toddler in pain, grabbing diaper and screaming

[Hawkeyemama]

I'd like opinions from parents of intact boys before I call our doctor. **ETA he did have a check-up last week, they found nothing wrong.** DS is 19 months. He has these episodes where he has been going from complete calm to shrieking and arching his body and ripping at his penis or diaper if wearing one. He shakes and acts as if he is in extreme pain, and then the episode passes. It happens most often at night or early morning. He has been sleeping terribly at night, up every hour or so. His penis looks swollen on one side at times, but not all the time. It does not look red or inflamed. No fevers, which I know is usually associated with UTI. He breastfeeds on demand at night and drinks frequently during the way.

Any suggestion for what might be going on?
UTI? But he does not cry every time he urinates.
Maybe it is gas?
Does it hurt to urinate if a boy has an erection?

What else should I be looking for or considering?

[hedgehogs4]

UTI sounds like a possibility. I would call your Ped now and make an appt... the description of a little guy shrieking and grabbiing his diaper is distressing even to read about! not quite a wait and see situation IMO.

[koalove]

my ds who is 4, says it does hurt a little, and is nearly impossible to pee with am erection, although he does it. i would be totally freaked out by those episodes. i would be calling the doc right away.

[Hawkeyemama]

Just to be clear- he was just at the doc last week for a check up and she saw nothing wrong. Before I call the doc again I wanted to hear if something in the description sounded familiar to people here before I ask for possible unnecessary poking and prodding or urine collection using catheter.

My suspicion is that it *may* be gas, possibly caused by a food sensitivity, as he's always has reflux type issues and just recently stopped recurrent vomiting due to reflux. I'm wondering if his body found a new way to manifest reflux symptoms. Possibly he is feeling pain in his lower abdomen.

[melanie_rabbitbarn]

My friend had a son who did something similar and it was an undescended testicle that kept going back up inside (I know my description isn't the best), but he would really scream and it took her a while to realize what was going on. He eventually had surgery to tie the testicle down where it belonged.

[perspective]

Originally Posted by Hawkeyemama

Just to be clear- he was just at the doc last week for a check up and she saw nothing wrong. Before I call the doc again I wanted to hear if something in the description sounded familiar to people here before I ask for possible unnecessary poking and prodding or urine collection using catheter.

My suspicion is that it *may* be gas, possibly caused by a food sensitivity, as he's always has reflux type issues and just recently stopped recurrent vomiting due to reflux. I'm wondering if his body found a new way to manifest reflux symptoms. Possibly he is feeling pain in his lower abdomen.

Could this be separation pains? Does he usually have these "pain events" during, or shortly after waking up? If so it could be erections, and if he is in the process of separating, it makes perfect sense that it would be painful when he had an erection. Sometimes separation can be very painful.

It is not very common to have a boy separate this early, but from my reading of what you describe that seems like a possible culprit.

[rabbitmum]

My little one thinks it's very uncomfortable to have an erection inside the nappy, and will scream, but then he is happy as soon as the nappy is off. From your description it sounds like your son has more pain than that, and like it happens also when he is not wearing anything?

I would check for a UTI. You don't have to use a catheter to have a urine sample, in fact no-one would even think of doing that to a small boy here. You can get bags with a hole for the penis, and that have tape around the hole so you can fasten a bag on him (inside the nappy so he doesn't pull it off), and just wait for the pee. All chemists sell them here in Norway, I'm sure you must be able to get them in the U.S. Then just deliver the bag to the doctor, who doesn't even have to look at your son.

[tutucrazy]

This sounds like what my son went though when his foreskin began separating. When the foreskin starts separating the urine can pass under the foreskin and sting quite a bite. The swelling is just the foreskin reacting to the truama of separation. My son was in a great deal of pain for a couple days until the glans smoothed over and the urine no longer stung the glans. It is probably worse at night and in the morning when the urine is more concentrated. If you see him urinate you might even notice some ballooning which is just the pee going under the foreskin. This is nothing to worry about.

Until the foreskin separates entirely he might go through phases of stinging as more areas are knocked loose and the fresh glans are exposed. Once the entire foreskin is separated it will not sting anymore.

That swelling you see on one side is probably the side where the urine is passing underneath. Foreskin is very vascular so it reacts when there is a trauma associated with separation.

I highly doubt this is a UTI b/c it doesn't happen every time and you didn't indicate that he has any fever or frequent urination. If you take him to the doctor you need to be very careful no one tries to retract him for any reason!

Please read these two threads:
http://www.mothering.com/discussions...893&highlight=

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

I'd say that about 97% of these cases we see on here are just symptoms of normal separation. Your doctor will not be likely to know about the symptoms of normal separation so you might cause more problems by going than if you just give it a couple days. My son's case was pretty extreme b/c his entire foreskin came loose all at once when he was 10 months old. He screamed in pain when he urinated and he had some pretty significant swelling. I was very worried but in about 3-4 days everything passed. Now he has a nice balloon when he pees but the glans have smoothed over. Ballooning is actually a good thing b/c it rinses out the dead skin cells when he urinates. Urine is sterile so you don't have to worry about it causing any infection. Please feel free pm me if you have further questions.

[jazzyiko]

I know this is an old thread, but I just wanted to know the outcome of your situation.  My son has had the same thing for 14 days and I felt the same as you to not want to have him prodded by doctors, but we're on our 5th doctor who is a Urologist and we still don't have an answer.  We're now waiting for our appointment to have an ultrasound on his kidneys and bladder, but I don't think the issue is there and it is killing me that he is still having this issue! 

[Hawkeyemama]

Hi Jazzyiko- I should have updated when we figured out what was going on!  He was having bladder spasms, caused by holding his urine for too long.  A sweet nurse at our peds office had the same issue with her child, and her experience is what helped us figure it out.  We really could not do much for him except to talk with him frequently about relaxing and "letting the pee come out".   He wasn't verbal at the time but I think he understood what we were saying.  He outgrew the problem after several weeks.   We have had no other issues related to urination or his penis, and he is 3 1/2 now.  

I'm sorry to hear your son is having pain, and I hope it's resolved soon. 

[MCatLvrMom2A&X]

Thank you for that update Hawkeyemama glad he outgrew it