San Antonio Urologist Willing to Try Steroid Treatment?

[vonn's_mama]

Hi Everyone,

My son has a very tight foreskin that balloons every time he pees. This makes it really hard for him to aim, and it also means that he drips for a while after he's done peeing. In addition to these trivial issues, the tip of his foreskin is often red and painful. I took him to a urologist who was recommended by my family doctor, and he was totally dismissive of the idea of steroid cream. He wanted to either circumsize him or cut a long slit down one side of his foreskin. I'm not in love with either of these options, and I don't see the harm in trying the steroid cream - worst case scenario, it doesn't work, right?!

Does anyone have experience with a San Antonio urologist who is open to alternative treatments for tight foreskin?

[hakunangovi]

While I can't offer any help re a urologist in San Antonio, I can tell you that the one you consulted is a few decades out of touch.  I would think that your son will develop normaly, given some time, and his foreskin opening will widen.  This process is triggered by hormones and is hugely variable age wise.

For your own peace of mind read:  www.cirp.org/library/treatment/phimosis  and www.biomedcentral.com/1471-2490/8/6 .  The application of a steroid cream such as Betamethasone has a very high success rate, but some do not advocate it's use on a pre-pubertal child.  However some have had great success.  You do not say how old your son is?  Even if steroid creams did not work, there are other options such as preputioplasty that do not involve the loss of any foreskin. 

[ursaminor]

Here is another helpful link about normal development http://www.cirp.org/library/normal

"

A narrow non-retractable prepuce in boys is within the normal range of development and usually causes no problems. The prepuce usually will spontaneously widen until complete retractability is obtained. About 50-60 percent of boys at age ten do not have fully retractable foreskins.¹⁷ This is normal.¹⁷ After puberty, the percentage of boys with full retractability rapidly increases spontaneously.¹⁷

If a narrow or non-retractile prepuce becomes a problem, a wide variety of conservative alternative treatments to circumcision are are now available. Circumcision is an outmoded, radical, traumatic, disproportionate, unnecessary surgery for a minor problem."

Ballooning is a really normal phase in foreskin development.  My son balloons also, tho he has a wider preputial sphincter.  I would find a foreskin friendly doctor to help sort out weather your son has an issue or not.  http://www.thewholenetwork.org/intact-friendly-doctors.html

[vonn's_mama]

Thank you both for the information! It is very helpful. To answer your question about his age, he is almost 5, and he has been complaining that it hurts, which is the main reason I feel like I should do something.

[hakunangovi]

It could very well be that your son's foreskin is starting to separate from the glans, and there are raw spots which will sting when he pees. This is a common occurence and should resolve in a few days with no need for any intervention.  The fact that he balloons when he pees is indicative of this.  A red tip to the foreskin is also common and does not necessarily mean that there is any problem.  If I were in your shoes I would just let it ride for a few days as these things often get better on their own.

[MCatLvrMom2A&X]

At 5yo there is no way I would consider having the slit done since he is urinating normally. Ballooning is showing that separation has happened to a certain extent and during that time he may have some pain and irritation because like a pp said it can leave behind raw spots. Once those resolve he should have no more pain.

Also like a pp said the urologist you saw seems to be several decades behind on intact care. I would not be comfortable with using the steroid cream at your ds's age either because it is meant for boys well into puberty or adults with true phimosis which at 5yo your ds cannot have unless someone has been retracting him and hurting him for the last 5 yrs.

[CorruptTears]

Try finding an intact friendly doctor.

http://www.thewholenetwork.org/5/category/texas/1.html

^^ They list two in your area.

Also try contacting doctorsopposingcircumcision, they maybe able to help you out.

[vonn's_mama]

Thank you all for your responses. I was surprised to see that the one doctor really listed as intact friendly in SA is my GP! Sadly, my sons see another doctor in the practice who I'm not crazy about, and they're not allowed to change to see my doctor because you can't change doctors within the practice. On the plus side, a friend of mine recommended a new doctor who just opened a practice here, and I've been emailing with him. He doesn't have experience with this, but he is very open to discussion, and he asked me for links where he could learn more about the issue, so that's a promising sign! I think I'm going to make an appointment with him for my sons 5 yo well child visit. I don't actually want to do anything with his penis, but it would be nice to have a doctor who would be aware of the issue and discuss any complications with me (e.g., my son had a couple of UTIs about a year ago, which was what prompted the visit to the urologist in the first place).

Anyway, thanks for your responses and support. My inclination is to leave my son alone, but I get pressure from family and it's nice to feel like other's back up my point of view!

[Quirky]

Could he be having a yeast issue? It may be a long shot but sometimes that can cause redness and irritation. If he eats a lot of sugars or processed grains, and/or he's had antibiotics lately, it might be a possibility. Also make sure to avoid soap in the bath until it's time to wash up and get out, and avoid bubble baths, too much time in pools, etc. as all of these can irritate genital tissues in both boys and girls. But my guess is that the ballooning will pass. I would never agree to a surgical solution, that's for sure!