Concerned about son's penis

[TwinMom]

My four-year old has been saying for a couple weeks that his penis hurts. His foreskin is pretty red on the end and looks raw, so I took him to the doctor, who said that it looks like yeast. I've been putting clotrimazole 7-day on his foreskin 2-3x a day for 10 days and it doesn't look better. There is a creamy substance that oozes out; I thought it was smegma but she said that it's probably the yeast.

I'm worried that something is really wrong, it seems like the cream should have worked by now. I've also been using a homeopathic anti-fungal spray for the last four days. His foreskin does not retract yet. The doctor said that if it's not clearing up I'll need to retract the foreskin to get the anti-yeast cream in further, but I will NOT forcibly retract it.

My other thought was that he is in the process of retraction, which I know can cause some discomfort and release of smegma, but it's going on for so long. What should I do?

BTW, I'm also giving him a liquid probiotic a couple times a day and smearing some on his penis when he'll let me.

[Rico'sAlice]

Other than the probiotic, have you worked on his diet. I see you mention gluten-free in your sig. Is that for him? Is he avoiding sugar, etc.?

[l_olive]

Has the doctor cultured the substance coming out? That would tell you for certain if it's yeast or not, and you could go from there.

[TwinMom]

Our house is gluten-free due to my other son's celiac disease. Not intentionally avoiding sugar, though he doesn't have it often. He does have a couple ounces of 100% juice twice a day to hide the taste of liquid trace minerals. She did not culture, but as soon as the office opens after lunch I am going to call and make an appointment to have that done.

[pixiepunk]

it might be also that the clortrimazole is irritating him. that stuff makes me swell up like a balloon, personally, and itch 10x worse than the yeast. so perhaps try diluted GSE (grapefruit seed extract) which i have always found effective in treating topical yeast. it would be a bad idea to add some to his juice as well. GSE has antibacterial properties so it will likely help if there is some sort of infection and not yeast.

also make sure he's staying clean, let him soak in a water-only tub a couple of times a day and let him go without undies so there's no trapped moisture (just like they tell mamas with thrush wrt their breasts and bras).

[TwinMom]

Okay, I have an appointment for him this afternoon. What should my response be if the doctor says she needs to retract his foreskin so that she can see the head of the penis? I know I will get all angry and blustery and completely lose my words, so it would be good to have a script in place.

[kiara7]

Originally Posted by TwinMom

Okay, I have an appointment for him this afternoon. What should my response be if the doctor says she needs to retract his foreskin so that she can see the head of the penis? I know I will get all angry and blustery and completely lose my words, so it would be good to have a script in place.

Just tell her no. You can take a swab yourself really. Tell him/her not to touch his penis at all. No need and there is nothing for them to see.

[TwinMom]

She swabbed the mucous coming out, but I held his penis for her so I know she didn't retract. She does seem sympathetic to me wanting not to forcibly retract, but really hasn't seen any intact boys. If the culture comes back as bacteria I guess he'll take antibiotics, but if it doesn't come back as bacteria she wants him to see a pediatric urologist. Oh, the horror stories I've heard about them! I'm not going to freak right now, just wait for the lab report.

Thank you to everyone!

[Treece]

Ok, just ~breath~. Your ds will be fine. (Repeat: Your ds will be fine)

IF she does say you need a urologist, say you wanna call around first. Then, call around and make sure that the one you get isn't pro-circ. Ask his/her position on circ, try to be as middle ground here so to get a "real" response. I have no exp with ped urologists (or any for that matter).

~Good LUck~ and your son is super to lucky for you to be his mama

[TwinMom]

Thanks, Treece. I'm still wondering if part of the issue is that he plays around with his penis so much that he's starting to retract. I'm going to continue with the ant-yeast cream until hearing from the lab & increase probiotics.

[tutucrazy]

He could be just having normal separation. Did you read our sticky? The creams are probably irritating him if he really doesn't have a yeast infection. A culture should be done before attempting any treatment. It is very normal for boys to have redness and discharge during separation process. Treating something without knowing sets him up for potential reactions. Just give him a nice warm bath and stop using stuff until you get a culture. Separation symptoms clear up on their own if left alone. My son's took about a week to go away.

[tutucrazy]

Btw, this is not a reason to see a urologist. If he can pee then his penis doesn't need the help of a urologist. Possibly you could see a dermatologist, but not a urologist.

Remember that boys can be rough on their foreskins during self-exploration. He probably just injured it a little and it takes awhile to heal. Foreskin gets very red easily b/c it is so vascular.

[TwinMom]

I did read the sticky, but I'm still unsure of what is going on. Several times a day he will start crying, saying his penis hurts. When I look at it, I can see that the tip is red, with mucous dripping. I've asked him if he can pull the skin back a little, and he can only pull a little, nowhere close to having the glans show, and can see that inside the foreskin is extremely red. I know that can be normal and I wouldn't even be that worried except that he keeps saying it hurts. I know that separation can take some time, but it has been at least two weeks. Could that still be normal?

[Cheshire]

My son had a yeast infection when he was two. I talked to my doc's nurse on the phone about his symptoms and she said to try an OTC yeast cream (like Monistat or one of the others). She said if we didn't see improvement in 24 hours to call her back.

We tried one brand (can't remember which) and it helped a little. After a couple of days I went and got another brand (again, can't remember which). We used the cream on him (just smeared it around the tip of his foreskin and then put a big blob of it on the tip of his foreskin before putting his diaper back on him at every diaper change). It took 10 days but it finally cleared up. No retraction at all necessary.

If it is yeast I'd try another cream. Some brands work better than others on different folks.

If you have to take him to a urologist it can be scary. When my son was 4 he developed a UTI. The pediatrician couldn't get it cleared up, we tried a number of antibiotics that the urine culture reports said should work but they didn't. I took him to our family doc before going to the urologist thinking he might be more foreskin friendly and he was awful! The only good thing that came from it was I got to practice saying "that is not an option" every time he mentioned DS needed to be circ'd.

I was able to get one recommendation for an intact friendly doc. When I called his office the nurse said my son would have to have an ultrasound (which he had) and an VCUG before the doc would even see us. I was not about to put him through the VCUG testing so I went ahead and made an appt with the urologist my ped recommended. It was not as bad as the visit with our family doc. I would say he was neutral to slightly leaning to circ. But, he was willing to work with us and we found an antibiotic (thanks to a rec from a momma on here) that cleared it up.

I just wanted to let you know that if you go into the appt with an attitude of this is your decision and you're not being confrontational or argumentative about it - it's just the way it is that your son will stay intact - you have a good chance of getting help. And, if you do run into a doc that is a complete UAV just thank him for his time and leave.

I know I was scared to go but when I reminded myself I was the one that would protect my son and that I knew he didn't need a circ no matter what the doc said it went as well as can be expected.

Best wishes. I hope you're able to find him relief soon.

[TwinMom]

Thank you so much for sharing your story, Cheshire! You rock. I'm going to keep that as my mantra, "That is not an option."

[TwinMom]

I have not used the anti-yeast cream or the anti-fungal spray on him since yesterday and it's looking better. I am hoping that it really was using the cream that irritated his penis. Maybe he accidentally cut himself with a fingernail in the bathtub and that's what caused it to originally look so red. Hopefully tonight it will still look normal.

[l_olive]

How's he doing today, TwimMom? And did the HCP tell you when you'd get the results of the culture back?

[TwinMom]

I think the results will be back today. When he woke up he said that it hurt, and it looked a little red, but not excessively so.

[mommyminer]

Just looking for an update....

[TwinMom]

STILL haven't heard the lab results but I'm no longer freaking out. Since I haven't been putting the clotrimazole on him it looks perfectly normal. I think the sruff I saw coming out was the cream I was putting on. Thank you to everyone!!