It retracted last night and won't go back

[newjrzee]

DS1 is nearly six years old.  It retracted last night in the bath as I was very gently cleaning him there as usual.  The glans is exposed and looks normal, but is just a little red at the tip and that part is clearly painful to him.  DH tried to reinsert it but the foreskin, which is rolled back, is "stuck" and doesn't go back forward over it.  He urinated without pain this morning and we are thinking to wait a little to see if it goes back by itself or trying again to roll the foreskin back in the bath.  We are hesitant to bring him to the Ped who may overreact.  Since the foreskin will always be a little tight the first time retraction occurs, I have to think it would often happen this way. Did anyone else have this experience?

[Lauren82]

Here is some info that might be able to help you:

http://www.circumstitions.com/Paraphim.html

Since his foreskin did get stuck, I would assume that it's not ready to be retracted and would not try to do so again. You can teach your son to swish it around in the bath water or to pull back what he is comfortable with if he wishes.

http://www.drmomma.org/2009/09/only-clean-what-is-seen-reversing.html

[eepster]

That is paraphimosis!

If you can't fix it pronto, you need to go to the ER.

You can try squeezing the glans while pulling the foreskin back into position, but don't waste much time.  If it doesn't work immediately , go to the ER. 

[Ron_Low]

Originally Posted by eepster 

You can try squeezing the glans while pulling the foreskin back into position, but don't waste much time.  If it doesn't work immediately , go to the ER. 

I would put it differently.  Focus on the squeezing of the glans.  This takes patience because the attention feels ticklish and may cause an erection.  Just keep pressing gently.  When it seems it will get no smaller the skin should be able to be slipped back into place. 
 

[MCatLvrMom2A&X]

Agreed with both pp's try your best to get it back if you cant then get him into the ER right away. He could loose circulation and cause major damage. Use some baby oil or some other genital safe lubricant. Dont let them tell you in the ER though that he needs circed he does not. Here are 2 links on the proper way to replace the foreskin at home http://www.circumstitions.com/Paraphim.html and medically fixing it http://www.cirp.org/library/treatment/phimosis/reynard1/ The second link has some very graphic pictures in it.

And from now on no retracting in the bath at all he obviously isnt ready for that.

For any lurkers out there. I cant stress enough the importance of fixing paraphimosis as fast as possible when it happens leaving it even a few hours is very dangerous.

[newjrzee]

Well, that was a pretty stressful 20 hours, but I am happy to report the third time was a charm and his foreskin is back where it is supposed to be.  Thank you all for your quick responses and information.  I want to stress that at no time did we, or any pediatrician, attempt to retract his foreskin in the past.  It occurred simply as the result of the simple kind of washing you would use in teaching your child how to wash that area, and in fact, I had never seen the glans until yesterday.  In my googling on the subject, there seems to be a rush to judgment that paraphimosis is often the result of an overzealous mom trying to clean the glans.  I would suggest that if your boy is not circumcised you should expect that the opening will be relatively tight the first time retraction occurs and may well experience the same issue.  It would be interesting to see any studies showing the differential outcomes of those children immediately going to ER versus those who did not.  I have a nagging suspicion a lot of this stuff about having to amputate if you don't act immediately and similar stories are anecdotal, but also want to stress my reaction depended a lot on my son's individual situation (no scratches or blood, no swelling of the glans, his age, etc.) and would likely have been different if he had still been a toddler. 

[MCatLvrMom2A&X]

So glad it is back where it needs to be. I still suggest that you tell him to skip the retraction to clean for now and let his body mature a little more so that this dosnt happen in the future again.

[newjrzee]

Thanks MCat, but like I said, there never was (and will not be) an attempt to retract.  Though it will surely happen at some point...

[azgirl]

Originally Posted by newjrzee 

Thanks MCat, but like I said, there never was (and will not be) an attempt to retract.  Though it will surely happen at some point...

What exactly does "gently cleaning him there as usual" mean? It sounds like you are moving the foreskin around a bit or exposing the glans to clean around there. My DS is only 3 but I never "clean him there" he just sits in plain bath water every few days. Are you going to be doing something different from now on to avoid retracting him accidentally? I think there might be some confusion...

So glad everything worked out okay!!

ah, I just reread your post, you haven't seen the glans before while cleaning...yikes, that must have been so stressful!

[elisheva]

Shouldn't a 6 y.o. be cleaning himself? My ds1 is 4 and has been cleaning himself in the bath for about a year now. 

[newjrzee]

By "cleaning as usual", I just meant that we generally wash the genital area with soap, and while rinsing, gently move the foreskin around.  Our son, who has a mild learning disability, sort of has the general concept but is somewhat lacking in execution.   Like most boys, it is not unusual for the tip of his foreskin to become red, and we really don't want it to become infected.  Given our recent experience though, I'm not going to even touch it anymore!  However, overall, I think it would be a very difficult sell to say that uncircumcised children should not wash their genitals, as that is precisely one of the reasons that has been used to support mass circumcision in the past. And if our experience is any indication, it should be something that parents of non-circs are prepared for. 

[MCatLvrMom2A&X]

The only washing I used to do of ds's genital was swishing his penis in the water. Now I have him do it by himself sometimes though I dont have him do it every bath because just sitting in the water does a good enough job and I never use soap on his or dd's genitals the only soap either of them get on there is what is already in the water.

[Pirogi]

Originally Posted by Ron_Low 

I would put it differently.  Focus on the squeezing of the glans.  This takes patience because the attention feels ticklish and may cause an erection.  Just keep pressing gently.  When it seems it will get no smaller the skin should be able to be slipped back into place. 
 

Ron, did you ever decide if you were going to write that book?

OP, glad things resolved with your son.  I tried posting right after your initial post, but MDC hung up on me, and I never got back to it.  I was also going to suggest trying lubricant.  Also, my MIL is from a country where virtually everyone is intact, and she said that when this happens, the boy or mother will put the penis in a glass of cold (not too cold) water for a few minutes to try to make the penis a bit smaller and facilitate the foreskin sliding back into place.  I have no idea if this works, but I thought I would offer it for consideration for posterity's sake.

[MCatLvrMom2A&X]

Sugar can also be helpful since it pulls fluid out and makes the glans smaller but that is usually for glans that have started to swell.

Link on that information can be found in this thread http://www.mothering.com/community/forum/thread/764732/possible-seperation-issues-sore-red-irritated-ballooning-normal-development-etc under paraphimosis.
Edited by MCatLvrMom2A&X - 2/15/11 at 4:00pm

[rhiandmoi]

I would just shmear on some KY and let the kid have some penis alone time. The lubrication should help everything get into place.