husband to emphasize what everyone is saying?

[eepster]

Originally Posted by AleksFeodoraSnyder

Re: Rigid band. In my son the tip looks like the sides of the opening are fused/glued with a line of discolored tissue, and then a little bit of of puffed skin at the end. It's not totally fused to the end. What kind of medical article do you know of that shows what you are describing?
A.

My son's penis looks very similar to the photo in this website: http://www.steadyhealth.com/articles..._a574_f27.html

If you are talking about the underside of the penis, that is the raphe line. All men are born with it.

The picture is just a drawing of a normal penis. What photos?

[robertandenith]

Fire him. He knows NOTHING about an intact penis. Where are you located? we can refer you to an intact penis friendly ped that will certainly NOT be advising amputation to heal a UTI I wonder what he will advice for girls with UTI... ?

IF it is a UTI, make sure your son eats lots of vitamin C foods and if you want to supplement go for it. 1000 mg every 5-6 hours will do the trick. BTW, the intact penis, is normal for the glans to look red/purplish/pinkish because that's how internal organs are supposed to look like, just the same as inside of a vagina.

Boys are not supposed to retract until puberty or so, so I recommend to stop that cream. Boys don't need steroid creams.

[robertandenith]

Originally Posted by AleksFeodoraSnyder

What kinds of literature can i show my Dr. and my husband to emphasize what everyone is saying?

http://www.asnatureintended.info/upl...74/babyboy.pdf

[chaoticzenmom]

Yeah, that drawing looks like a normal penis. Even my husband, when not erect, has that little thing at the end, as do my 3 sons.

[AleksFeodoraSnyder]

Originally Posted by eepster

If you are talking about the underside of the penis, that is the raphe line. All men are born with it.

The picture is just a drawing of a normal penis. What photos?

This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

[chaoticzenmom]

That's still normal for a child your son's age. When you described it, I thought there would be some crazy abnormal looking stuff, but the two pictures you've posted here look pretty normal.

Is your husband also from a country that doesn't circ? Is he on your side here in wanting to protect your son from circumsision?

[robertandenith]

if he is peeing normal and not complaining, let it be.

[Anastasiya]

Check this out: http://www.mja.com.au/public/issues/...w10610_fm.html

Includes photos.

ETA: I didn't read the article so I have no idea what it says. I only found the pics.... also, I agree that if he's peeing fine then leave it alone. And one more thing - I've also read that cases of true phimosis are just not found in the under 5 age group. So unless your son is a super rare case, I'd think he didn't have "true" phimosis. And lots of kids who do have true phimosis likely have it because they have had their penises manipulated and scar tissue has resulted.

[chaoticzenmom]

Also notice that on Sancta's found pictures, there is pubic hair starting to grow, so it's a pubescent boy pictured there, not a baby.

Looking again, I could be wrong. But my kids don't have hair like that, It doesn't say what age...hmmm

Either way, I'd leave it alone for awhile and re-adress it if he starts hurting again.

[Yulia_R]

Originally Posted by AleksFeodoraSnyder

This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

Looks normal to me. Phimosis in babies/young boys IS NORMAL (that is what it is supposed to be like before it naturally separates). What is not normal is TRUE phimosis (which simply means that foreskin fails to retract in adult man), therefore, true phimisis can never be diagnosed on a child.

By the way, did you watch when they cath'd him? Did they retract him?
Many ignorant doctors/nurses would retract the foreskin for cath (which is a HUGE no-no) and can lead to problems and scar tissue.

If I were you I'd:

1. (first and the most important) FIRE this ignorant ped;
2. If your son tolerates cranberry (no rash, eczema, digestive problems afterwards) I'd give him some cranberry juice regularly as well as lots of fluids (these two things are so good that they can actually treat an existing UTI); I am not sure if they have cranberry tablets for kids (they do for adults), but you can definitely check;
3. Make sure no one ever retracts him;
4. No soapy or bubble baths;
5. Encouraging potty-learning (you may want to check Elimination Communication forum here on Mothering. I did EC with both of my kids and my son was out of diapers at by 12 months and my daughter at 18 months of age. I think that all the heat and mosture that full disposable diapers creat is a very bacteria friendly environment.
6. Use only very mild natural soap on your son's penis (if any at all because you really do not use soap on boys' intact genitals, just rinse it with water);
7. Make sure your son eats healthy meals (as well as snacks on something better than crackers/cookies) and try to have sugar free (or low sugar diet). Sugar feeds all kind of bacteria while bringing immunity down;
8. Keep him on good probiotics (at least 10-15 billions a day) for few months; good bacteria keeps bad bacteria in check. I personally like Nature's Way brand (they have tablets and powder for kids)

[Yulia_R]

Originally Posted by rhiandmoi

Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.

fused labia is not normal while fused to the glans foreskin IS.

[Quirky]

That picture looks totally normal to me. That's what baby penises are supposed to look like. The foreskin is supposed to be fused to the head (glans) of the penis, exactly like the fingernail is supposed to be fused to the nailbed of the finger.

I agree with the PP that your son sounds normal. What about getting a second opinion from a urologist?

Just FYI, the link between foreskins and UTIs has been disproven. In other words, intact boys are no more likely to get UTIs than circumcised boys. Nor is the foreskin likely to cause UTIs -- it's usually a problem with the kidneys and urethral system.

Cutting off the foreskin may make the boy MORE prone to UTIs by exposing the opening of the urethra to more bacteria.

Plus, one in ten circumcised boys will develop meatal stenosis as a result, where the urethral opening scars and narrows because of chafing. This does require painful surgery to correct.

Leave your son alone. Don't cut off his foreskin. That's 19th century medicine and won't do him any good, and will do him great harm.

[Quirky]

Originally Posted by rhiandmoi

Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.

And I am fairly sure that no doctor would suggest labial amputation to cure UTIs in girls.

[eepster]

Originally Posted by AleksFeodoraSnyder

This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

In that photo, who ever is holding the penis has twisted it. The raphe line is visable on the opposit side from the testes. Whether or not the child in the photo actually has a problem, I don't know, but my immediate impression is that if I twisted and pulled just the right way I could make most intact baby penises look like that (which I wouldn't do for various reasons.)

Does your DS penis seem normal when it is not being manipulated? The relavent question is, is his urine truely obstructed? I'm not talking about whether it balloon, or if it goes in a funny direction, those things are harmless. The only problem would be if he couldn't empty his bladder.

You have stated that he has full diapers, and have not described any symptoms of urine retention. Therefore, I doubt the urine flow is blocked.