red, ballooning, swollen intact 16 mth old

[papadaddy]

[I] have read many posts here that have kept me from going to ER but we are getting a bit nervous now. it has been about 30 hours since we first noticed our son's foreskin area is swollen on one side a little bigger than a pea (smaller than a grape). it is quite red and he seems to sometime have pain when he pees. he can't communicate his feelings but overall he seems in good spirits (he plays as normal) eats well and no fever. we have been giving him warm salt baths but no real change in condition. If this is seperation how long can it take? the swollen/ballooning area has been there from the start of the problem - not just during urination - I don't know if this is typical symptom. can anyone relate to this?

[eepster]

Are you talking about general over all swelling and redness, or a specific spot like a blister? When you say ballooning, are you talking about when he pees?

General swelling, slight redness especially at the tip, ballooning while peeing and discomfort are all symptoms commonly associated with separation. They tend to go away in 24 to 48 hrs. A simple lump under the foreskin can be a harmless smegma pearl.

What you are describing doesn't quite sound like this though. Could you clarify?

[papadaddy]

I would say it is a little swollen all over but on one side of the foreskin/tip there is a "balloon" (swollen area about the size of a small grape). this balloon area has been there for about 30 hours - not only when he pees. no blisters or open sores or bleeding seen.

i just took him out of his diaper and he had a couple small brownish spots and the swelling seems to have gone down a little - SO - we are hopeful it is clearing out. -

the pea/grape size swollen area has been there the whole time it looks a little better too. my wife just said the whole thing looks a little purple now.

we have been watching it very closely - we are very worried. I am clipped so no experince with intact - thanks for all help

[eepster]

Could it be a mosquito bite?

[Quirky]

Does the pea/grape thing seem like something you can palpate, i.e. you touch it and it moves around like there's something under there? I'm wondering if it's a smegma pearl working its way loose as part of the separation process and whether the discharge you're seeing and the lump going down at the same time is just smegma coming out.

[eepster]

Originally Posted by Quirky

whether the discharge you're seeing

Discharge? Is this what the "a couple small brownish spots" were, or were you talking about spots on the skin. If it's spots on the skin I think bug bite, but if you did mean discharge, then I agree with quirky that it's probably smegma.

[papadaddy]

spots were discharge - not spots on skin - spots in his diaper - they were quite small. I do not think it is a bug bite.

Quirky - I have not tried to move it - he really doesn't want me to touch it - i think it is painful to him.

[Quirky]

I would keep up with the warm salt soaks, but my first guess is that he's got some separation irritation with possible discharge of smegma (which is a totally harmless substance) from the lump which is most likely a smegma pearl.

If it doesn't improve soon and you do take him in to the pediatrician, make sure they swab the end of his penis for a culture without ANY retraction whatsoever. A swab culture will indicate if there's something going on, but retracting to "get a look" at the inside will only make things worse, not better, and is totally unnecessary to diagnose any true medical issue.

[papadaddy]

thanks - we have a 15 month ck up appt with his ped tomorrow - his doc will probably want to move it so we will have to be on top of them (sad).

I tell you - as soon as I got nervous enough to post here it started looking better. swelling is down even more now. we have not really seen much smegma/discharge. is he more likely to continue having this issue over and over again? can the "pearl" remain in there and cause problems? his doc pushed his foreskin back a little when he was about 4 months old - not much - he didn;t cry and never showed any signs of discomfort afterwards but now that this has happened i wonder if some damage was done.

Any thought on what I can expect going forward.

[eepster]

Originally Posted by papadaddy

thanks - we have a 15 month ck up appt with his ped tomorrow - his doc will probably want to move it so we will have to be on top of them (sad).

I tell you - as soon as I got nervous enough to post here it started looking better. swelling is down even more now. we have not really seen much smegma/discharge. is he more likely to continue having this issue over and over again? can the "pearl" remain in there and cause problems? his doc pushed his foreskin back a little when he was about 4 months old - not much - he didn;t cry and never showed any signs of discomfort afterwards but now that this has happened i wonder if some damage was done.

Any thought on what I can expect going forward.

If it's a smegma pearl, remaining inside the foreskin till separation fully releases it is harmless.

Premature forcible retraction does sometime seem to make the the natural retraction that happens later more eventful (this is based solely on what I've seen moms and dads report on these boards though, so very anecdotal, so take it for what it's worth.)

[MCatLvrMom2A&X]

Did you read this thread http://www.mothering.com/discussions...d.php?t=764732

[papadaddy]

MCat - yes - that thread was very helpful and probably kept us out of the ER. he seems to be making big improvements over the last 5 hours. we started to worry because not much had changed over the first 30 hours and we may have taken him in had we not seen this improvement. momma is putting him to bed right now - hopefuly tomorrow he will be back to normal. he is still a little swollen and red but the "balloon" at the tip is pretty much gone.

[MCatLvrMom2A&X]

Glad he is improving. I know that was a scary thing when I went through it with ds I didnt know what to do. In his case though he did have a bacterial infection that needed treatment with bacatracin and oral abx. He hasnt had a single problem since then though and wouldnt have then had I been more careful changing his diaper. He had been outside playing and his hands where very dirty and he was pulling and tugging as usual and that introduced the germ.

[papadaddy]

i am actually scared to tell his doctor tomorrow because i don't want an episode of who knows best but if he still has swelling i guess i will have to. as i said before - i am afraid her look at 4 mo may have helped cause this problem. she has never tried to touch it since.

did your son get progressively worse until he recieved the meds?

[MCatLvrMom2A&X]

He did yes. Poor little guys penis was swollen to at least 3x's its normal size it looked horrible and it just kept getting bigger and bigger. I took him the next morning after the swelling started and by that time the swelling was so severe the Dr. couldnt tell by looking if he was intact or not. Red streaks where also appearing along the shaft.

I didnt make them do a culture because the Dr. said that no matter what bacteria was present the same med would be used, keflex. So I didnt see a reason to insist on the swab. What I did do though was when I showed it to the Dr. I told him that I didnt want him touching it at all and the dr put his hands behind his back and looked at me kinda oddly but was ok with me moving the whole penis around not the foreskin so he could see the bottom and sides.

[papadaddy]

thanks for sharing - i am glad he is all good now. times like this i really love the internet - we would have been in the hospital for sure. i will update tomorrow!

thanks everyone

[MCatLvrMom2A&X]

I know what you mean dont know what I would do or how I managed without the net

[tutucrazy]

I wanted to chime in b/c my son had a pretty painful separation episode with ballooning, swelling and redness like you described. It is different for every boy, so some boys have more symptoms than others. For my son, the pain took well over 48 hours to go away. It actually took almost a full week because the freshly separated glans (head) had to smooth over. Urinating really stung for about 5 days. For this reason I created this thread that discusses this specific symptom of separation:

http://www.mothering.com/discussions...ting+urination

I also made this thread about normal development of the intact boy:
http://www.mothering.com/discussions...893&highlight=

Usually we say 30-48 hours but in my son's experience it was much longer. Like I said, every boy is different.

The discharge is a clear indication that separation is happening, the brownish ting is actually a little blood mixed with smegma. This just means that some of the natural adhesions have come loose.

Sometimes the symptoms of separation can be aggravated if there is a yeast infection. Usually yeast is apparent with a peely looking rash. If you don't see anything like that then don't worry about it. Yeast usually comes from cloth diapers that have not been stripped or after a round of oral antibiotics.

You may notice that your son balloons when he pees (if you ever witness him pee). This is a normal phase of the development of the intact boy and nothing to worry about. Hope this helps and I'm SO glad you didn't take him to the ER!!! Make sure that NO doctor manipulates his foreskin in any way, shape or form. The vast majority of doctors don't know about the normal development of the intact boy, thus they almost always misdiagnose normal separation symptoms. You came to the right place for info!

[papadaddy]

just got back from dr office. he is doing much much better today. he still seems a little uncomfortable when peeing but it look 100% better. dr did try to reach for it but we said NO NO and she didn't. we will continue to watch it but i think it is pretty much run its course. this morning he had a bigger smegma pearl in his diaper so hopefully that is the last of it.

thanks again for the info