I have a big problem with my uncircumcised son, need help! *update*

[NYMOM07]

so today my 3 year old told me his penis hurt and when i looked at it the tip was really swollen so i took him to the pedi right away. he said it was an infection under the foreskin and gave an antibotic. that was around 11 am. so as the day went on, his entire penis swelled up and he was in so much pain and it hurts for him to pee. so we went to the hospital for a second opinion, and they agreed with the pedi and said he also had a mild uti. they were very concerned that his foreskin is not retractable at all, and that if we cant clean it that this is going to happen again and that we may/probably will have to circumcize him.

i am now very concerned because

a. i need to make sure he pees, he at this time is scared to because of the pain and i dont want them to put in  a catheter.

b. is this going to be reoccuring, ended in the need to have him circumized, because i dont want him to have to endure this again is is really bad.

c. i am concerned with the inability to retract his foreskin because it seems like it has disconnected from the head but the hole is so small that it cannot be pulled back at all, possibly indicated that he does have a problem and it wont go back on its own.

if anyone can direct me with their own experience with something like this, i would really appreciate it.

also, any advice on natural ways to get the hole to open so the skin can begin to be retracted?  i think we are heading for a disaster if we cant start to pull back his skin and clean his penis correctly, and i dont want to circumsize him if we dont have to (obviously(

thanks!

[Night_Nurse]

Did they do a culture/swab?

Your son is only 3, he doesn't need to retract just yet. Many boys aren't retractable until they are in middle or high school. He also doesn't need special cleaning, just let him sit in the bathtub and wash it like you would a finger. If it hurts him to pee right now, let him pee in the bathtub or in a cup of warm water. Maybe he's just having some separation pain (which can be normal).

I'm sorry, maybe someone can find you the link we used to have. This new format hurts my eyes and head too much to search for it but it used to be a sticky at the top of this forum.

I really don't think your son would need a circ over something like this.

[MCatLvrMom2A&X]

Quote:Originally Posted by NYMOM07 
so today my 3 year old told me his penis hurt and when i looked at it the tip was really swollen so i took him to the pedi right away. he said it was an infection under the foreskin and gave an antibotic. that was around 11 am. so as the day went on, his entire penis swelled up and he was in so much pain and it hurts for him to pee. so we went to the hospital for a second opinion, and they agreed with the pedi and said he also had a mild uti. they were very concerned that his foreskin is not retractable at all, and that if we cant clean it that this is going to happen again and that we may/probably will have to circumcize him.

i am now very concerned because

 

a. i need to make sure he pees, he at this time is scared to because of the pain and i dont want them to put in  a catheter.

 

b. is this going to be reoccuring, ended in the need to have him circumized, because i dont want him to have to endure this again is is really bad.

 

c. i am concerned with the inability to retract his foreskin because it seems like it has disconnected from the head but the hole is so small that it cannot be pulled back at all, possibly indicated that he does have a problem and it wont go back on its own.

 

if anyone can direct me with their own experience with something like this, i would really appreciate it.

 

also, any advice on natural ways to get the hole to open so the skin can begin to be retracted?  i think we are heading for a disaster if we cant start to pull back his skin and clean his penis correctly, and i dont want to circumsize him if we dont have to (obviously(

 

thanks!

3 years old is a pretty common age for the separation process to start and it is often confused with infection. If they didnt do a swab then you cant know for sure it is an infection. Here is a helpful thread that you should look at to protect your ds from the Dr.. who obviously are scaring you for no reason. http://www.mothering.com/discussions/showthread.php?t=764732

a. did you try having him pee in a cup of water or in the bath. That will stop the sting.
b. The only reasons for circ are gangrene, frostbite and cancer if this was your dd with a labial infection would you even thing about cutting on her? Not snarky just putting that out there to help you think. As for it happening again the odds of that are very small.
c. at 3 I would be surprised if he where retracting. The avg. age for retraction is 10.5 years and it isnt considered an issue until the boy is in his teens or an adulthood.

My ds got a bacterial infection at 3yo his penis swelled to the size of his wrist it was horrendous but once I got him on the abx he was nearly back to normal in 24 hours and totally back to normal in 48 he has never had a single problem since and wouldnt have then had I not changed his diaper and let him play with dirty hands after being outside.

No one but your ds should ever retract it. You are cleaning it right as long as you are wiping it like a finger and not retracting at all.

The advice to retract causes scar tissue and major issues down the road. Please dont let them retract him and if he does get a cath. remove their hands should they even look as though they are pushing the skin back. With him that swollen it could very well get stuck behind the glans then you would have a major problem.

I know it is hard seeing your ds in pain BTDT with both my kids ds with the bacterial infection and dd with a monster yeast infection but they do recover from it without cutting. If they keep up the circ talk ask them how they would treat him if he was already circ since yes circ boys get infections like that to.

[eepster]

Getting him to pee is your first priority.  You are right that if you can't they will have to cath him.  Try getting him to pee in comfortable temperature water.  Try bribery.  Try making him watch the faucet running.

If you can't get him to pee and he needs a cath,  do not let them retract him!  Be very very clear with nurse about this.  Keep an eye on the nurse the entire time.  If the nurse says it can't be done without retracting, then ask for a new nurse.  One from the NICU or a foreign trained nurse should know how to do it correctly.

Once you have gotten him to pee and things have settled down, read this article:

http://www.mothering.com/health/protect-your-uncircumcised-son-expert-medical-advice-parents

[buckeyedoc]

"it seems like it has disconnected from the head but the hole is so small that it cannot be pulled back at all, possibly indicated that he does have a problem and it wont go back on its own."

This part is totally, totally normal for a boy his age. I would make sure he is peeing and let the antibiotics work. If a culture was not taken, and especially if the antibiotics don't help, a culture should be taken.

[NYMOM07]

update the next day : a culture was taken , but i dont have the results yet. the inital testing showed a mild uti.  also, he was not able to pee except for drips, and then i noticed a white thing coming out of the hole of his foreskin. i laid him on the bed and squeezed the tip gently, and the white thing popped out and some pee came out behind it! that was creating some kind of blockage, so now he is finally able to pee and the swelling seems to be going down/ the antibotics seem to be working.

what do you guys think that white thing was? a blockage of schmegma?  could that have caused the infection- or is a biproduct of the infection? 

either way, we are on the healing end now, and i can finally breath a sigh of relief.

we are going to a pediatric urologist in 2 weeks for a follow up, and i want to see what his recommendations are for proventing this from happening again.

p.s. is it better for me to bathe my son or give him a shower? which one will clean the penis better? (i am guessing the bath)  we have been giving him a shower for the past few months, and maybe it hasnt been getting clean enough.

[eepster]

I would say blockage by loose smegma pearl must be a 1 in a million freak incident.  This is the first time I've ever heard of it happening.

This isn't about keeping it clean by bathing.  Smegma is a perfectly normal thing (and up till this moment I've never heard of it causing any harm at all.)  The passage of urine is normally enough to clean out the inside of the foreskin.  Now that that pearl is gone, every thing should be fine.

The urologist is very likely to tell you your DS needs to be circ'd to prevent this from happening again.  Possibly s/he might recommend regular forcible retraction.  Neither of these are necessary or advisable.  Obviously amputation prevent the possibility of future problems with said body part, but generally we try very hard to save the body part first.  Your OB/GYN would not recommend a radical mastectomy for clogged milk ducts.  Amputation should be a last resort with the foreskin, not the first step.  Forcible retraction causes all kinds of problems, it can lead to infections, scar tissue, or even paraphimosis.  I would cancel the appointment unless something new comes up.

Out of curiosity, if your DS was unable to pass urine, how did they get a sample to test for UTI?

[MCatLvrMom2A&X]

Was the white thing long and skinny or was it roundish? The reason I ask if a thread got up in there it would have caused irritation and an infection. Just like a piece of thread would cause an infection if it got into the vagina if it didnt come out fast enough BDTD :s

Sounds like your ds is on the mend I am so happy for him and you :hug

[buckeyedoc]

Originally Posted by eepster 

The urologist is very likely to tell you your DS needs to be circ'd to prevent this from happening again.  Possibly s/he might recommend regular forcible retraction.  Neither of these are necessary or advisable.  

I agree that you are likely to get this advice from an American-born urologist. Do you really need to see a specialist if the infection is cleared up and he's peeing great? I mean, I wouldn't need to see a specialist for a UTI. I am worried that you are being referred only because of the inaccurate diagnosis of phimosis.   

[eepster]

Originally Posted by MCatLvrMom2A&X 

Was the white thing long and skinny or was it roundish? The reason I ask if a thread got up in there it would have caused irritation and an infection. Just like a piece of thread would cause an infection if it got into the vagina if it didnt come out fast enough BDTD :s

Some toilet papers fall apart while wiping and leave lint that can get into uncomfortable places.

[Lauren82]

When my intact ds was 2, he had the same thing happen. His foreskin was red and swollen and he didn't want to pee. I gave him baths in baking soda and the next day he had a large amount of smegma come out. The redness went away within about 3 days and everything was back to normal. This is part of the foreskin separation process sometimes. It can be alarming at first but it's normal. Also, that same ds is now 8 and is only about 3/4 of the way retractable. At least that's how it looked to me when he came up to me and wanted to show me a new trick he learned.

[NYMOM07]

he was able to pee at the hospital, so they checked for the uti and i found out that it was not a uti.  that leaves us with an infection under his foreskin.  i think that his skin has separated from the head of the penis, because it balloons when he pees. but- since the hole is so small it is creating a pocket beneath the foreskin we are unable to clean and where i guess this bacteria infection grew.  i know that this ballooning is normal, but i dont want him to get reoccuring infections now. i dont want to circumise him, but if the steriod cream has no side effects besides retracting the skin early, wouldnt it be better to be able to properly clean the area?  i just dont understand why it shouldnt be retracted early in this situation, and that why he would get something this bad if it was supposed to be better left alone. something wrong obviously happened, and i need to be able to prevent this in the future because he is already really traumatized by the whole thing.

[NYMOM07]

Originally Posted by Lauren82 

When my intact ds was 2, he had the same thing happen. His foreskin was red and swollen and he didn't want to pee. I gave him baths in baking soda and the next day he had a large amount of smegma come out. The redness went away within about 3 days and everything was back to normal. This is part of the foreskin separation process sometimes. It can be alarming at first but it's normal. Also, that same ds is now 8 and is only about 3/4 of the way retractable. At least that's how it looked to me when he came up to me and wanted to show me a new trick he learned.

[Storm Bride]

Originally Posted by NYMOM07 

 i just dont understand why it shouldnt be retracted early in this situation...

It's still attached. Even if it's ballooning, it's not completely separated yet. Would you pull our fingernail back to clean under it in this situation?

[eepster]

Originally Posted by NYMOM07 

he was able to pee at the hospital, so they checked for the uti and i found out that it was not a uti.  that leaves us with an infection under his foreskin.  i think that his skin has separated from the head of the penis, because it balloons when he pees. but- since the hole is so small it is creating a pocket beneath the foreskin we are unable to clean and where i guess this bacteria infection grew.  i know that this ballooning is normal, but i dont want him to get reoccuring infections now. i dont want to circumise him, but if the steriod cream has no side effects besides retracting the skin early, wouldnt it be better to be able to properly clean the area?  i just dont understand why it shouldnt be retracted early in this situation, and that why he would get something this bad if it was supposed to be better left alone. something wrong obviously happened, and i need to be able to prevent this in the future because he is already really traumatized by the whole thing.

Just b/c it wasn't a UTI, doesn't mean it was an infection under the foreskin.  Unless they swabbed and cultured the area, it could have been just run of the mill separation with some swelling and discomfort.  I had the urine came back positive for UTI.  

The steroid cream does have side effects.  It thins the skin.  There are other possible side effects as well, you can read more about topical steroid use here.  The steroids are for adult men who are bothered by their tight foreskins during intercourse.  The steroids are used in conjunction with stretching exercises that are basically masturbation with a purpose.  This is not some thing that you want to do with your DS.

Cleaning it underneath the foreskin does not prevent infections, it causes them.  It would be the same thing as cleaning out the inside of you vagina.  I'm sure you GYN told you to not wash up there with soap.  Washing it out too much dries out the mucus membrane, it irritates the area, it changes the PH balance, it throws off the natural flora, and it is an opportunity to introduce bacteria.  It is sealed for a reason, it should be left that way till it is ready to open on its own.  You would never consider breaking a little girls hymen to get more access to clean her vagina, so why do the equivalent to a boy.

[NYMOM07]

they didnt swab his penis, all of the tests they ran from the urine sample... i am guessing this is not the correct test? the pedi told me that it was balantis, which i see from the internet is somewhat common in uncircumised males.  how to you ladies bath/clean your sons ?  do you wipe them after they pee?  do you use soap or just water?  how can separation be that painful and cause him to not even be able to pee- the antibiotics started to clear it up within 24 hours... unless that was a coincidence, but i dont think so. thanks for all the input!

[Pirogi]

My understanding is that 'balanitis" technically refers to any inflammation of the glans.  It is sort of a catch-all term.  The fact that your ped is recommending steroid cream makes me think he believes it is actually balanitis xerotica obliterans (BXO), which when actually present, is a more severe condition.  BXO is rare - 6 per 1000 males.  Here is a page on balanitis with some info and a picture ... did your son's penis look like this?

http://www.cirp.org/library/treatment/BXO/

I would imagine that your ped was correct in his assessment of "balanitis" but not in that your son had BXO.  If the tip of his foreskin isn't white/hardened, then it's not really BXO.  He probably had an infection that is clearing on its own.  If he is on antibiotics, he is more likely to have a reoccurrence of yeast overgrowth, so if it were my son I would consider upping his probiotic intake.

It's hard to see our kids in pain or with medical issues.  Try not to panic.  It is unlikely that your son will have recurrent infections during the separation process.  And even if he does, non-surgical treatment is the best option.  I understand that he may be a little traumatized, but I would imagine circumcision would be even mroe traumatic.

[eepster]

Originally Posted by NYMOM07 

they didnt swab his penis, all of the tests they ran from the urine sample... i am guessing this is not the correct test? the pedi told me that it was balantis, which i see from the internet is somewhat common in uncircumised males.  how to you ladies bath/clean your sons ?  do you wipe them after they pee?  do you use soap or just water?  how can separation be that painful and cause him to not even be able to pee- the antibiotics started to clear it up within 24 hours... unless that was a coincidence, but i dont think so. thanks for all the input!

Balantis is a pretty meaningless dx.  

I always just put DS in the bath to soak.  I do put a little bubble bath (it's actually Avalon organics glycerin hand wash) even though bubble bath are not recommended.  I always rinse him off with plain water.  Back when he was in diapers, I never bothered to wipe him just for pee, I only wiped after poopy diapers.  The part that gets dirty is the scrotum, not the penis.

Irritation, pain, redness, and swelling from separation tends to clear up in 24-48 hours.

[Mom2Brendan]

My son only rinses off in the shower and when he was a baby he would soak in the tub . When he was in diapers I would just wipe as if I was wiping my fingers from eating . No soap has ever been used on my son's penis region.

It does sound like it was seperation trauma that occured with your son since it usually starts to get better within 24-48 hrs .

Things that cause the trouble peeing is because of the foreskin seperating it leaves open blisters so when urine goes pass by it that will sting since urine is full of acid . So many kids don't like to pee if they get a 'response of a sting during pee

The things to do is to help with the peeing and edging the smegma out is warm bath and the kid can pee in there that way the urine is diluted so it's not as acidy plus as your child is peeing the smegma will flow out with the pee or even during playing in the bathtub .

Variations of pain can be from mild , moderate and to severe but with it only being with seperation trauma it will be like only a day of pain or maybe even 2 days of pain. Sitz bath will definetly help out wit the pain .

My son was 3 1/2 when he had his first signs of seperation trauma -scary looking and he was in pain that he was crying .  He had warm bath  with baking soda, naked time and then he got ready for bed and slept . 

He only had his symptoms within 24 hrs hasn't had any more of that and he's 6 now . It was just a one time thing for him .

[lboosmommy]

Just adding my experience.

DS is 3. He's had some issues on and off. He has a very long foreskin and it's narrow at the tip. For a period of a few months he would regularly, well, basically urine would get stuck. No kind of plug would come out, but we did have to gently squeeze to release the pressure (and the stuck urine) when he was uncomfortable. It's probably been about a year since we had a problem, it seems like the tip has stretched. Of course, he's been playing with himself (lol) since he's potty training and in underwear a lot of the time now, so maybe that's why. Either way, for a while we thought we might have to circ him and are happy that that doesn't seem to be so anymore.