Hi, this is the (long) basics of my story, and I'm really torn about what to do for the best. I obviously don't want to see my son in pain but an operation seems so drastic, and EVERYONE seems to give a different opinion.
The text below is mainly taken from an email that I have this week sent to a private paediatric urologist that I am hoping to make an appointment with, and gives pretty much all the details..
My little boy has just turned two, and has had recurrent problems with balanitis (sore penis tip and painful peeing) from about the age of 15 months. He started off with one infection that was treated with antibiotics. He was then fine for a while but had another bad bout of it in May/June 09 time where it seemed to come and go for weeks and various antibiotics were tried. He has since been fine again, up until last week where he was in pain whilst trying to urinate, and he is currently taking Augmentin (co-amoxiclav) for this.
I've been reading a lot about various conditions, and getting a lot of mixed messages from the NHS about whether any drastic action is needed.
One of my GPs is of the opinion that if I can't pull the foreskin back completely by now (which I can't - nowhere near in fact), then he definitely needs to be circumcised, but general consensus from the rest of my GPs is that he doesn't need circumcision at the moment.
A paediatrician he saw during one bout of balanitis said that it was quite normal to have occasional infections while he was going through some developmental changes "down below" with the skin cells breaking down etc. He said he may need a course of antibiotics occasionally, but what's the big deal in that.
I then got referred to a urologist (not paediatric) who looked in his nappy for about 2 seconds and told me he had "practically no hole" and that he needed circumcision.
He is currently on the waiting list (even though I haven't heard anything so far) to be circumcised but I am really undecided about whether or not it is actually necessary. The urologist was very unfriendly, didn't really answer any of my questions and just made me feel bad about questioning whether or not the circumcision was needed.
I have found a LOT of websites that oppose circumcision in toddlers unless its an absolute last resort. They seem to suggest that all children develop at different rates and there is no real definite age by which you should be able to pull the foreskin back completely, and also that children might go through a bit of pain and discomfort every now and then, but that its all "part of the process" and if left well alone to develop normally they would most likely end up not needing to be circumcised. They also talk a lot about balanitis and phimosis being really commonly misdiagnosed, and the whole thing has just left me with lots of questions.
Generally he is fine, with the odd flair up of discomfort/redness, which generally rectifies itself. I only take him to the GP when it is painful for him to urinate. I have been told that his foreskin is quite tight and the opening quite narrow, but I'm confused as to whether this is actually normal for a 2 year old, and is something that will resolve itself as he matures.
Sometimes when his penis is kind of "erect" it looks like his opening is really small and that the skin is really strained tight over the erection (as it doesn't retract), and then at other times, especially in the bath, the foreskin opening seems to be quite loose and what would appear to me to be normal.
One of my GP's prescribed some steroid cream that I could apply to try and stretch the foreskin so that it can be fully retracted, but again, I am not sure whether the skin should be able to do that by 2 years old anyway.
I was just hopeful for any advice you can offer at all - I really just want to know what is and isn't normal, and what my actual options are (as I know there are other things that can be done besides circumcision).
As a mum who is getting quite desperate about the whole thing, I very much look forward to hearing from anyone with their opinions.
The unfriendly urologist told me that everytime he got balanitis and I treated it with antibiotics that it would leave scar tissue (this would get worse each time) and that this would cause problems (eventually phimosis) as well.
Another thing I am not sure about is whether I am cleaning it properly. He has a bath (plain water with a tiny blob of unperfumed soap on a sponge for the armpits, hands and feet) and whilst under the water I just give the penis a wipe with the sponge and gently open up the skin with my fingers. I wouldn't say that I am retracting it as such (and certainly not forcefully), but sometimes its like the skin at the tip has stuck together so I just gently open it to expose a little bit of the glands underneath - but again I don't know whether this is helping or hindering...
Thanks for any advice, and sorry for the massive post.
Loufrank x
The text below is mainly taken from an email that I have this week sent to a private paediatric urologist that I am hoping to make an appointment with, and gives pretty much all the details..
My little boy has just turned two, and has had recurrent problems with balanitis (sore penis tip and painful peeing) from about the age of 15 months. He started off with one infection that was treated with antibiotics. He was then fine for a while but had another bad bout of it in May/June 09 time where it seemed to come and go for weeks and various antibiotics were tried. He has since been fine again, up until last week where he was in pain whilst trying to urinate, and he is currently taking Augmentin (co-amoxiclav) for this.
I've been reading a lot about various conditions, and getting a lot of mixed messages from the NHS about whether any drastic action is needed.
One of my GPs is of the opinion that if I can't pull the foreskin back completely by now (which I can't - nowhere near in fact), then he definitely needs to be circumcised, but general consensus from the rest of my GPs is that he doesn't need circumcision at the moment.
A paediatrician he saw during one bout of balanitis said that it was quite normal to have occasional infections while he was going through some developmental changes "down below" with the skin cells breaking down etc. He said he may need a course of antibiotics occasionally, but what's the big deal in that.
I then got referred to a urologist (not paediatric) who looked in his nappy for about 2 seconds and told me he had "practically no hole" and that he needed circumcision.
He is currently on the waiting list (even though I haven't heard anything so far) to be circumcised but I am really undecided about whether or not it is actually necessary. The urologist was very unfriendly, didn't really answer any of my questions and just made me feel bad about questioning whether or not the circumcision was needed.
I have found a LOT of websites that oppose circumcision in toddlers unless its an absolute last resort. They seem to suggest that all children develop at different rates and there is no real definite age by which you should be able to pull the foreskin back completely, and also that children might go through a bit of pain and discomfort every now and then, but that its all "part of the process" and if left well alone to develop normally they would most likely end up not needing to be circumcised. They also talk a lot about balanitis and phimosis being really commonly misdiagnosed, and the whole thing has just left me with lots of questions.
Generally he is fine, with the odd flair up of discomfort/redness, which generally rectifies itself. I only take him to the GP when it is painful for him to urinate. I have been told that his foreskin is quite tight and the opening quite narrow, but I'm confused as to whether this is actually normal for a 2 year old, and is something that will resolve itself as he matures.
Sometimes when his penis is kind of "erect" it looks like his opening is really small and that the skin is really strained tight over the erection (as it doesn't retract), and then at other times, especially in the bath, the foreskin opening seems to be quite loose and what would appear to me to be normal.
One of my GP's prescribed some steroid cream that I could apply to try and stretch the foreskin so that it can be fully retracted, but again, I am not sure whether the skin should be able to do that by 2 years old anyway.
I was just hopeful for any advice you can offer at all - I really just want to know what is and isn't normal, and what my actual options are (as I know there are other things that can be done besides circumcision).
As a mum who is getting quite desperate about the whole thing, I very much look forward to hearing from anyone with their opinions.
The unfriendly urologist told me that everytime he got balanitis and I treated it with antibiotics that it would leave scar tissue (this would get worse each time) and that this would cause problems (eventually phimosis) as well.
Another thing I am not sure about is whether I am cleaning it properly. He has a bath (plain water with a tiny blob of unperfumed soap on a sponge for the armpits, hands and feet) and whilst under the water I just give the penis a wipe with the sponge and gently open up the skin with my fingers. I wouldn't say that I am retracting it as such (and certainly not forcefully), but sometimes its like the skin at the tip has stuck together so I just gently open it to expose a little bit of the glands underneath - but again I don't know whether this is helping or hindering...
Thanks for any advice, and sorry for the massive post.
Loufrank x
