Inguinal hernia and scared about retraction.

[Attached2Elijah]

My son is going to the Urologist next month for a probable inguinal hernia, which I'm assuming, will result in a scheduled surgery. I have been a part of this forum since he was born and have read about all the retractions done by Urologists and I am scared to death. I have given in to the Doctors on more then one occasion when it's something I don't agree with simply because I have a huge fear of confrontation. I don't know if it's because of social anxiety or what but it's a problem in my daily life... and this is something I KNOW I have to be strong about and I think I can do that while he is being examined but I am SCARED.TO.DEATH of the surgery when I won't be in there with him. He is not retractable (He'll be 7 at the time of surgery) at all and if they catheter, I'm sure they will try to retract as his foreskin is very tight. I'm so scared for him... he has been cath'd before at 8 weeks old before I knew as much as I know now and I still, to this day, have no idea whether he was retracted back then or not since I wasn't in there. I don't think I could stand the not knowing again. Thankfully he is more vocal now and would be able to tell me if it hurt... but I don't want it to happen in the first place ... and the worst part is that it is Columbus Children's Hospital that will be doing the surgery, which employs one of the biggest pro-circ surgeons in the country and that scares the Holy living CRAP out of me. I will be printing out the retraction agreement and writing "intact, don't retract" on his belly but I just can't get over this stomach dropping fear that something is going to happen regardless of what I do.

[MCatLvrMom2A&X]

I would be worried to. I think it is a great idea to write on his tummy and also use the intact care agreement. Odds are that if they see you are this serious about him not being retracted they will not do it for fear of being sued. I to have major issues with confrontation but after dealing with Dr's several times now on keeping their hands off I have gotten a lot better at it thankfully. But I still dont like it.

[eepster]

You can do the following:

• Post in Finding your tribe asking for Dr recommendations.
• Take an advocate with you to all the appointments. This could be anyone, but I recommend a close relative who also believes in not retracting but is also more out spoken than you are.
• Be willing to travel. You say that the surgery will most likely happen at a hospital you are uncomfortable with, but why? If you don't trust the hospital, then go to a different one.
• Any time you feel uncomfortable say "I'd like to go get a second opinion."

There is another issue you may not be aware of; a 7yo, who can not retract, is at a high risk of being dx with phimosis. I'm not saying your DS has phimosis, it is way to early to worry about that, but urologists seem to love that dx and I have seen it given to much younger boys than 7 yo. Then they start in on the improper treatments. Tvey usually do give you the steroid creams but give poor directions for application and don't mention the stretching exercises that are necessary to go with the cream, but entirely inappropriate to do on children (this treatment was designed for adults to do themselves and is basically masturbating with a different goal.) When the improper steroid treatment fails they say he needs to be circumcised.

[Night_Nurse]

Ask that he be cathed before the pre-op meds to sedate him and insist on being present during the cath. That way you can remind them NOT to retract and slap their hand away if they start to do it. Also remind your DS to yell "stop, you're hurting me" if it anytime he feels pain from a medical worker moving his foreskin. Obviously he can't do that if he's sedated but there is no reason he can't be awake during the cath. Be prepared for resistance if the Dr/nurse thinks your son will be too scared to be cathed while awake (when I worked w/ pediatrics I've found kids that age can be either okay with or extremely terrified at the thought of a catheter).

[musicteachermom]

Good news for you - We just had surgery for my son's inguinal hernia yesterday. The did not need to catheterize him as it was a short half-hour surgery, but I did have a scary moment. The urologist came in to talk to us right before they took him for the procedure, and I told her I wanted to make sure no one was going to try to retract his foreskin. She looked right at me and said, "I always retract the foreskin to clean" and I'm sure she saw the freaked look on my face. I brought up how no one was supposed to retract except the boy and how it was still attached and she said it would prevent infection so she always cleaned under there. I kept saying I was not comfortable, and she finally said she wouldn't do anything we wouldn't approve of, and so she would not retract him. When she left and the surgery nurse came to get him, the first thing she said was that the doctor had talked to her and said not to retract him, so I think everything was good.

As far as recovery, he's been fine, penis looks fine, and very minor swelling of the scrotum, but otherwise it's like it never happened. I wish you the best. Just be firm on your wishes and hope they will follow them. You can also tell them he does not retract yet and it is still attached and explain that it can create scarring and pain if retracted at this age. Then offer them literature. This might scare them into leaving him alone. But do tell all of the nurses when you get there so they start talking about it and spread it to everyone who will be taking care of him.

Editing: He was partially retracted by the Physicians Assistant when we went to the urologists office, even though it had nothing to do with the hernia. Before anyone there touches him, I would tell them that your son's foreskin does not yet retract and please don't try to. Your son is also old enough to stop them with his hands if they try, and you should probably teach him to push their hands away if they mess with him.

[Nitenites]

If you need to find another hospital and/or doctor, PM me. I'm in Indy, so only a couple of hours away. My son had a communicating hydrocele and hernia, corrected by surgery at 4 years old. Our pediatric urologist was (is) anti-circ. I made sure when I spoke to every, every nurse, orderly, doctor, etc before his surgery to say, "Do not retract my son, or I WILL sue you and this hospital." I also wrote on his tummy (below his navel) "DO NOT RETRACT!" in Sharpie marker. I spoke to his ped urologist right before the surgery, who assured me that there would be no reason to retract, even if a cath were needed (which was unlikely). He said he would be sure to restate that to the nurses (as in, he was going to tell them again), just to be abundantly clear.

DS came out of the surgery just fine, no retraction. I love our ped urologist - he's a great doc, and pretty crunchy too boot!