Need help w catheterizing an uncircumcised baby boy

[nicandboys]

I need reassurance and am hoping someone has info or experience with this.

I'm 32 weeks pregnant with a baby boy who has been diagnosed with kidney reflux in utero. At 20 weeks I was told it was hydronephrosis, at 30.5 I was told it was downgraded to reflux, which has a good chance of resolving itself.

But baby will need to see a pediatric urologist and will probably need a procedure called a VCUG which involves inserting a catheter. Baby will not be circumcised, and I've had bad experiences with medical personnel trying to retract my other uncirc'd boy and have had to be vigilant. It was easy with him, just to say "Do not touch his penis. Period."

But I can not say that with this baby, if he needs a catheter. I'm very concerned that because circumcision is the norm in the US, I'll end up with people who don't know how to cath an uncirc'd male, and they'll forceably retract him and cause adhesions and other unnecessary trauma.

I'm feeling demoralized, because I've done a lot of searching and can find hardly anything about cathing an uncirc'd male, and so many moms online have told me he'll just have to be retracted and it's no big deal.

Well, it is a big deal to me. I feel like it will be so hard to protect my baby from unnecessary pain and trauma.

Dh and I plan to discuss this with the person performing the procedure, before they touch him at all. But I'm still concerned they will retract him and I won't realize until it's done. Is it impossible for them to insert the cath if dh or I are the ones who pull the foreskin back the tiniest bit in order for the nurse to see the urethra opening and insert the cath? Therefore, insuring they don't pull it back so far that they forceably retract foreskin that's not ready to be pulled back.

Any tips or experiences greatly appreciated.

ETA: Any info on finding a no circ friendly pediatric urologist in my area would also be great! I'm in the DFW area of TX.

[Devaskyla]

There is NO need to retract to do a catheter. If it's being done in a hospital, you could request someone with experience, like an NICU nurse.

[Lkg4dmcrc]

My son was catheterized 4 times a day for over 10 months and we never retracted his foreskin. There were two times in the hospital that the nurses did, however so I totally get your worry. Don't settle for "yes I know how". I would simply explain, you do not want any retraction whatsoever and explain what you mean by this. One nurse told me that my son's skin was so lose that it did not matter..and that she had a son with an uncirc'd penis. (Like that helps).

Will this be done in a children's hospital? Many of the nurses have experience doing it on an uncircumcized penis. They do need to move the foreskin a bit to be able to see where the opening is but they do not need to retract the foreskin.

[brant31]

I'm sorry that your son and family will have to go through several tests on him. I wish you well and hope that he is in fact born with minimal problems.

You may want to inquire about VCUG options. They might always be different on a newborn, but none of the 3 voiding cystourethrograms I've had involved any sort of catheterization. I ingested a contrast fluid and the X-ray showed exactly what was going on with my bladder and urethra. Of course, I was more compliant about voiding on command than most newborns.

Some parents have actually taken to writing a quick message on the baby's abdomen: "Doctor & parents request NO FORESKIN RETRACTION". You can also ask to meet the entire team that will be dealing with your son and make your wishes known.

PS - I have called a buddy of mine, an intactivist dad of an intact son in Dallas, to ask whether he has any leads on PedUrols and other doctors.

[MCatLvrMom2A&X]

You can have a NICU nurse come down or someone who knows how to flair the foreskin without retracting. Just stand your ground and be prepared to physically stop someone if needed.

[eepster]

When you go, have a third person with you. They will want someone to hold and comfort the baby, so if it is just you and the baby, you can't also be keeping a close eye on what is happening.

If you can't get a NICU nurse, then see if you can get a nurse who went to school in a non-circing country. Around here, many nurses went to school in Ireland, then moved here.

[Calleiah]

Holy moly, Im in your area and we've seen the Ped Urologist for pretty much the same thing! We saw Dr Snodgrass at Children's in Plano (off Preston). He is VERY evidence based, doesnt believe in the prophylactic use of antibiotics or automatically doing the post birth sono (which he said was actually fairly useless) or doing the VCUG without substantial cause. Let me ask this really quick. Does your baby just have dilation of the kidneys (suspected reflux?)
Our little one was diagnosed with an 8-10cm dilation of the kidneys. Dr Snodgrass was amazing and after reviewing the extended sono said he felt like the likelyhood of it resolving on it's own was very high, so high in fact that he said unless we actually have some issues, that if we wanted peace of mind to bring baby in at 6 weeks for a quick sono to check his kidneys. I do not know his stance on circ/retraction, but just for his evidence based medical approach I recommend him. Msg me if you want to talk!

BTW, our little man arrived this past Thursday and I've never been SO happy to change wet diapers!
<hug>

[brant31]

Originally Posted by Calleiah

BTW, our little man arrived this past Thursday and I've never been SO happy to change wet diapers!

Hey, congrats on #3!

[fruitful womb]

What about a bag cath?

Its a sterile bag that adheres to the penis. Its perfect since you don't have to insert a catheter.

[eepster]

Originally Posted by fruitful womb

What about a bag cath?

Its a sterile bag that adheres to the penis. Its perfect since you don't have to insert a catheter.

In a VCUG, They squirt dye up into the urinary tract, it isn't about getting a sample.

[fruitful womb]

Originally Posted by eepster

In a VCUG, They squirt dye up into the urinary tract, it isn't about getting a sample.

gotcha.

If it must be done then request a NICU nurse who knows how to cath a penis with all its parts intact.

[nicandboys]

Originally Posted by brant31

ps - i have called a buddy of mine, an intactivist dad of an intact son in dallas, to ask whether he has any leads on pedurols and other doctors.

thank you!

[nicandboys]

Originally Posted by Calleiah

Holy moly, Im in your area and we've seen the Ped Urologist for pretty much the same thing! We saw Dr Snodgrass at Children's in Plano (off Preston). He is VERY evidence based, doesnt believe in the prophylactic use of antibiotics or automatically doing the post birth sono (which he said was actually fairly useless) or doing the VCUG without substantial cause. Let me ask this really quick. Does your baby just have dilation of the kidneys (suspected reflux?)
Our little one was diagnosed with an 8-10cm dilation of the kidneys. Dr Snodgrass was amazing and after reviewing the extended sono said he felt like the likelyhood of it resolving on it's own was very high, so high in fact that he said unless we actually have some issues, that if we wanted peace of mind to bring baby in at 6 weeks for a quick sono to check his kidneys. I do not know his stance on circ/retraction, but just for his evidence based medical approach I recommend him. Msg me if you want to talk!

BTW, our little man arrived this past Thursday and I've never been SO happy to change wet diapers!
<hug>

This is the best thing I have read since we began this whole journey with baby's kidneys at 20 weeks gestation! I have had a lot of anxiety and your post made me feel so much better, I could cry.

I checked and Dr.Snodgrass is in my network- thanks so much for the recommendation.

Yep, baby just has dilation of the kidneys and it is not severe dilation.

Congrats on your new little boy! I am so glad he's wetting and everything's going well with his kidneys. You've made me feel a lot better.

I'm sure I will msg you with further qs as they come up, thanks for offering!