udate on pain with urination now new problems?

[bev02]

You may remember that my 8 year old was having pain while peeing about 2 weeks ago. He now does not complain of that.

But I have noticed that his foreskin opening is tiny, about the size of a pen head. I worry that maybe he has or will have phismosis.
The ped. said the foreskin opening should be much bigger at this point and said that if steriod cream does not work he will have to be circumcised. I have not tried the steriod creme, I was taking my time and letting him get over the urination pain. He balloons alot while peeing, and the stream of urine is small.
He has been asking why his penis gets stiff. He never noticed when that happened before.

Please give suggestions.

[brant31]

I think you have answered your own question. If your son has a small preputial opening and yet has comfortable erections, he is fine. Despite what his doctor said, it is well within the normal range to have a very small preputial opening at your son's age. Ballooning is OK, too.

Just about every intact boy has phimosis. It is the normal state of being for boys up to the age at which they can retract naturally. In other words, any diagnosis of "phimosis" that isn't predicated on confirmed preputial scarring (such as a consequence of injury or BXO) is inappropriate before puberty. If your son's Pediatrician doesn't know that, find another.

Putting steroid cream on a pre-pubescent boy's healthy foreskin -- even if it is extremely tight, which is normal -- is the equivalent of giving growth hormone to your 8-year-old because he's normal height for his age but shorter than his dad.

As your son gets to puberty, he'll explore himself more earnestly. Don't discourage it; along with the hormonal changes, it's part of the process of a tight foreskin resolving itself. Right now, his foreskin is still performing a protective function. He sounds like a normal boy, and he's only about half the age at which he should consider steps to address this. My bet is that by then it will be a non-issue.

[bev02]

I hope it is normal. Although I do want to ask what is "preputial scarring" I noticed that when he pulls back on his foreskin the outer rim of the opening is almost white. Is this a scar or is this skin turning white because it is tight and being pushed back.

SO hard not to worry and over think.

[bev02]

I just read about preputial scarring. It sounds just like I described. It actually looks like a scar around the foreskin opeing when he pulls back his foreskin. I am VERY afraid that he does have phismosis. He is 8 how do I know if this will correct on its own...or will it?

[MommytoB]

Bev-
He pulls back his foreskin that does not sound like phimosis .

I think your seeing the ridge band of the foreskin look up on foreskin anatomy on doctor opposing circumcision. It can help explain the ring under the foreskin .

Your son stiffness is from erections and tiny hole in foreskin are always small to the keen eye even if your look at an adult you would not even seen an wide obvious hole because all you would see is the lips of the overhang .

I was always at interest watching how my ex would be able to pull back his foreskin to go pee it just amazed me to see how something seems so closed that many things that can be put into it and how glans could come out of it .

[MCatLvrMom2A&X]

The foreskin opening is a sphincter like the anus and only relaxes to allow urination then it clamps back down.

Ballooning is a 100% normal part of development for some boys and is nothing to worry about. Oh and now that he is ballooning you can almost bet money that the urination pain was due to separation starting and not any sort of infection.

Your ds does have phimosis but it is the normal type phimosis all boys have until they are able to retract when the hormones of puberty kick in.

Have you read this thread http://www.mothering.com/discussions...d.php?t=764732

The best thing to do is keep the Dr. from seeing your ds right now unless something else comes up causing him pain because all the dr is going to do is scare you without cause.

Until your ds is fully into puberty there is no way to diagnose true phimosis.

Steroid cream is for adults who cant retract and should never be used on a pre pubescent boy. It might help while he is using it but once he stops his body will go back to its normal state.

Unless your ds was repeatedly retracted there is no way he has scaring at the tip and it isnt something you need worry about at this point in time.

[hakunangovi]

Bev, your son is perfectly normal. In Denmark, a country where circumcision is not practiced and neither is foreskin retraction in adolescents, the average age of having one's foreskin become retractable is 10. To put your mind at ease read: www.cirp.org/library/anatomy/normal .

Now, as Brant pointed out, if he still has a tight foreskin in about 8 years more, there are many remedies available, starting with the steroid cream your doctor mentioned, and if that fails there are many methods of preputioplasty which widen the opening in the foreskin without him loosing any of it. Please read: www.cirp.org/library/treatment/phimosis , and also you might this very interesting: www.biomedcentral.com/1471-2490/8/6 .

Please do not worry - your doctor is pretty uneducated in this area - the Europeans are way ahead of us !!

[bev02]

Oh, I hope everything is okay. The opening is so tiny. And white around the opening when he pulls back on the foreskin, which sort of looks like scar tissue around the rim? I guess I am so worried that something is wrong that I am looking for all bad signs.

[PlainandTall]

Bev- While a non-retractile foreskin is normal for quite a while... that does not mean that problematic situations can not exist in that time frame. Your description of the white looking scar tissue looking edge of a pinhole size opening sound to me to exactly fit the description of BXO and does not sound like normal typical juvenile development.

Try a google image search for BXO- I found this article in a cursory search from Colombia that had good pictures to compare unretractable normal looking and BXO foreskins under retraction pressure. The author describes a "flower" type of appearance to the normal prepuce.

http://www.urologiacolombiana.com/re...e-2003/012.htm

The question to me seems- not "is there something wrong" ... the question is- "if there is something wrong, how do we go about treating it!?" (is this Dr. approaching this as if my child's body is valuable to him- or is he just looking for an excuse to circumcise him? is this Dr. well versed in treating foreskin problems- or does he simply view the problem is "having a foreskin") are there conservative treatments for BXO? How is bxo diagnosed? are there alternative surgeries other than circumcision that could relieve the tightness?

CIRP is another good place to look for info on BXO

[bev02]

How would I know if it is BXO?

[eepster]

Why is your DS pulling back on his foreskin till it turns white? This might be causing the pain.

The most likely reason his penis "gets stiff" is b/c he is getting erections (which is completely normal.)

[brant31]

First off, true BXO would be extremely rare in a child of your son's age. I wasn't implying that that was something he may have had; I was merely saying that some adult men who have had that then experience preputial scarring. Please don't jump to any conclusions.

Now, let me put your mind a bit at ease about scar tissue -- which again, is unlikely the culprit here. (Remember Occam's Razor: the simplest or most common explanation is usually correct.) Actual scar tissue in that region would present as a slightly discolored (lighter) ring -- even when you're not pulling on it -- with redness around it. It sounds like what you're seeing is nothing more than blood leaving the area when the skin is stretched tight. Perfectly normal. Maybe stop doing it.

Scar tissue forms in response to trauma or infection. It is not clear that your son has had either to the obvious extent that it would leave such damage. Moreover, as scar tissue forms, a key characteristic is that collagen is up, yet fails to array itself in its normal logical pattern for a period of 3-6 months. After this time, it then starts to rebuild in its proper orderly array. This process is called "remodeling".

Even if your son did have an egregious infection 2 weeks ago (which sounds doubtful), there would be no way to tell the extent of any possible scarring before Christmas. This is because toward the end of the process, the tissue regains some of its elasticity from the successful arraying of collagen.

I don't think there is a basis for saying any of this is going on. It sounds like your son is a normal boy with a later-developing foreskin. I urge you to just ride things out quietly until he's on the other side of puberty. By then, he will be able to research for himself how his development is coming along, and what he can do if there's something to address.

[bev02]

It is so hard not to worry. I have to remind myself that the body in its natural state is right. And let nature take its course. I will take a deep breath and try.
I guess its the unkown, and what if's, of this whole thing that are concerning me. I want him to have a normal functioning penis. And I dont want to do anything that intefers with that.

[PuppyFluffer]

I am guessing that he currently has a normal functioning penis. Remember, the only function of the penis at this point in time it to allow the passage of urine from the body.
It's hard to relax when what you have experienced personally as normal (majority of men circumcised) is truly not normal (circumcision is not normal).
Intact is normal, it's just that for many of us, what is normal is not what we are accustomed to.
I second just allowing his body to progress and believing that it will do so, exactly as it needs to. The vast majority of boys and girls grow up develop normal sexual parts. Try to hold on to that fact and shift your mindset from that of looking for a problem to believing in the perfect design. It's a paradigm shift.