Normal for 4 year old? Looking for reassurance.

[SCav]

Hello,

I have a son who just turned 4 last week, and I have some questions on whether this is 'normal' or not.

He is intact.  He is not able to retract really at all.

His penis balloons when he urinates, but the stream is full and it 'deflates' as he is finishing.

A few weeks ago, he had an infection in his penis (red, sore, discharge) (it was 'proteus mirabilis' and anti-biotics cleared it up).  While at his pediatrician's, she mentioned that it is somewhat rare to get this infection and if he got it once, chances are it would recur, and circumcision may be recommended in the future.  FWIW, I live in a pretty liberal city and the doctor's own sons are intact.

I took my son today to the head of the pediatric urology department at our university hospital. I was less than impressed.  I came away with basically 'you can circumcise him or you can leave him as he is, but he probably won't get any better'.  They did retract him a little to see how far he would retract (which broke my heart).

From what I've read lately, it seems that ballooning can be considered normal, and that not retracting at this age is normal (even though you see the statistics of 90% can retract, that was based on an old study I guess?).

Currently, we're planning on leaving things as they are and just see if any infections do recur and take it from there.

I guess I'm just looking for reassurance that we're doing the right thing, and that the doctor did not provide adequate info.  There is also the steroid cream, but he said it probably wouldn't make much difference at this point. The could also do the dorsal slit.

Another family I emailed told me their son tried the cream and it didn't work, and are going in for the dorsal slit on Thursday (he is almost 5). The doctor told her that her son's penis was adhered to the tip because of scarring from a prior infection (which he sort of told me the same thing more or less).  I understand that to be false, as the tip IS naturally adhered to the tip, yes?

Sorry, this is long and fairly random, but there's so much information out there and I was so disappointed to come away from such a respected medical institution with what I believe to be poor information.  Having said that, I would be very upset if we did nothing and it ends up needing to be circ'd years from now.

Thank you!

Sarah

[MCatLvrMom2A&X]

Your ds at 4 is normal for not being retractable. The avg. age of retraction is 10.5 and many boys are not retractable until puberty is well established. That study has to be old because that isnt the current research.

The Dr you saw is not up to date on things and the boy going for the slit at 5yo is outrageous. That is something reserved for not being able to urinate at all or in late puberty.

Dr's shouldnt even be messing with the foreskin at all to see how far it will go it only causes worry for the parents and possible damage by doing it.

Ballooning is a natural part of the separation process, see this thread http://www.mothering.com/discussions/showthread.php?t=764732

Ballooning is a normal developmental stage and is not a cause for concern and does not require treatment, it is actually a sign that nature is doing it's job. Ballooning occurs when separation of the foreskin from the glans has started but the sphincter at the tip of the foreskin is still tight causing urine to pool under the foreskin. This is not harmful but it can be disconcerting to see it as the foreskin can balloon up quiet dramatically. It can last a short time or can come and go for months or years.

One infection does not a problem make. My ds had a bacterial infection at around 2yo abx fixed it and he hasnt had another problem since.

Links about retraction age
http://www.cirp.org/library/complications/vanhowe/
http://www.doctorsopposingcircumcision.org/pdf/2008-03retractileforeskinleaflet.pdf