Intact questions

[kakirk]

Hi everyone -- it's been years since I posted here on MDC, but I have questions about my intact son & this is the only place I can think of to ask. :

My 4yo son has always had a "crooked foreskin". By that I mean it is slightly longer on one side than the other, resulting in him peeing nearly 90* to one side. It occasionally balloons a little but hasn't caused any problems at all. We asked about it at his 2yo WCE and 3yo WCE and they always told us not to worry except for ballooning (we didn't ever worry at that; it's intermittent enough to not cause alarm).

Well, at the 4yo WCE we asked again and our NP (GENTLY) checked to see how far, if at all, his foreskin was retracting. She seemed slightly concerned that it wouldn't even retract far enough to see the glans. She suggested trying the steriod cream, encouraging him to play with his penis, and if all else fails a referral to a urologist for a likely circ.

(It should be noted that we see a very forward-thinking Ped who has an equally forward thinking Naturopath/ARNP, always very very supportive of our alternative parenting choices, including no vaccinations, extended breastfeeding, co-sleeping, etc.)

Anyhow, I'm seriously freaking out here. My 4yo son is twin brother to my daughter who has severe epilepsy, autsim & global delays. She's my "medically fragile" child, and the thought of having to do something "medical" to my son is nearly enough to put me over the edge (yes, yes, we all know I need therapy, LOL!).

Is this a normal thing for my boy? Should I be worried & scheduling the urologist now?

Katie

[MCatLvrMom2A&X]

Your ds is fine. Ballooning is normal and no cause for concern at all no matter how badly he balloons. The steroid cream in only for boys who are well into puberty and for adult men with true phimosis. Not for a 4 yo it is totally normal for a boy his age to not be retractable at all. When his body is ready he will retract.

Here is a link you might find helpful http://www.mothering.com/discussions...d.php?t=764732

[Fellow Traveler]

I don't think you have anything to worry about. Boys may not retract until their teens. There is no minimum progress that has to be made all boys start and progress to retraction at different rates. If it isn't bothering him it's not something to be concerned about.

[BlessedMommy2006]

Agreeing with the others that it is quite normal. The average age of retraction is around 10 years old. Don't schedule a urologist appointment, your son is just fine!

Applying steroid cream to a 4 year old's foreskin to try to get it to retract would be about equivalent to giving a 10 year old girl hormone therapy to get her to start menstruating. Everyone develops at different rates. Anecdotally, I didn't start menses until I was almost 17 and I've never had any fertility problems, I have two kids now.

Expecting all boys to retract by 4 years old is like expecting all girls to have their period by their teens. Everybody is different. As long as those milestones are achieved by adulthood, I don't see any cause for medical intervention.

[Quirky]

Your doctor may be forward thinking on other issues but she's so totally uninformed on the intact penis it's not even funny! She's wrong on every count. She's wrong that he needs a steroid cream, she's wrong that he needs to be encouraged to play with his penis more, and she's wrong wrong wrong wrong wrong that a circumcision would EVER be medically justified in this scenario.

Cancer, frostbite, gangrene, and possibly BXO are the only true medical justifications for circumcision.

[tennisdude23]

In the U.S., we live in a culture in which we over obsess about nearly everything concerning the body or so it seems. As long as your son is not having difficulties with urination and is not suffering from a serious penile condition, he is just fine. You hear so much about foreskin problems because people just can't leave them alone.

PS: The age of retraction is a bell curve with the apex being at around 10, 11 years. So, unless your son will be having difficulties with his foreskin 15 years down the road, I would not worry about it.

[eepster]

The NP should not be trying to see if he is retractable, no matter how gentle she is. It can cause damage. No one but your son should try to retract it.

Your DS is fine, read this article.

[Dave2GA]

There are conditions that might be of concern. The penis could be congenitally torsed. Since he pees 90 degrees to the right and there may be a foreskin abnormality, I would go to a pediatric urologist to have him checked out. It's not the lack of retractability that would concern me, it is the angle of urination and the possible foreskin deformity. Standford U. Med School's website has some photographs of various penile anomalies that may help you. You can discuss with the ped urol beforehand the fact that he should not be retractable at this age anyway and that you don't want him retracted forcibly. But I would have him checked out for an abnormality.

[MCatLvrMom2A&X]

I am on Stanford's website and trying in vain to find photo's. A link would be most helpful.

ETA: I found the photo gallery at Stanford U. that Dave2GA mentioned.

LINK
WARNING THE PAGE OPENS RIGHT INTO PICTURES. There are also some pictures of fresh circ's & various abnormalities of the penis some very disturbing.