Need help - freaking out

[miztrezzlyn]

My son is 4 years old. He is uncircumcised and I am/was adamantly against circumcision.

Yesterday he came to me and told me that it hurt when we went pee. He peed again and again said it hurt. I called the doctor and they couldn't get him in until this morning.

He hasn't gone pee since yesterday at 5pm EST and my husband took him to his appointment this morning and it took them 1/2 an hour at the dr office to get him to urinate into a cup.

The part I am freaking out about is that his doctor is telling my husband that there is a problem with the foreskin and that its growing over his penis? And that he may have to be circumcised to fix it? WHAT?

I don't want my son circumcised and I certainly don't want to do it at FOUR years old.

Have you ever heard of this before? Is there anything I can research or...I trust his doctor, I do. He was very supportive about the non circumcising but this has got to be wrong right?

Please someone tell me that I don't have to subject my son to that.

[bandgeek]

I would think UTI before severe phimosis (tight foreskin). Phimosis itself isn't very common (and most boys your son's age have NORMAL tight foreskins) and severe enough to restrict urine flow? Probably not. He's probably struggling to pee because it hurts to pee because of infection. And no a UTI isn't caused by having a foreskin, so don't let the doctor tell you that!

I wouldn't trust that doctor....maybe he's otherwise a good doctor, but even good doctors aren't usually educated on intact penises.

Even IF (and that is a huge "if") he has severe phimosis, circ is NOT necessary. There are creams and stretching exercises to loosen it and at the very extreme, a surgery performed to make a slit in the foreskin. Complete removal is not necessary. But again, severe phimosos probably isn't the problem. They need to check him for a UTI.

I'm sure someone will be along shortly with things you can do at home to help keep the UTI from getting worse if that what he has. I know water and real cranberry juice are recommended.

[TCA2008]

Please go to the NOCIRC.org website and pull up the brochure on avoiding circumcision after the newborn period.

Have you observed his stream of urine? If it flows fine, in a reasonable stream, then there is no problem with the foreskin. If it literally only comes out in a trickle, there might be a chance it is too tight, this can easily be corrected with steroid cream.

As a strong intactivists, I have also freaked out a few times when my sons (ages 11 and 8) have complained of painful urination.

Almost every single time, it was just a minor irritation - the exact same thing that at some point happens to basically every little girl too - an irritation such as - bubble baths, chlorine from a pool, or well, just diaper rash irritation. We do not cut little girls' labia off because they get inflamed or irritated from time to time.

Since he is complaining of painful urination, it does make sense to have a urine culture and test for a UTI. If it is not a UTI, you might want to rule out yeast infection too.

If those are not the answers, and your son's stream of urine is fine - it seems to flow adequately, try a few simple things like letting him soak in some warm water baths (no soap), and applying acidophilus to his penis (health food store).

Everytime this has happened to one of my sons, after a few bath soaks they were totally fine in a day or two.

call Marilyn Milos at 415-488-9883 to consult with her further, she is an expert on foreskin issues.

Also, intactamerica.org has an excellent handout on foreskin care available under their resources section. I hope you will share information you've gathered with your son's doctor too.

[miztrezzlyn]

Well my husband just came back from the appointment and he has no infection.

The doctor says he has "Phimosis".

From what little I've read about it so far, its really freaking me out.

They are saying that it won't get better but worse and the next step is to take him to a Pediactric Urologist but there isn't one in the area.

[eepster]

It is most likely that he simply is having a bit of pain and possibly swelling from normal separation.

Separation is a natural process that all boys go through at some point up to puberty. It occasionally is uncomfortable, like many steps of development. It is no more a cause for surgery than the bad cramps most girls get when they first start menstruating.

You can read more about it here.
http://www.mothering.com/discussions....php?t=764732?


This is a general article about Drs misdiagnosing foreskin problems.
http://www.mothering.com/health/prot...advice-parents


If the Dr tried to retract your DS's foreskin during the examination, the pain is likely to last longer than usual for simple separation pains, since the Dr probably caused some damage. Your DS is also more vulnerable to infection if the Dr tried to retract him.

[kiara7]

With all due respect, you may like the doctor and trust him, but he knows nothing about normal development of intact boys.
Phimosis can not be diagnosed in a 4 year old the same way it can't be diagnosed in an infant.
With absense of other issues, it's most likely separation. You can have him pee in a cup of warm water and take baths with baking soda to help soothe the irritated areas.

[BlessedMommy2006]

Originally Posted by kiara7

With all due respect, you may like the doctor and trust him, but he knows nothing about normal development of intact boys.
Phimosis can not be diagnosed in a 4 year old the same way it can't be diagnosed in an infant.
With absense of other issues, it's most likely separation. You can have him pee in a cup of warm water and take baths with baking soda to help soothe the irritated areas.

Don't worry, your son doesn't need a circumcision. Why more doctors aren't more educated on intact boys is beyond me.

[miztrezzlyn]

Thanks so much for the information/advice so far.

My posts previously have been short and apparently not very cohesive. I'm just freaking out and I don't at all trust this diagnosis. I don't know if its just because I don't want to believe that he has this problem or if its just because it doesn't seem right to me.

My only real concern is that he is having trouble urinating. Although just now he urinated without a lot of difficulty and said "it hurt a little" then immediately after said "maybe not". When he is actually urinating its coming out in a stream and looks fine, no misting or only coming out in dribbles.

The doctor "showed" my husband that he is not "seperated". He didn't pull the foreskin completely back in any forceful way. There isn't ANY seperation whatsoever going on with my son's penis. Is this normal? I know that it will retract when ready but as it is right now, there is just a very very small opening where he pees, no sign of seperation at all with the rest of the skin. I am a little worried about that but then I don't know very much about the "normal" appearance of uncircumcised boys.

I am hoping with all hope that his doctor is just wrong, we are going to go see a pediatric urologist but I am worried that I'll get some circumcision happy one. I want one that I know to be anti-circumcision. We'll have to go to Rochester to see one since there isn't one around here but I'm afraid. I won't know this doctor and what their beliefs are.

I absolutely don't want my son circumcised, I mean thats why I made the decision in the first place. I am firmly against it. My husband is as well. Especially this late, at 4 years old. I feel it would be very traumatic for him and for us. I can't see doing that to him.

I am afraid that my husband is very worried and tends to automatically trust my son's doctor, where I am usually the opposite. His feelings are that if there is a problem that can't be corrected any other way that circumcision is probably the way to go.

How do I know if this is a REAL problem? I mean my son IS having difficulty/pain urinating. But this just all of a sudden came up yesterday. Nothing ever was suspicious about it before. It just seems strange.

So, I've read some of the things that you have directed me to and I am just still so confused. How do I know which part of it is normal for uncircumcised boys and when is it a problem? Will it just get worse? How do I know that I'm getting sound medical advice?

I don't know if I am just overreacting but I am completely distraught about this.

What I'd like to see is pictures of "normal" uncircumcised boys at or around this age. Is there anything like that? I am afraid to search for it myself, I don't know what will come up. I just have NO idea if what I'm seeing in my son is abnormal or not.

[Claire and Boys]

My oldest son is 5, he is completely unretractable as well. It's normal. The discomfort your son is having as previous posters said is more than likely the beginning of separation. If this is something new that only just came up the past few days, I would wait it out and see what happens. He's peeing, so I don't see what the big emergency is requiring a surgery right away.

[miztrezzlyn]

He is peeing but he is reluctant to do so because he fears the pain that he says he has when he pees.

Yesterday he only peed 4x between the time he woke up and the time he went to bed with the last time being at 5pm EST when he went with my husband and he was unable/unwilling to go this morning before his appointment. At the appointment it took my husband coaxing him to pee in a cup in the bathroom for about 15 minutes before he did and that was at 9:15 am.

BUT, just about 30 minutes (11 am) ago he peed again for me and after just a small hesitation didn't seem to have any problem. He was also unclear on whether it actually hurt or not.

Should I really just "wait it out"? I feel that I might be a bit irresponsible if I do that? I should avoid going to see this pediatric urologist altogether?

[bandgeek]

Originally Posted by miztrezzlyn

Should I really just "wait it out"? I feel that I might be a bit irresponsible if I do that? I should avoid going to see this pediatric urologist altogether?

Sounds perfectly reasonable to me. He's getting better, not worse, and they said there's no infection, so it's certainly not dangerous to wait.

BTW, my 4 1/2 year old is still completely unretractable and has a "pinhole" opening. When he pulls back on it, you can't see his glans or meatus at ALL. It really is normal.

[MommytoB]

I wonder what doctors really think a foreskin looks when they say the foreskin is growing over its head and I'm like what in the world .

Correct me if I'm wrong don't most all males with foreskin have foreskin covering up the glans except for those who are born with shorter foreskins.

I would do the wait and see . If your son continues to have pain during pee have him pee in a warm water cup that will reduce the acidy of the urine that is proably heading along those tears as the foreskin releases.

[Claire and Boys]

Originally Posted by MommytoB

I wonder what doctors really think a foreskin looks when they say the foreskin is growing over its head and I'm like what in the world .

Correct me if I'm wrong don't most all males with foreskin have foreskin covering up the glans except for those who are born with shorter foreskins.

I agree. It really sounds like they don't know what a normal penis is supposed to look like. And I would not personally trust someone like that to know how to handle my intact son.

[Fay]

My DS1 had a similar problem at age 5, and I received some wonderful advice on this forum that I'd like to share.

First, you should rule out a UTI. Pharmacies sell home test kits for UTIs, very simple to use.

Second, the most likely cause is an adhesion, which is normal in the process of natural retraction. You won't believe how simple the treatment is for an adhesion. Have your son dip his penis into a cup of warm water when he urinates (this will be tricky because the cup will overflow, but it does alleviate the pain significantly). Give him warm baths WITHOUT SOAP, and allow him to urinate in the water just before stepping out of the bath. The warm water treatment should eliminate the pain within 2-3 days (it worked in 24 hours for my DS1).

I hope that your son finds relief from the pain soon and can avoid unnecessary circumcision.

[bandgeek]

I think they are very familiar with adhesions on circ'ed penises, so they assume the "growing over" problem is something that you have to look for in ALL boys. But they don't realize that adhesions are different in circ vs. intact. In intact, they are right where they are supposed to be. In circ'ed they have been ripped apart and are trying to grow back, sometimes not in the best place. I mean, it's common for doctors to recommend re-circ for circ'ed boys with "extra" foreskin that has re-adhered. IDK, maybe an intact boy who is regularly forcibly retracted could have that sort of problem.

[miztrezzlyn]

I agree, after reading a lot more I am more hopeful that it is indeed just "normal" and want to wait and see how it develops.

My husband however is nervous and just wants to be sure it isn't something that will just become MORE of a problem if we "wait".

The other thing my husband just told me about what the doctor said at the appointment was that the doctor thinks that his foreskin is growing "inwards"? Anyone know what that might mean?

I like this doctor, I have had some issues with his advice before though. My husband really respects him but I just don't know. He failed to diagnose his GERD and in fact treated me as if I was silly when I suggested it after much research and it caused a LOT of problems. Also there was an issue where he was suggesting that I supplement with formula when my son was born. Of course, I didn't follow that advice and just breastfed as often as possible.

But these things, coupled with this very important issue to me, really makes me think that I must find him a new pediatrician. He has ALWAYS been very supportive of my not circumcising and in fact I believed him to be anti-circumcising but...this I just don't feel good about him as my son's doctor right now.

What about this foreskin growing in thing?

[kiara7]

You guys need to relax. Call Marylin, she is a RN and she'll tell you everything you need to know.
3-5 years old is a common age for beginning of separation. Have your son pee in a cup of water and give him a baking soda bath. It hurts to pee because urine stings the newly separated skin. Usually goes away within 24-48 hours.
With a UTI, you'd have fever, etc.

And honestly, your doctor is full of it. Foreskin growing inwards??? How did he even come up with that??? Insanity.....

[bandgeek]

Originally Posted by miztrezzlyn

What about this foreskin growing in thing?

Again, probably doesn't know what an intact penis looks like. The foreskin is a like a double layered sleeve that comes to a fold at the end (tip) of the penis and them "rolls" back in on itself. Maybe not the best description. A foreskin will always look "rolled in" to some degree. It's just how it's designed. That's all I can figure is he sees normal and isn't familiar with it.

Really, all doctors are taught about it is how to cut it off. They aren't taught the ANATOMY of a foreskin. Next time you take him, ask the doctor to label the parts of a foreskin. $50 says he can't do it.

[SleeplessMommy]

If this doctor is older, he is probably used to how things were in the 80's - more than 90% of boys were circed. If there was any penis problem, you just circ again to try to "fix" it.

As others have said, there is no reason to surgically "fix" the pain during urination. Pee in a cup and it will be better in a few days. Re-testing for UTI (at home, not at the doctor's office) would be a good idea, as there might be a UTI which was missed by the office test.

The foreskin is supposed to be adhered to the glans at this age. You will probably never see it retractable, as that will happen in early teenage years, and your son will not be willing to show you. In general, the intact penis is easy care from here on in. Once it is retractable, your son will simply retract and rinse *without soap* while in the shower.

[miztrezzlyn]

Ok I will call Marilyn once I formulate my list of questions and things I'd like to go over.

Thanks again for all the reassurance, its been such a huge help. I really appreciate it.

Now for my "moment of rage". My husband said that our choice was to see either a local urologist (since no pediatric urologists are around here) or go see a pediatric urologist about 2 hours away. After initial reading I was wanting to at least see a pediatric urologist vs one that doesn't specialize in children. My feelings have changed now, want to wait vs seeing anyone but my husband wanted me to at least call the pediatric urologist and see how long they felt was an acceptable "wait and watch" period was. All that aside I just got off the phone with my pediatrician's office and the secretary told me that the local guy can do "it". When I asked what "it" was, with increasing dread, she said "the circumcision" /BOGGLE

Certainly they have it ALL wrong, the pediatrician KNOWS me and I can't imagine he thought that I would just blindly go in for a circumcision like that. I was furious, and told the secretary that no we would NOT be making that appointment. I am not at all interested in exploring circumcision and that right now I just want to get more information and PERHAPS a consultation with a pediatric urologist in the future. She says she couldn't even just give me the number to the pediatric urologist so I can talk to them myself.

I'm just frustrated and annoyed now.

BUT, my son went pee again (becoming a lot more frequent since yesterday) and he said it didn't hurt at all. He is also happily playing in a warm bath right now.

Thanks!