red painful penis

[lolabelle]

My son is 18mos. old and is intact. He was irritable yesterday and just not himself. At bathtime I noticed that his penis was red and it looked inflamed. He screamed when I barely touched it. Needless to say he had a rough night. I changed his diaper in the middle of the night and noticed a white discharge. This morning he was in good spirits and his normal self, but when I changed his diaper he had more discharge and the tip is now inflamed and flattened and the penis itself looks inflamed and kind of bulging on one side. It's still painful and he want let me put a diaper back on.
I have made an appt. to have it checked out today and the nurse on the phone said that is important to keep it clean and to gently pull the foreskin down and wipe it with plain warm water. Does this sound okay?
I have a feeling that it may be caused by a new bubble bath I got last week.
Any thoughts on what this is or what I should do and what not to let the docter do?
Thank you!

[Quirky]

Poor little guy!

I definitely would not pull the foreskin up or back (ie retracting it) or let a medical person do it "even a little bit." You don't want to make the problem worse! I would maybe swish it in a plain water bath but not manipulate the foreskin.

It could be the bubble bath, or it could be irritation from natural separation. Either way I would discontinue the bubble bath and let him have as much nakey time as possible. If you use cloth dipes, run them through a hot wash with no detergent just in case some detergent buildup might be irritating him.

There are lots of knowledgable folks on these boards who will probably reply soon; you've come to the right place!

to MDC and I hope your son feels better soon!

[Frankly Speaking]

The bubble bath definitely could be the cause or it could be just part of the normal separation process.

You have to realize that the foreskin is much like the lips and slight trauma will cause it to turn red and swell. It rarely amounts to much. If it is the bubble bath, that is easy to take care of. If it's the separation process begining, it will take care of itself within 24 hours. However, this does sound like a little more than normal separation.

Do not "pull the foreskin down" or allow anyone to do it including medical personnel. Retracting an infant's foreskin can lead to damage and future problems. Warn the doctor and nurse ahead of time that they are not to retract your son's foreskin and then watch them very closely. They can and will do it in the blink of an eye.

It is almost 100% certain that the white discharge is smegma which is normal and natural and nothing to be concerned about.

Other than the normal separation process, there are three other possibilities. One is the bubble bath or other irritant. There is the rare chance of a bacterial infection which can be easily treated with antibiotics and there is a chance of a yeast infection which can also be easily treated. What ever happens, don't even let them suggest a circumcision!

Good luck and let us know what happens




Frank

[mattemma04]

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[lolabelle]

Wow! Thanks so much for your quick replies!! On the phone, I did ask the nurse if they see a lot of uncircumcised boys...and she said "yes...a lot of people just don't want to do it". I didn't know how to take that. Anyway, I will be sure not to let the Dr. pull on the foreskin, up or down. Thanks!

[scubamom]

my ds who is 7 weeks old is intact and were very happy.
it was never an issue for me and im glad to say wasnt for my dh either. never even thought about getting it done.

pediatrician even told us she prefers to keep it the way nature intended.

[scubamom]

whoops

sorry dont know how i managed this but this was meant to go on a different thread
whoops

[gilnikche]

Originally posted by lolabelle
Wow! Thanks so much for your quick replies!! On the phone, I did ask the nurse if they see a lot of uncircumcised boys...and she said "yes...a lot of people just don't want to do it". I didn't know how to take that. Anyway, I will be sure not to let the Dr. pull on the foreskin, up or down. Thanks!

That nurse's response is scary. I would advise caution also. It is not just a matter of "not wanting to do it". It would literally be ripping tissue that is not supposed to even be moving yet! Retraction could actually cause a stricture.

I have two intact sons. The older one is six. His foreskin did not become retactable until after his third birthday. He has had a few episodes of an inflamed tip.Calendula baby cream cleared it up. Most of the irritation after that was from him playing with it. :

I am not sure if you have gone to the doc yet; but if not...

Did they ask what color the discharge was?Smell? Fever? These are standard questions.

Is this your regular doctor? You should feel comfortable with their practice.

[Frankly Speaking]

Heather:

I'm very sure it was a non-issue for you and your pediatricians information doesn't surprise me either. In Newfoundland, only about 6 of every 1,000 boys are circumcised. A boy who has been circumcised would certainly be an oddity and probably the talk of the town! I'm sure most of your friends and neighbors would find it quite disgusting.



Frank

[lolabelle]

update

__________________________________________________ __
Originally posted by lolabelle
Wow! Thanks so much for your quick replies!! On the phone, I did ask the nurse if they see a lot of uncircumcised boys...and she said "yes...a lot of people just don't want to do it". I didn't know how to take that. Anyway, I will be sure not to let the Dr. pull on the foreskin, up or down. Thanks!
__________________________________________________ __

I hope I didn't confuse anyone...the nurses response was to my question if the doctor sees many uncircumsized boys. I guess it was in the manner she said it that didn't register well with me.

The doctor we saw has been my son's doctor since birth and we chose him because he is a family practitioner and was AP friendly and didn't hassle us with vaccinating. We saw him up until 9 mos. when we moved across town and I didn't feel it was neccessary to continue on since we were not vaxing.

The doctor looked at his penis and apparently he doesn't see as many as his nurse implied. He winced as it does look painful....and is....but he said he thinks it's a bacterial infection. He said he has never seen anything like it because most boys now a days are circumcised. I just let it go, and nodded...
He doesn't think it was just the bubble bath because it looks more than irritated ( he also added...NO BUBBLE BATHS...they should be outlawed for children because they cause nothing but trouble). He said that maybe he scratched it and it got infected. He made a call to the childrens hospital and spoke to a pediatric urologist and they agreed to treat it as an infection for now and treat with antibiotics. I am to call him after 10 am to update him on how it looks after his two doses yesterday of the antibiotic. Unfortunately, It doesn't look much better but I don't think I got enough of the antibiotic in him last night...it gags him and I think I might have diluted it too much. We did much better this morning with a straight dose. If it doesn't look better, he is sending us to the Children's Hospital to the urologist.

I am so scared for him. Just the other day after reading through some post here, I said to him...You are going to thank me some day for not letting anyone cut your penis! and I was proud of myself for researching and educating my dh and deciding not to circ. and now this! I can just here all my friends who we debated this with saying, "see...I'm glad we did circ"

I will stick to my guns though and reject any suggestions of circ'ing from the Dr's should it come up.

Any ideas on what this might be? Last night I did some reading and it sounded like maybe infant phimosis. It use to be treated with circ'ing but studies have shown topical 1 % hydrocortisone to be an effective treatment.

His symptoms are: a red inflamed penis/or forskin, the tip is inflamed and slightly flattened and has some smegma. It is also very sensitive.

edited to correct spelling of "phimosis"

[MistyD]

You can also try some salt baths. Just sprinkle a liberal amount of salt or sea salt in a warm bath (no soap). Maybe add a few drops of tea tree oil too. Several baths a day and let him run around naked to air out afterwards.

[Frankly Speaking]

You can forget about phimosis. He has it and nothing is needed to treat it.

You see, there are two kinds of phimosis. There is normal and natural phimosis called developmental phimosis. This is when the foreskin is not ready to retract yet and the opening in the foreskin is very tight as it should be. The other is pathological phimosis that is caused by repeated infections or trauma such as repeated premature retractions. You son does not have this.

You should see a noticeable improvement in your son's condition within 36 to 48 hours after starting the antibiotics. Be sure to continue the treatment until the prescription is finished.

What the doctor has done is guessed at a bacterial infection and has given you a broad range antibiotic. This is an antibiotic that will kill a number of different bugs. If this does not show quick results, you should take your son back and have a culture done so they can identify the specific bacteria and prescribe a treatment that is known to attack that particular bug. A culture is nothing more than taking a swab of the area, growing it in a petrie dish and then inspecting it under a microscope. This takes the doctor's blinders off so that he is not guessing anymore and can attack the specific bug.

Keep us updated.



Frank

[lolabelle]

update

I didn't call the doctor yesterday because I thought that I might have diluted the antibiotic too much the day before to have any real effect. Yesterday I got my ds to take it straight. By afternoon I was able to change his diaper without the screaming and by evening his penis was starting to look a bit less inflamed and returning to normal color and size the bit portion closest to his body. But, twice when I changed his dipe, there was a bit of yellow waterish discharge on the diaper that looked like it came from the tip. This morning it looks SO MUCH better and I was able to touch it without a reaction and he also was able to touch it... I could just see his mind working as he touched it with his little finger.. "Hmmm...this doesn't hurt!" It did have some white smegma on it but I guess this is a good sign, yes?

Thank you all sooo much for your advice and help...esp. you, Frank.

On a side note...My FIL is the only person we know who is intact.
He and my husband own a business together and ds and I went to the office yesterday to go out to lunch. When I walked in FIL asked how my son was and then my husband says..."We have been doing it all wrong and it makes since. Dad says we should be pulling the foreskin back and cleaning it out!" I said "NO we shouldn't! You should NEVER do that!" My FIL who is very outspoken and insistent says...YOU have to do that, urine gets trapped under that skin and that is causing the infection. It's a cleanliness factor. That is why the Jews started circ'ing...because of the cleanliness." I informed them that everything I have read from med. to circ. websites say that you never do that. It went back and forth and FIL said well just call your doctor and find out. Gesh....
Well, I came home and copied about five links to proper care of an intact penis and sent them to my husband to pass on...as well as a link to a Jewish learning site with the reasons they originally started circ'ing.
My husband said he got my emails when he got home and I said well...and he was just like ...whatever. I said "you have to know these things and you need to let your dad know as well. They might have done that when 70 years ago when your dad was young but not know. And...I don't want your dad touching ds penis when they watch him...like if they give him a bath I don't want him pulling back the foreskin and washing it out.
And that is where it was left. I will just have to have a talk with my mil when they watch ds next.

[mattemma04]

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[Frankly Speaking]

Lolabelle:

Has anyone babysit your son who could have retracted his foreskin? Like your MIL? Since there are so many people who believe an intact penis is so hard to care for, one of them could have retracted him causing this problem. They think they are doing the right thing when in fact, they are causing problems such as this. Infections such as this are really rare despite everything people say as long as they don't mess with it. As a matter of fact, yours is only the second case I have ever heard of in more than 3 years on several sites. The other was a staph infection the boy would have gotten even if he were circumcised.




Frank

[lolabelle]

No, Frank...no one has sat for him recently except for when we workout at the YMCA...they have a nursery and they don't change him. My husband said he had washed it with a wash cloth, but I know he didn't retract it. I was putting a lot of bubbles in the bath the week leading up to this and then a few days before we took him swimming at the Y's indoor pool, which I know is heavily chlorinated. I was thinking that the combination of the two might do it. I was also wondering if too much acid in his diet could contribute to anything? Ds discovered he liked oranges and for a couple of days would eat like 2-3 in one sitting and spaghetti on the evening the trouble began.
I just don't know. Could ds himself pulled on it to hard? He does sit in the tub and pull on it. Another theory I had is...he has these rubber duckies that have holes in the bottom of them in which water collects. I have heard these can harbor bacteria and I try to clear the old water out but I am afraid I am not always on top of it...Any way he sometimes puts a duck on his penis...I thought maybe bacteria got to it that way...I am just racking my brain and making guesses here. I'm getting rid of the ducks anyway.

[gilnikche]

lolabelle,

I used to work as a nurse (just so you know where I am coming from).

I wonder if your doctor would make the diagnosis of a bacterial infection so easily on a circumsized baby. I think he should of taken a swab of the area for a culture.

I think it was overkill (literally) to prescribe a broad spectrum antibiotic. Why not a antibiotic cream? It could very well have been acute dermatitis which is usually treated as you described...

It use to be treated with circ'ing but studies have shown topical 1 % hydrocortisone to be an effective treatment.

My first thought on your FIL's comments were "Geez, how could he remember what was done to him at 18 months?" His advice seems appropriate for a teenager and up, but not for a toddler :


Absolutely get rid of bath toys that can harbor bacteria! If water can get in them then bacteria or fungus can easily grow. Heck, putting the duck toy on his penis (causing slight abrasion) combined with the bubble bath could have done it. Bacteria may have never been involved.


It sounds as if you are a first time mom. People (especially family) just love to tell you what you "should" be doing with your child. They mean well. My MIL made me cry when my first babe was 2 days old by constantly telling me what I was doing wrong. My hubby nipped that in the bud. My own mother took every opportunity to harp on me. I realized that this was an issue of respect.

My MIL & I get on well now. Never did get anywhere with my mom...

Personally; I would address the issue with your in-laws before they watch your son again. Why wonder the whole time what they "might" do?

One more suggestion. Ask around * see if you can find a "intact friendly" doc.


I did not mean to go on quite so much...

[momto3boys]

Hi

I had the same thing happen with my ds after he poured a whole bottle of bubble bath in the tub. We used a topic ointment and it was better by the next day.

[momto3boys]

I found link about circ in Canada.

http://www.cirp.org/library/statistics/Canada/

[Frankly Speaking]

Chlorine, citric acid, bubble bath. Yep, any one of those could cause a problem and if it's not bacterial, it's a possibility that the three of these could have worked together. I know one mom with 2 circed and one intact son. After swimming, the circed boys had clorine burned glans and the intact boy had a burned foreskin but an unaffected glans. Personally, I think I would have rather the outside of my foreskin take the damage rather than the glans. She felt the same way.





Frank