What does the correct way to catheterize an intact 2 year old look like?

[AbbieB]

Can some one please explain to me how an intact child is catheterized without retraction. I want to know what it should look like so I can be better equipped to handle the situation the next time it come up. (DS will be in and out of the hospital for a few years so it is likely to happen.)

Don't worry, I know it's bad, bad, bad to retract. DS has been in the hospital for a few weeks and one morning I woke up to find the nurses in the middle of catheterizing him. When I went over he was fullyretracted. :Puke
Since we were in the middle of a very frightening medical crisis I did not make a huge deal. But it is on my mind and I will be taking it up with the PICU staff. It concerns me that when I proactive spoke to each new nurse not a one seemed to know the word "intact" or "retractable".

FWIW DS never bleed or looked irritated in anyway. I had noticed his foreskin looking loose in the last month so maybe he is retractable, but to my mind no one should be retracting a 2 year old, ever!

[AbbieB]

Not one person knows?

[Night_Nurse]

Originally Posted by AbbieB

...It concerns me that when I proactive spoke to each new nurse not a one seemed to know the word "intact" or "retractable".
...

Outside of places like Mothering and intactivist circles, most people are not used to the word intact, at least in reference to the penis. I've worked in healthcare for 2 decades. The vast majority of Drs & nurse I know don't use the word "intact" because the general population is unfamiliar. If you asked a parent if their son was intact they'd look at you like you had four heads. I'm not trying to debate why it should be used vs not using uncircumcised, only to say most people don't understand it. I have no idea why they wouldn't understand the word "retractable".

To answer your question, I have no idea. I've cathed intact grown men, but never little babies. I know they can bag cath a boy and I think most NICU nurses either do nothing with the foreskin (if it's short) or kind of pull forward to flare out the loose skin to visualize the meatus (pee hole). I don't think cathing a 2 year old should be difficult for them. However, if after talking to them you feel uncomfortable, ask the nursing supervisor or a doctor if a NICU nurse can cath him instead. Most of them do have more experience w/ intact boys than regular pediatric nurses.

FWIW, my son was completely retractable by 2.5 yrs so it's possible your 2 yr old is too. The age of retraction varies greatly.

I'm sorry your son is ill. I hope his time in the hospital is short and easy for you all. Never be afraid to speak out and advocate for your son! The nurses are there to help you and if you feel they aren't providing quality care, you always have the right to ask for someone else to help!
Good luck!

[MCatLvrMom2A&X]

There is a description on the proper way to cath in the resources sticky under The Definition of Retraction & why it is BAD

What should happen is the foreskin should only be flared enough to visualize the urethral opening in the glans and line the 2 holes up. So only the loose skin at the tip of the foreskin in manipulated. Some "fish" for the opening (stick the cath into the foreskin and move it around to find the opening in the glans) but that could cause scratches on the glans and not something I would be OK with.

Even if he is fully retractable there is no need to retract all the way to do the cath. the reason being at his age paraphimosis is a big concern. Where the foreskin could get caught behind the glans because it isnt ready to retract yet. Since the foreskin usually releases from the glans first then the sphincter gradually becomes less tight it is very possible to cause paraphimosis.

[AbbieB]

Thank you, thank you for explaining that to me. Now I know specifically what to talk about if he ever needs to be catheterized again.