Balanoposthitis--seeing ped urologist tomorrow. Advice needed!

[StrawberryFields]

Hi there,

This is going to be a little abbreviated because I have three kids running around like maniacs, but I would love some advice or BTDT.  My ds (5) has complained of pain in his penis since last night.  This morning it was very swollen and painful and by afternoon he was running a slight fever.  I spent a ton of time searching and reading the forum this afternoon and read a lot of good information.  I tried warm baking soda baths and Motrin to ease his discomfort but ultimately decided to take him in.  He was referred to a pediatric urologist at the local Children's hospital. 

I've been searching since I got home and found this link:

http://www.consultantlive.com/pediatrics/content/article/10162/1633757

The photograph looks EXACTLY like what is going on with my ds right now.  Does anyone have any experience with this before I go in and see the urologist.  I would like to be educated in case they start trying to retract him or suggest circumcision.  While the doctor may be completely knowledgeable about the intact penis, and I hate to jump to conclusions, I want to be prepared in case he or she is not.  The doctor we saw today, for example, was very nice but did not have any idea what I was talking about most of the time and did not even really understand what I was saying when I mentioned that my ds was not retractable and not to retract him during the exam. 

In the meantime we were prescribed an antibiotic that he will start tonight.

Thanks so much for any been there, done that info you might have!!  I really appreciate any and all information.  The mama in me is a little worried, scared, and panicky when I see how red and swollen he is. 

[StrawberryFields]

I don't know if that link is working for anyone else, I can't seem to get it to work when I click on it but it works when I put it right in my address bar.  This is my first time using this new format and I am so confused.  Not to mention I am so stressed out and worried about this and while I am trying to read and research and find help, my ds peed on himself and my two darling daughters dumped a whole box of crackers on the floor and smashed them with their feet.  And then my 3 year old had a potty accident.  So it's not going well.

Maybe this image will work?  Has anyone else's intact ds experienced anything like this??

http://www.consultantlive.com/image/image_gallery?img_id=1633241&t=1281029019386

[Fyrestorm]

It appears that this can be treated with topical ABX and antifunglas...I would def. not allow retraction.  If they want a urine sample, make them to a bag catch and make them swab it!

[MCatLvrMom2A&X]

The first thing that should have been done was a swab to see what if any bacteria was present if you start the abx a swab will be useless. It sounds like he may have a bacterial infection or possibly a yeast infection. That picture that you linked to looks a lot like my ds when he had a bacterial infection only his penis was swollen to the size of an adult it was scary and painful for him but the abx had him nearly back to normal within 24 hours. I also applied OTC bacatracin and a lot of it. He was still in diapers when it happened so I put it on every diaper change and did diaper free time.

If you havnt started the abx I wouldnt until a swab culture can be done but if you have then keep giving them. It is scary when something happens but it is totally fixable if you know what you are dealing with ie yeast or bacteria.

I hope the Dr. you see is intact knowledgeable and dosnt give you bad information and scare you. Remember whatever it is is fixable without cutting anything off your ds.

[eepster]

A fever is a good indicator of infection.  I don't understand why they didn't just prescribe some antibiotics?  Why the need to see a urologist?

[StrawberryFields]

Thank you for your responses!!  I have started the antibiotics.  Normally I am not one to run and get abx right away... in fact, I don't recall my ds ever having them before.  But I was very distressed about what I saw today and wanted him to start ASAP hoping that he would have a vast improvement by tomorrow in hopes of possibly canceling the appointment with the urologist. 
 

Originally Posted by eepster 

A fever is a good indicator of infection.  I don't understand why they didn't just prescribe some antibiotics?  Why the need to see a urologist?

Honestly, I think the doctor I saw today was VERY overwhelmed and unsure about what he saw in ds.  We saw a different doctor in the practice today because of the short notice to work ds in.  I don't think he was experienced with intact penises and honestly I felt encouraged by the fact that he stepped back and transferred care to someone else rather than fiddling around and spouting a bunch of made up nonsense (like other people I have seen in the past).  I think he was really concerned about the fact that he was unable to properly diagnose ds and was worried about the possible long-term consequences if he was not treated properly.  He was actually very nice and and as helpful as he could be, and I agree I am unsure that there is a need to see a specialist, but I am glad that he was willing to step up and say, "Wow, yeah, this is outside my comfort zone,"--know what I mean?

I did read about OTC bacatracin and began that as well.  I am hoping for a marked improvement tomorrow and if so I plan on calling the urologist to talk over whether I need to be seen or if I can continue treatment as I am.

I also bought epsom salts and baking soda for warm soaks.

Now--I would like to bring up the urine sample possibility because the doctor did seem to think they would want to do one tomorrow.  My ds has never had a urine sample before and it is something I am concerned about.  Is there somewhere I can read up about the proper procedure for a urine sample, possibly even something I could print and bring in just to be safe?

Thank you so much, I really am so thankful to have the CAC forum for these panicky moments where I just feel overwhelmed and not sure what to do! 

[MCatLvrMom2A&X]

If he is still as swollen tomorrow as he was today I would insist on a clean catch in a cup and not allow a cath. If there is an infection which I think there probably is inserting a cathiter would be a really bad idea. It could possibly push the infection up into his bladder and you dont want to risk that at all. At 5yo a clean catch in a cup is perfectly doable keeping in mind that with this going on the urine sample would be contaminated by whatever is going on with his penis.

Hopefully you will see big improvement like I did with my ds.

[eepster]

Originally Posted by StrawberryFields 

Thank you for your responses!!  I have started the antibiotics.  Normally I am not one to run and get abx right away... in fact, I don't recall my ds ever having them before.  But I was very distressed about what I saw today and wanted him to start ASAP hoping that he would have a vast improvement by tomorrow in hopes of possibly canceling the appointment with the urologist. 
 

Originally Posted by eepster 

A fever is a good indicator of infection.  I don't understand why they didn't just prescribe some antibiotics?  Why the need to see a urologist?

Honestly, I think the doctor I saw today was VERY overwhelmed and unsure about what he saw in ds.  We saw a different doctor in the practice today because of the short notice to work ds in.  I don't think he was experienced with intact penises and honestly I felt encouraged by the fact that he stepped back and transferred care to someone else rather than fiddling around and spouting a bunch of made up nonsense (like other people I have seen in the past).  I think he was really concerned about the fact that he was unable to properly diagnose ds and was worried about the possible long-term consequences if he was not treated properly.  He was actually very nice and and as helpful as he could be, and I agree I am unsure that there is a need to see a specialist, but I am glad that he was willing to step up and say, "Wow, yeah, this is outside my comfort zone,"--know what I mean?

I did read about OTC bacatracin and began that as well.  I am hoping for a marked improvement tomorrow and if so I plan on calling the urologist to talk over whether I need to be seen or if I can continue treatment as I am.

I also bought epsom salts and baking soda for warm soaks.

Now--I would like to bring up the urine sample possibility because the doctor did seem to think they would want to do one tomorrow.  My ds has never had a urine sample before and it is something I am concerned about.  Is there somewhere I can read up about the proper procedure for a urine sample, possibly even something I could print and bring in just to be safe?

Thank you so much, I really am so thankful to have the CAC forum for these panicky moments where I just feel overwhelmed and not sure what to do! 

bold mine

Yeah, I do generally think a Dr who is willing to admit s/he doesn't know absolutely everything is a generally good thing.  No one can actually know everything.

We tend to be a bit gun shy of urologist referrals around here, b/c they usually lead to a circ recommendation over something that is either completely normal (ballooning for example) or easily treated with out surgery (such as the infection your DS has.)