What is natural retraction like in 4y/o?

[moonbeem]

Talk to me about the process because he kind of looks suddenly circumsized. This morning he said his penis hurt, i asked to look and he put me off for a while. Finally i saw his glans exposed and purple/dry the foreskin pushed back in a swollen ring.

i cant determine how this came to be - he says he doesn't know, but also acts a little secretive. He had a playdate yesterday and a history of playing doctor.

he doesnt want to pull his foreskin down, he wants to leave it like that, i told him i won't touch it against his will but my instinct says it should cover the glans.  i it should co

[Lula's Mom]

Oh goodness. He needs to put it back. If he leaves it retracted for an extended period, the foreskin and glans could swell and then he will not be able to return it to its normal position. That is called paraphimosis and it's an emergency.  If he is already having trouble, he should try squeezing the glans while pushing the foreskin forward.

editing because I'm not sure I emphasized like I should have that if he CAN'T put it back with the squeezing, it is an emergency and he will need to go to the hospital.  He could lose part of his penis if the blood flow is compromised for a long time.

[Lory]

I know there was a diagram about how to fix it, but I couldn't find it although it's very helpful. Lula's mom is right, but if you need the instructions in different words:

"First aid for this condition is simple. The head of the penis must be squeezed very tightly between thumb and forefinger. This forces blood out of the head and reduces the size. The foreskin can then be brought forward to its normal position. Application of ice may also be helpful."

http://www.circinfosite.com/40.html

Like the other poster said, either he or you need to do it soon.

[moonbeem]

thank you so much for your info.  i gained his permission and got the glans back inside.  i had squirt breastmilk on before to lubricate the tissues and he was sensitive to that so a good sign there is no nerve damage i hope. there is still some tissue sticking out. i can think of no other analogy than to compare it to a hemoroid.

[MCatLvrMom2A&X]

You should talk to him and explain that he could really hurt himself if he dosnt put the skin back. I know at that age they are not to good about listening so keep a close eye on him and immediately put the skin back down any time you find it up. As he gets older it will slid back down on its own as the sphincter looses more but for now keep it down. It really is dangerous to leave it retracted like that. Here is the link to the diagrams on how to get it back for anyone who might need it http://www.circumstitions.com/Paraphim.html It talks about using sugar to help reduce swelling if needed. I really like the idea of using breast milk as well since it will kill germs off and aid in healing to any damage done.

[moonbeem]

Thank you for that last link, it is essentially what i did. The foreskin now covers his glans again. But what about the tip, it looks a little inside out?

i discovered it shortly after he woke around 9 and "fixed it' about noon. He was able to urinate this morning. he can be rather stoic about pain, so when his glans was covered i asked if it felt better and he said no. he didn't like that i manipulated his penis back into normal position but he did allow me to do it. he never wants to do that again, so i'm concerned he may hesitate to tell me if it keeps hurting

is this a step in the retraction process or did he or another child retract forcibly? he was not clear on how or what happened and at this point i'm not sure he knows or is willing to discuss

[MCatLvrMom2A&X]

It can be normal for the foreskin to get a bit stuck behind the glans when it first retracts. Odds are it was ready to retract at least in that it had released between the foreskin and glans but the sphincter is obviously still a bit tight. It is really hard to say if it happened by accident or someone else messed with it or he just did it himself.

Just keep an eye on him and make sure that it is put back as soon as possible after retracting. I would hate for you to end up in the ER with Dr's saying Circ is the only answer to you. There is another link that deals with fixing paraphimosis when it is so bad the glans cant be put back easily that will prevent circ I will add that one as well. It is really graphic so I didnt post it before.

Warning graphic pictures of paraphimosis reduction http://www.cirp.org/library/treatment/phimosis/reynard1/

[JulianneW]

Originally Posted by moonbeem 

Thank you for that last link, it is essentially what i did. The foreskin now covers his glans again. But what about the tip, it looks a little inside out?

i discovered it shortly after he woke around 9 and "fixed it' about noon. He was able to urinate this morning. he can be rather stoic about pain, so when his glans was covered i asked if it felt better and he said no. he didn't like that i manipulated his penis back into normal position but he did allow me to do it. he never wants to do that again, so i'm concerned he may hesitate to tell me if it keeps hurting

is this a step in the retraction process or did he or another child retract forcibly? he was not clear on how or what happened and at this point i'm not sure he knows or is willing to discuss

On the topic of it looking inside out while covering the glans. Could it be that his penis is growing and the foreskin no longer covers his glans the way it used to? 

Warning graphic- Coverage #6 http://www.newforeskin.biz/CI/CIchart.htm

[Sarah]

It sounds to me like the inner tissue  is still a little swollen.  I think a day's rest will probably have it back to normal.  I'm glad you were able to get it back into place, paraphimosis is a very serious situation.

[moonbeem]

Thank you all again for your information. The tip is more like the picture in c-9. maybe it is a new normal appearance. ?  he says urination is not painful...are we in the clear?

[JulianneW]

Yes, I would say you are in the clear!