Intact 2yo with pain after peeing -- need advice

[GodChick]

Hello! I don't know if anyone here remembers me; I used to post here, but I haven't posted here in quite a while. But I know there are lots of wise mamas here, so I thought this was the best place to ask:

Anyone in the know about this?

Just the last day or two, my 2yo (24 months) has been pulling at his diaper and saying he "needs dry" as soon as he pees, which is a little unusual for him; usually I have to check, and then he still insists he doesn't need changed.

When I do change him, he sometimes says "owie" when I put his dry diaper back on him and will then pull at his clean diaper in the front.
He doesn't have any redness or signs of a rash. In trying to determine the problem, he seems to say "owie" when I gently touch the tip of the penis -- not retracting or anything, just lightly touching the tip.

No blood visible in urine, no funny smell to urine, no fever.

We are using disposable dipes, and have been using the same brand for over a year. (I was using cloth, like I did for my other kids, but couldn't keep up with the laundry so switched to sposies about a year ago.)

I will take him to the ped, if necessary, but I don't want to take him unless I have to, because I've heard lots of horror stories about intact boys being circed just to get a catheter sample.

Any ideas?

[tutucrazy]

You are very wise to ask here first!

Have you read our separation sticky? This is a good one to read. My guess is that he is just experiencing some normal separation symptoms. Separation is when the foreskin begins to separate from the glans. The symptoms can include:

mild/moderate redness
mild/moderate swelling
pain/stinging
itching
smegma discharge
smegma pearls
ballooning during urination
spraying during urination
sting during urination
uneven separation

These symptoms can come and go throughout childhood and are sorta like a growing pain.

When it is something more than normal separation:
If the entire penis gets very very large and swollen
If he gets fever
If he has a yeast infection

Read though both of these threads:

Intact Care and Development:
http://www.mothering.com/discussions...893&highlight=

SPECIAL INFORMATION ABOUT THE DEVELOPMENT OF THE INTACT BOY:

During childhood/adolescence your son will go through a normal separation process as the foreskin separates from the glans. As I said before, the foreskin is fused during childhood to protect the developing penis from feces and other pathogens. Separation is different for each boy and happens at a different age for each boy. During this time he might experience some irritation, itching, stinging, minor redness, minor swelling, ballooning, spraying, smegma pearls, uneven retraction, etc. These are all totally NORMAL and resolve by themselves. I get get many concerned parents come here asking about their son's irritated, red, or slightly inflamed penis. 97% of the time it is just normal separation occurring. Some boys don't experience any of this but most boys have 1 of these symptoms at some point especially around ages 2-5 when boys really begin to explore their genitals with their hands. During self-discovery is a prime time for separation trauma to appear. UNLESS it gets increasingly worse, extremely inflamed, he has fever, or you suspect yeast infection there is nothing to worry about. (Bacterial infections are VERY RARE and usually only occur only after forcible retraction or a wound to the penis.) Usually the symptoms of normal separation resolve themselves within 48 hours. Due to the fact that US doctors know very little about the development of the intact boy, it is wise to wait it out and let this resolve on its own. Since boys tend to be more "hands on" with their genitals and their genitals are not as internal these symptoms appear more frequently than with girls. You may want to remind your son to be gentle with his privates as he begins to self-explore.

Print this article and keep it on hand:
http://www.mothering.com/articles/ne...uncircson.html

Here is a helpful thread about separation and when to be concerned:
http://www.mothering.com/discussions....php?t=764732?

Remember that just b/c the foreskin has separated from the glans does NOT mean that anyone should try to retract your son. The opening of the foreskin remains very narrow and widens with sexual maturity. A foreskin only becomes retractable after the foreskin has separated and the opening has widened. Hormones play a big role in the widening process. These hormones replace the fiberous tissue with a more elasticy tissue. Through self-discovery your son will learn when he is retractable. Only 50% of boys are retractable by age 10. It is normal for a boy to not become retractable until after puberty. The only person to retract a boy should be the boy himself. Once a boy/man is retractable he can retract his foreskin, rinse with water only, and replace the foreskin back over the glans during his showers. Easy as that!

***If your son becomes retractable at an early age you will notice that his glans and inner foreskin is very red and moist. This is NORMAL!!!! The intact boy's glans are an internal organ, unlike a circumcised boy. Circumcised boys develop extra layers of skin over their glans, this puts the blood flow further from the surface than with the intact boy. Because the foreskin is protecting the glans the intact boy's blood-flow is very close to the surface which gives it a red appearance. The foreskin is also very vascular (like the lips) so this also gives it a more red appearance. The normal appearance of the intact boy is red and moist. If your son becomes retractable at a young age, remind him that he should always replace his foreskin over the glans after retraction.***

Separation Sticky:
http://www.mothering.com/discussions....php?t=764732?

My advise is to give him a nice warm baking soda bath. Add about 1/2 cup baking soda to a full bath. This will soothe the glans that are separating. Also be aware that sometimes as boys mature the feeling of erection can feel "painful" to them. This is just b/c it is a new feeling. Many boys just don't quite know how to express that feeling.

Ask away if you need more help.

[Night_Nurse]

Upon reading your post I first thought of separation (and I still think that's what it is- it's completely normal). Does your ds have any residual urine left in his bladder after he goes (is he saying he needs to pee again soon after he already urinated)? If so, you might want to have him checked for a uti, especially if you notice he has a fever or the urine is cloudy (I know he currently doesn't). But it really just sounds like you're describing normal separation discomfort and I'm guessing it'll resolve itself soon.

[GodChick]

Thank you so much, ladies! After reading your posts and the suggested links, it does sound like seperation discomfort. I'll keep monitoring to make sure it doesn't worsen, but what is described in the links does seem to fit this situation to a T. I had been wondering if it could be related to seperation, but I wasn't sure if age 2 was "too young" for that. (My other kids are girls; this is my first boy -- can you tell? )

Thank you so much for taking the time to answer my questions -- and thank you for not jumping on me for missing that sticky! *slaps forehead* I poked around a little looking for info, but somehow I didn't even notice that; I guess I need to slow down and pay better attention!

[tutucrazy]

Originally Posted by GodChick

Thank you so much, ladies! After reading your posts and the suggested links, it does sound like seperation discomfort. I'll keep monitoring to make sure it doesn't worsen, but what is described in the links does seem to fit this situation to a T. I had been wondering if it could be related to seperation, but I wasn't sure if age 2 was "too young" for that. (My other kids are girls; this is my first boy -- can you tell? )

Thank you so much for taking the time to answer my questions -- and thank you for not jumping on me for missing that sticky! *slaps forehead* I poked around a little looking for info, but somehow I didn't even notice that; I guess I need to slow down and pay better attention!

You are very welcome! I'm glad you found all the info helpful. No worries about the sticky. With the new layout it is not so easy to find. I'd have missed it too! Come back if you have anymore questions! Glad to help.

[eepster]

My first thought, just like the PPs, was seperation, but I also have a second thought.

It might be time to potty learn. It's possible that he is recognizing the need to pee sensation, but doesn't have the words to express it yet so he says "ouchie." I would try putting him on the potty when it happens (if it doesn't just go away by tomarrow in which case it was probably seperation.)

[GodChick]

Just a quick update -- he has had no more complaints today. Thank you, ladies!

Hmmm . . . I'm having such a good time hanging around here, maybe I need to update my siggie (it looks like it's approximately 2 years old!) and hang around a little more . . .