Does smegam cause pain? Or what is this?

[ambivamom]

I have an intact 18 mo, he is my fourth intact boy and I thought I had seen everything.  Tonight ds was obviously in pain and when I got him ready for bed I saw that his penis was swollen-- not the foreskin, but the whole thing, bulging on one side.  Color is not bright red but maybe "flushed."  A bit of milky moisture at the opening.  So I would say a smegma pearl is working itself out...but for the pain?  It doesn't look like yeast on the outside or anything.Could that be it? With the pain?  I am checking in a little while to make sure he is wetting his diaper because I couldn't tell if he peed when I put him in the warm water.TIA, mamas.

[MCatLvrMom2A&X]

Smegma itself will not cause pain. All it is is dead skin cells much like dandruff (used that one since you can actually see it) The pain can come when the separation process starts because both surfaces, glans and foreskin are raw when it first happens. It can burn when urine hits it or like a paper cut.

Here is a thread I put together that you might find helpful in determining if he needs meds or if this is part of the natural process http://www.mothering.com/discussions/showthread.php?t=764732

Odds are higher it is separation.

At 18 months he is on the young side for separation but it is in the normal age range still.

[ambivamom]

Thanks for that link; I have read it a number of times before and even tried perusing tonight to see if anything was there I had forgotten.  I just have never seen a swollen entire penis before when there wasn't obviously some other external irritation!  I will just have to see what tomorrow brings, I guess.

Edited because I meant to ask:  Would separation cause the entire penis to swell, especially in a one-sided way?

[MCatLvrMom2A&X]

When ds had his infection the swelling started on one side only but his was red and obviously painful and within 6 hours the entire penis from base to tip. So I am guessing if it is an infection you will know it very shortly. I hope it goes away instead of getting worse

It could just show up on that one side where the separation is going on. Time will tell one way or the other. Since separation and infection can present very similarly in the first stages. I wish I could tell you for sure.

[ambivamom]

Ok, good to hear someone else's experience.  I am curious:  Did you treat ds with medicine?  And did you find it difficult to get a doctor to culture with a swab?  I am asking because my experience with doctors has been that they would rather just "try this and see" than do a culture.

[MCatLvrMom2A&X]

I did take ds in because his penis was so swollen, it was half the size of his wrist really. I did mention a swab to the Dr. but he said the medication he was prescribing was the same he would no matter what the infection showed so I let it go. He prescribed amoxacillan and OTC bacatracin. I honestly thing the bacatracin did the job because within a few hours after putting in on the swelling started going down but I had already started him on the abx so I finished them.

If you have any bacatracin it wont hurt to give that a try and see if it helps. Just slather it on thick over the entire penis and tip at each diaper change.

[eepster]

I would put off using bacatracin till I was sure there was a bacterial infection.  It can through off the flora balance and lead to yeast.

[titania8]

That sounds just like what happened to my ds. He was 11 mo, and it started as just a little red, and maybe it kind of looked swollen, but i wasnt sure. Next day bright red and really obviously swollen, the whole thing. Some milky/yellowy stuff dribbled out at one point. He wasn't in obvious pain, but it sure looked awful.

I gave him several baths with tto, and I might have put bacitracin on it, but I can't remember. It improved overnight. Was back to normal in a few days, iirc.

Not long after that incident I changed his diaper and his foreskin was retracted a bit, so I think it was separation.

[ambivamom]

Well, he is a bit better today: Not as swollen or red.  Some darker spots in his diaper that was from some sort of discharge but it hasn't shown up again.  Not dark colored (like blood) but jsut a spot that was darker than the peed-on area on the cloth.  I am keeping an eye out... 18 mo does seem early for any significant separation, but I guess anything is possible!  Will keep giving warm baths and look for changes.   This was a new one for me!