My 9-year old son once again has an infection on his foreskin, which his ped suspects is an "overuse" issue (boys and their toys, LOL). Treating with topical antibiotic ointment and it's resolving. He had this about a year or so ago as well. I'm not particularly worried about the infection/irritation, but the other signs we're seeing. Guess I haven't really paid much attention until he started complaining, since at his age he bathes himself and takes himself to the bathroom!
I know his foreskin was retractable at least to the point that you could see the glans when he was younger (no one ever retracted it for him, but I remember seeing him do this himself). Now it doesn't retract at all. The opening is so small as to basically be invisible. He can of course pee, but has significant ballooning and has to put pressure on the foreskin by squeezing with his hand to force the urine out. It takes him a LONG time to urinate, the flow is a slow trickle and he's in the bathroom for 5-10 minutes. This doesn't seem normal or okay to me. I know he holds his urine and only goes when he really really needs to because he doesn't want to take the time. Yes, I've talked to him about not doing this but. . . When we took him to the Dr. w/ this infection and the last, our biggest concern was that urinating was very very painful for him, to the point that he was crying and refusing to urinate. It's slowly gotten better, but he's still complaining that it burns somewhat. We're encouraging him to pee more often and to drink more water so his urine is dilute.
I've been reading about ballooning, small openings, non-retractable foreskins and it all sounds like this is probably normal. If he wasn't having issues with urinating I wouldn't be concerned, since it doesn't bother him. His doctor said the only real concern is that if the pressure w/in the foreskin is too high, it could actually force urine backwards & he could get UTIs or a kidney infection. Ped also discouraged us from getting a referral to the urologist we can see because the urologist is VERY old-school and likes to recommend circ. I don't consider this a viable option. We tried betamethasone cream last time to try and loosen it up with no change (although my latest readings say it may need to be used for 6 weeks. . .we didn't do that). Thoughts? Try the betamethasone for a longer time? Try to find a local intact-friendly urologist? Ignore it until he goes through puberty and see what happens?