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retract "just a little"

post #1 of 19
Thread Starter 
My friend's doctor (who supposedly does not retract foreskins in the office) recommended to my friend to retract her 15month old's foreskin "just a little bit" in the bath now.

I know this isn't okay, but her DH wants the reasoning for why NOT to do this. (I thought perhaps the dr should have provided a reason WHY do it in the first place. But I digress.) Other than the link stickied, is there a good thread/link discussing why not to retract it even a little? It might help her more than just me saying "retraction is bad! don't do it!"

Thanks!
post #2 of 19
I dont have any links onhand, but retracting "just a little" is like pulling up a fingernail "just a little". It hurts like hell, introduces infection and is completely pointless. If anything, it hurts like hell, and between you and me, manipulating the penis in that way just smacks of....ickiness.
post #3 of 19
The reason why not to do it is that the foreskin is fused to the head of the penis. Retracting even a little bit can tear the connecting fibers, cause scar tissue, and encourage infection.

Perhaps you could share with them the AAP position on retraction? And encourage them to find a new doctor?

There is absolutely no good reason to be retracting a 15 month old in the bath and lots of good reasons not to.

GL!
post #4 of 19
INstructions to "partially retract" "gently retract" "retract to the point of resistance" "retract a little" are based on two misconceptions.

First, the belief that a boy "should" be retractable by age 3, so there is an expectation that by 15 months ( or 1 year or 2 years - I've heard variations on this) it should begin to be retractable. In fact, the average age at full retractability is about age 10. Many if not most 15 month old boys will not be anywhere near being retractable at all. So this is simply an incorrect time-table applied as cookie-cutter advice by a person who apparently does not know the evidence on the true age range of retactability.

MOre info on development of the intact penis:
http://www.cirp.org/library/normal/

Second, the belief that if a boy's foreskin is not cleaned under regularly, that he will get terrible infections or some other horrible thing going on under there. (This is a carry over from the demonization of the foreskin that started back in the Victorian era, where sexual parts were considered filthy.) This is not correct either. The foreskin of a young child is well-designed to keep itself clean and protected: It is fused to the head of the penis, it has a tight outlet, it has muscles that close the foreskin in a sphincter-like fashion, it flushes itself outward with sterile urine multiple times a day, and it has immunological active cells and substances.

Those practitioners who are most familiar with the intact penis (e.g. Doctors Opposing Circumcision) say to leave the foreskin alone, and just wash off the outside. Once the child discovers he is retractable on his own, he can be taught to rinse off underneath occasionally. One Canadian pediatric urologist (Peter Anderson) has been quoted as saying, "there's no evidence there's any need to clean underneath the foreskin before puberty). Your son playing with his penis in clean tub water is about all the cleaning he is going to need for a good while.

http://www.doctorsopposingcircumcision.org/DOC/faq.html

The short answer is, retraction by parents is unnecessary and potentially harmful. Any attempts to retract or clean under the foreskin can wait until the boy is old enough to do this on his own.

Retraction by anyone other than the boy can potentially be harmful if done too forcefully (only the boy will knwo how much force is too much), and by disturbing the naturally closed foreskin, can potentially introduce infection.

http://www.nocirc.org/publish/6pam.pdf


Gillian
post #5 of 19
Thread Starter 
Thank you! And thank you Gillian for the specific information. I passed along the thread link to my friend. Now I'm hoping she'll go back and share the information with her pediatrician.

On a side note...our sons are the same age, and I look at my DS and wonder why anyone would even look at a baby and think hey! Let's retract that! So bizarre that any doc would recommend as such. I think my own pediatric practice has learned to just keep their mouths shut around me when it comes to my son's penis, breastfeeding, or vax.
post #6 of 19
Well Said Gillian !
Now only if ALL the Medical Associations could diseminate this valuable and necessary information to all physicians who examine and treat boys. I am waiting for the day when such information is mandated as Continued Education credits for all physicians when they renew their licenses to practice medicine. I nominate You to create and conduct the training seminars! Even some on-line versions would be great to start educating those who remain ignorant out there.....
post #7 of 19
Quote:
Originally Posted by Dev View Post
Well Said Gillian !
Now only if ALL the Medical Associations could diseminate this valuable and necessary information to all physicians who examine and treat boys. I am waiting for the day when such information is mandated as Continued Education credits for all physicians when they renew their licenses to practice medicine. I nominate You to create and conduct the training seminars! Even some on-line versions would be great to start educating the ignorant masses out their.....
Actually I did do an inservice with a group of doctors and nurses on this subject this summer. I do plan to do more. Thanks for the vote of confidence!

GIllian
post #8 of 19
I am the mama she is referring to in her post and I shared some info and links with my hubby and he is 100% convinced now. It was hard for him to imagine since he is circumcised but once I read him the AAP's recommendations against foreskin retraction he is now wondering why pediatricians are so clueless on this! Thank you!
post #9 of 19
My ped's NP told me I should try to stretch out my son's foreskin by retracting it a little bit, so it wouldn't be too tight when he got older. Also that he could get little bumps under the foreskin and we'd have to work them out. I found out this was bad information, and I told her I thought it was in the office. The AAP statement on care of the uncircumsized penis is pretty clear that retraction is a no-no. The second thing is normal also. If I remember correctly, the bumps are just a build-up of smegma, and go away on their own. Anyway DS hasn't had any of those that I've noticed.
post #10 of 19
Why not do this? The same reason not to open a baby girl's vagina "just a little". Not necessary and possibly damaging (not to mention painful).
post #11 of 19
It may be enlightening when this comes up to ask the opposite: "Why retract, even a little?"

"Because you should" is not an answer.

"Because it will help them become retractable by such and such an age" is a lousy answer, but would then give you the ability to check their recommendation against other resources.

"Because dirt accumulates" is also a lousy answer, but then you can check against other resources.

Asking why until they give a reason that can be researched can be enlightening. It forces them to think and explain, rather than simply say stuff.

Regards
post #12 of 19
Quote:
Originally Posted by Mom2K&Gray View Post
I am the mama she is referring to in her post and I shared some info and links with my hubby and he is 100% convinced now. It was hard for him to imagine since he is circumcised but once I read him the AAP's recommendations against foreskin retraction he is now wondering why pediatricians are so clueless on this! Thank you!
Awesome news and welcome

Quote:
Actually I did do an inservice with a group of doctors and nurses on this subject this summer. I do plan to do more. Thanks for the vote of confidence!
Gillian, that's amazing. You are a wonderful spokesperson, and I'm thrilled to hear you're helping educate the medical profession. Just think of the difference you can make! Thank you
post #13 of 19
Quote:
Originally Posted by Mom2K&Gray View Post
I am the mama she is referring to in her post and I shared some info and links with my hubby and he is 100% convinced now. It was hard for him to imagine since he is circumcised but once I read him the AAP's recommendations against foreskin retraction he is now wondering why pediatricians are so clueless on this! Thank you!
Yay! Thanks for posting your update.
post #14 of 19
I have seen 3 doctors in my practice who say, stretch the foreskin a little to help it along. I have always ignored that advice. One thing that I don't want to do is to disrupt the function of the sphincter-like band of muscle at the tip of the foreskin. I figure if I stretch it out, it won't be able to close up as tight.

I think doctors who give the "retract a little" advice do not understand the function and development of the foreskin. In fact, they most likely think it has no function.
post #15 of 19
OT:

All this messing with little boys penises squeaks me out. It seems like molesting to me. A little boy I watch is circ'd and I get really uncomfortable seeing the head of his penis. My dh is also circ'd and I've become uncomfortable with my daughter seeing his penis now too.

No one would suggest messing with a girls labia to prevent adhesions or perenial massage for when she gets older.
post #16 of 19
Quote:
Originally Posted by Equuskia View Post
I dont have any links onhand, but retracting "just a little" is like pulling up a fingernail "just a little". It hurts like hell, introduces infection and is completely pointless. If anything, it hurts like hell, and between you and me, manipulating the penis in that way just smacks of....ickiness.

It also can end up forming scarring tissue, leading in the future to true phimosis.
post #17 of 19
Quote:
Originally Posted by Mom2K&Gray View Post
I am the mama she is referring to in her post and I shared some info and links with my hubby and he is 100% convinced now. It was hard for him to imagine since he is circumcised but once I read him the AAP's recommendations against foreskin retraction he is now wondering why pediatricians are so clueless on this! Thank you!
Unfortunately, many of them are clueless .
I highly recommend reading A Warning to Parents With Intact Sons http://www.mothering.com/discussions....php?t=1050941

Your son is so lucky to be whole !
post #18 of 19
I had an argument in an ER about this with a pedi who told me the same thing. He was a real... piece of work. He got me so upset and then started teasing me and asked me WHAT THE AAP WAS.

Some pedis are just... yeah. His argument was "I am a boy. I know these things."
(I am a boy, seriously!?)
post #19 of 19

adjectives

I believe this is the danger in phrases like "don't forcibly retract".

Unfortunately some people take this to mean retraction is ok if its not forcible.
Hence 'gentle' retraction seems ok.

Also who is going to admit to themselves they are forcible? Everyone thinks they are being gentle.

I think the phrase should be "don't retract " (even gently).

There is a danger in the use of adjectives.
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