Baby boy retracted by nurse

[~Nancy~]

I'm kind of concerned about my son, and I'm hoping someone here will have some advice.

My 2-year-old son was diagnosed with kidney reflux when he was 10 weeks old.

Follow up care involved a lot of cathetars. He has probably had a cathetar put in around 20 times.

My husband and I have always insisted that he is cathed by a urologist, or at least a pediatrician that knows how to handle an intact baby boy.

A few months ago, he had a VCUG (x-ray taken while voiding). He has to have a cathetar for this procedure. For the first time, they wanted to put him under light sedation.

He had some minor complications with the sedation, which made DH and I very upset and distracted. Our son was laying down, on his back, and kind of fighting sedation. So we were on either side of him, consoling him, focused on his face and worried about his breathing.

We totally dropped the ball on supervising the cathetar. *sob*

I didn't know they were doing the cath yet, and a nurse asked, kind of surprised, "Have you not been retracting his foreskin everyday?" I turned around, and saw that she had him fully retracted, and was advancing the cathetar.

DH told her no, that you're not supposed to retract intact baby boys. We were both too sick at what happened and worried about our son to really react and deal with what was happening.

His foreskin looked like hamburger meat for a few days.

A few weeks after this happened, our son started complaining that his penis hurt. I took him in for urine cultures, to make sure he didn't have an infection. His culture was clean.

I have made an appointment with his doctor (pediatric urologist) to have him examined. I am very afraid that he has adhesions, but don't really know how to check him for this? Or if I should?

Our son is going to have surgery, some time in the next year, to repair his kidney reflux. Now, we are wondering if we should have him cirumcised when he has his surgery.

Some background, DH was circ'ed as a teenager - he thinks this had to happen due to damage from being retracted at a young age. So, this was traumatic for him, and if our son has been damaged, he doesn't want him to have to deal with this later.

Does anyone have any advice, or personal experience to share? I do not want to circ our son, but I also do not want him to require a another surgery later.

[texmati]

I don't have any advice-- but shame on that nurse! I'm sorry this happened.

I would think that he should heal himself, but perhaps other poster will have more info.

[MCatLvrMom2A&X]

He will be fine as long as it is left alone from here on out. It is normal and right for it to reattach to heal what was done.

Having him circed would be a huge mistake you where able to protect him up till this point which is great.

I would though make 100% sure that the Dr. understands that he is not to touch his penis during the surgery since we have had a few stories here about Dr.'s forcibly retracting during surgery for other things.

Repeat forced retraction is where you run into problems with things down the road like true phimosis where scar tissue prevents normal retraction.

Even that though can be treated without circ if it happens stretching and steroid creams first followed by a dorsal slit if it fails. circ should not even be considered.

I am sorry that happened to your ds but honestly I would not worry that he will have issues because of it later on unless it keeps happening which I know you wont allow.

[~Nancy~]

Thanks - I appreciate the advice.

I have a lot of faith in the doctor that treats our son. He is a pediatric urologist, and everyone at his office is knowledgeable about handling an intact boy. It was a nurse at the radiology department that retracted him. Our doctor was not there.

DH had phimosis when he was young - circumcision was the only option presented. I'm glad to see there are other options.

Right now, I am mostly feeling terrible that my son's penis is hurting. He takes off his pants and underwear as soon as we get home. He loves swimming, but he refused to put on his swim suit this weekend. Finally, DH realized what was wrong, and we cut out the mesh underwear out of his swim suit. Then, he was willing to put it on.

We're going to the urologist next week, for an exam, and some advice.

[Night_Nurse]

I'm so sorry all of this is going on with your son. I hope he's feeling better soon. When he's better and everything calmed down, I hope you'll consider sending that nurse and the radiology clinic some info from DOC (the hospital/clinic will have the name of the nurse who "cared" for your son). What she did was improper care and hurtful. No doubt in my mind she will continue to harm other intact boys and give out incorrect cleaning info to their parents.
Like others have said, I doubt any more trouble will happen if his penis is left alone. It will continue to heal itself (if it hasn't already) and as long as it's not retracted by anyone but him in the future, he should be okay!

DOC: http://www.doctorsopposingcircumcision.org/ (I think if you contact them they will still send a dr/RN/facility some info).

[MCatLvrMom2A&X]

also be sure to tell your urologist so that he can talk to them as well since he is knowledgeable from what you said.

[eepster]

Has the foreskin been pulled back down into its regular position? If it was left in the retracted position, then that would explain the continued discomfort.

[~Nancy~]

Yes, his foreskin has pulled back down into the regular position.

I am going to talk to my urologist about what can be done to educate the medical staff at the adjacent children's hospital in regards to handling an intact little boy. This is where we go for testing and procedures regarding his kidney issues.

I can't tell you how stressful it is; I'm already on edge while at this hospital, because my child is either sick, or having painful procedures. To have to constantly police his foreskin adds to my stress.

[serendipity22]

My 2 cents

I am very afraid that he has adhesions, but don't really know how to check him for this? Or if I should?

Only circumcised boys have adhesions, this happens quite often, skin attempts to grow back after circumcision. Cruel doctors sometimes tear these with anastethic,

The term "adhesions" is sometimes mistakenly used to describe the normal state of the intact penis. At birth, the foreskin firmly fused to the glans, as skin is. Sometime, usually before puberty it will naturally retract, at the age of 10, 50% of boys will have a completely retractable foreskin. There is no such thing as phimosis in young boys, a tight foreskin is normal.

Obviously, there is no need to check for "adhesions."

Circ would not help his reflux.

The nurse is very ignorant.

[jenP]

Nancy, I am so sorry for your poor little boy with his sore penis! I hope he is all better real soon. And I hope your doctor does help to inform the staff at the hospital on how to properly handle patients with a foreskin.
But, this was a one-time deal and with your good after-care and vigilance I would think there would be no further effects. There's no reason at all to think that a single forced retraction on a two-year-old would result in such severe problems much later in life that circumcision would become the only option. I'm just speculating here, but probably your husband's parents were told they had to retract and wash with soap and water at every diaper change, and after the diaper years to continue to retract and wash with soap at every bath. Now that kind of treatment throughout childhood I could see leading to scar tissue and phimosis. Then on top of the bad advice on cleaning, his doctor also probably didn't know about less drastic treatments for phimosis; circumcision is only a last result if other treatments have all been tried and failed. It must have really sucked for your husband. I'm sorry. But, there would be no point to circumcising your son now. Even on the way, way, way, way off-chance he would for any reason actually require a circumcision later in life, doing it now instead does not actually spare him any trauma. He would still experience all the trauma of a circumcision, just now instead of later.

I think it is really awesome that your doctor who sees your son for his reflux actually knows about foreskins and is not pressuring you to circumcise! Usually in the case of intact boys with a urinary tract infection, it seems doctors FIRST want to circumcise (because they have this superstition that UTI's are caused by foreskin.) Then if the boy gets another UTI after being circumcised, they will consider checking for reflux. Like, "oh, gee, look, his UTI's were actually caused by a kidney malfunction, imagine that! - sorry about that completely unnecessary amputation we already did!"
So, it is really encouraging that you and your doctor know that foreskin has nothing to do with your son's infections. And I hope those infections stop soon, too!
I know what you mean, what a drag to have to constantly be on guard to protect the foreskin! Like you don't have other, more pressing problems that need your attention. Why can't people just leave the thing alone, already?

Jen