advice for infected intact penis of an 8 year old?

[spiraldancer]

hi there - sorry if this is long, but I need some input (and a safe place to tell this story).

putting ds to bed tonight he looked worried and said "I think I peed a little bit". there was a bit of moisture on his pants so we removed them and replaced them (without examining them too closely). he was very upset, as he NEVER pees his pants (we did EC and he was out of diapers very early), and said he wanted to see if he needed to go again. he came back and I asked if it hurt to pee or if he had a sore stomach - thinking maybe a UTI. he said no, seemed to be feeling ok, so we said goodnight. I took his dirty pants downstairs and looked at them in the light, noticed it wasn't pee but PUS! and sorry if it's TMI but very stinky! so now I'm really worried and show DH, who is supposed to be getting up at 5 to take the kids on an all day spring break ski trip with friends. we decide to go back up and look at ds's penis, to see what's happening. it is quite red and swollen, and he says it has been like this for a day or two - why he didn't mention it is a mystery though he is a very quiet, private little guy. we talked about it (he cried) and gently reminded him that he needs to tell us if there's every anything painful or strange going on with his body so that we can help him feel better.

unfortunately our hot water heater has been broken for the past 2 weeks : (it gets replaced tomorrow, yay!) so it is pretty possible that it could be a result of poor hygiene - ds is going through a "grubby" stage and hates to bathe at the best of times. so we boiled some kettles of water and made a little bath with some lavender oil, got him to soak in it for 20 minutes or so then back to bed. we have decided to postpone the ski trip, despite some very disappointed kids, in order to heal his infection. he was really tired today, maybe from this.

so tomorrow I'll try to get him in to see our family doctor, I'm wondering if any of you have any suggestions regarding treatment - whether oral antibiotics are really necessary if she prescribes them, how they compare to topical ointments, and what kinds of home remedies might be helpful? especially essential oils and homeopathics. and lots of baths, I know!

I guess on the bright side this will be a good reminder about the necessity of better hygiene for my poor little grubster. I feel like I've been kind of out of touch with him recently since the birth of a new LO, and sad that I probably could have helped him prevent this problem with better self-care. feeling like a bad mom right now. . . thanks so much for reading and in advance for any of your wisdom!

[MCatLvrMom2A&X]

It might be seperation with a secondary infection or yeast from not being able to bath thought not bathing in itself will NOT cause infection as long as he has been washing properly ie wiping like a finger.

Here is a thread you might find helpful if you do or do not decide to go in to the Dr. http://www.mothering.com/discussions...d.php?t=764732

Remember NO retraction allowed by the Dr. your ds is old enough that he can do it to show the Dr. IF he wants to. A simple culture will tell you what is going on. Dont just let the Dr prescribe abx without knowing exactly what if any infection is there because if it is yeast then the abx will make it worse.

If it where me I would start with OTC yeast cream and see if that showed any improvement then if it didnt move on to the OTC bacatracin. If no improvement then on to the Dr.

The reason I feel this way is having delt with a bacterial infection with ds I could have saved us the co pay by trying those first.

[l_olive]

Was his foreskin retractable before this episode? If not, is it now?

[latinalonestar]

It could be normal separation truama, yeast infection, or (rarely) a bacteria infection.

1. Have the doctor do a culture to determine if there is a yeast or bacterial infection. It could just be normal separation and smegma.

2. If it is a bacterial infection and the doc. gives him an antibiotic you will need to be very careful to keep him on probiotics during and for at least 1 week after the course of antibiotics. Antibiotics (ABX) as you know can cause a secondary yeast infection b/c they kill all the good and bad bacteria allowing yeast to overgrow. You might want to keep him on a no sugar diet if he is on ABXs too. Yeast feeds on sugars/starches. Keep a close watch for yeast infection after the course of ABX.

3. If it is yeast then you will use an antifungal treatment.

Remember NO retraction unless the boy does it himself. The culture can be done by simply swabbing the tip, retraction is not necessary. Do NOT begin any treatments until the culture results show that there is an infection and which type of infection is present.

Let us know how things go over the next couple days.

[Yulia_R]

Our very holistic MDs (both: family one and my kids' pedi) always remind us about good probiotics. So, whether it is yeast or bacterial infection, good probiotics (at LEAST 10 billions a day) is a must. If you have to use antibiotic, make sure your son gets probiotics for at least a months after that. Low sugar diet is a good advice as well.

[spiraldancer]

update and thanks

Thanks everyone for your thoughtful and informative responses - I love the collective wisdom of MDC! Dh took ds to our family doc (a woman) this morning, she said it looked like a bacterial infection and suggested putting some polysporin (topical antibiotic ointment) on it 2x day. It looked better than last night by this morning, still kind of swollen and pink, but not so red and sore looking. Ds said it was feeling almost all better. He hasn't retracted it all the way yet - and doc certainly didn't try to retract it for him - we are waiting for ds to do so on his own time. Luckily our doctor is a mother of 2 boys, and while she's fairly conventional is pretty "hands off" for the most part. I don't normally head straight to a doc, but that puss really freaked me out!

Thanks for the reminders about probiotics - we'll get on that ASAP, it's a great suggestion. I think that the point about it possibly being a yeast infection is a really good one, too. Has anyone ever tried putting plain yogurt on a yeast infection directly? If so, any tips? Kind of messy, I know, but I've heard it really works for some women with yeasty problems.

This is such a great resource and community support system.
I had just had a second ds, also beautifully intact, and it's heartwarming to know so many mamas and papas are protecting and nurturing our sons' whole, healthy, perfect and intact bodies! May they all grow into strong, kind, and wise young men, free from the trauma of institutionalized mutilation.

[Lula's Mom]

Since he wasn't completely retractable and it started getting better on its own, I would bet that it was actually some more separation occurring. An infection doesn't get less red and less painful overnight. I know that you saw what you think was pus, but trust me, smegma can be confused for pus, and often is. When my son became retractable, the smegma that came with it was even green! Anyway, that's my opinion.

[latinalonestar]

I would say that it is just normal separation. Normal smegma can be greenish/yellowish. Infections are rare and when they happen they get worse, and worse, and worse. He would get increasingly swollen and have fever.

Btw, don't put any antibiotic ointments on him unless you have done a culture and he has tested positive for a bacterial infection.

[spiraldancer]

I had no idea that separation could be painful and include discharge - I appreciate your thoughtful feedback. I thought maybe the lavender bath last night had worked some magic on the infection. Could smegma really be thin and watery with a foul odor? I'm feeling kind of ambivalent about the antibiotic ointment - latina lonestar can you tell me more about why not to use it? (a culture wasn't done - the doc diagnosed bacterial infection based mostly on our report of a pus-like discharge. ) thanks again!

[MCatLvrMom2A&X]

The reason not to use the antibacterial ointment is if it is yeast it will make things worse not better. Yes smegma can be watery and thin and stink to high heaven since in the newly separated penis it may have been trapped in there for a very long time. The thin comes from urine mixing with it.

Once separation is complete smegma is no more stinky than any other genital secretions since it is regularly washed out.

Did you read the thread I link to in my PP? It goes into detail about smegma and the difference in appearance it might have.

[latinalonestar]

Originally Posted by MCatLvrMom2A&X

The reason not to use the antibacterial ointment is if it is yeast it will make things worse not better. Yes smegma can be watery and thin and stink to high heaven since in the newly separated penis it may have been trapped in there for a very long time. The thin comes from urine mixing with it.

Once separation is complete smegma is no more stinky than any other genital secretions since it is regularly washed out.

Did you read the thread I link to in my PP? It goes into detail about smegma and the difference in appearance it might have.

:
It's been trapped there for many years so it will have an odor!

[eepster]

Originally Posted by spiraldancer

I'm feeling kind of ambivalent about the antibiotic ointment - latina lonestar can you tell me more about why not to use it?

I'm not latinalonestar, but I wanted to add, that a fair number of people will have a reaction to neosporin/polysporin when used on the (more sensitive than regular skin) mucosal tissue of genitals. Bacatracin is recomended instead, since it is less likely to cause a reaction.

[robertandenith]

You can also try epsom salts baths, this stuff works great, it's soothing and natural

((hugs))

[spiraldancer]

Thanks for all the support and advice, mamas! Epsom salt baths sound like a great plan, and I really appreciate knowing why polysporin might not be the best thing for ds without knowing for sure he has a bacterial infection. I'll update if we have any further questions/problems with this, but so far looks like things are healing up nicely. You ladies rock!: