My 2 yr old nephew is not circumcised and has 2 major infections in the folds of his foreskin. They are recommending circumcision becaused they are worried that he will have continued infections and there is scar tissue build up and they are worried about how that might affect retraction down the road. These infections have been extremely painful with lots of crying with every pee. What do you think? Is there any other options besides circumcision or is the best way to go?
2 yr old with penis infection- circumcision question
I am sorry about your little one! I am not sure how infections would cause the growth of scar tissue. I would start looking for 2nd and 3rd opinions. I understand your DS has been in great pain - but if you had small daughter that dealt with 2 infections, no doctor would suggest any genital amputation as a cure. What type of infection was it? Could it have been diet related? I always recommend taking a look at the Whole Network's list of intact friendly doctors. Maybe there is one in your area: http://www.thewholenetwork.org/intact-friendly-doctors.html . Marylin Milos, who is a resource person for mothering, takes calls and emails on these matters - I am sure she would help with finding an intact friendly doctor in your area. Her contact info is on nocirc.org. Another thing, has your son been forcefully retracted at all or has anyone washed under his foreskin with soap?
ETA, PP mentioned separation of the prepuce. Here are some articles explaining normal separation and pain issues. I believe there is also info in TCAC sticky.
Edited by ursaminor - 2/29/12 at 5:12pm
Infection is never a reason to circ unless it turnes into gangreen. My advice would be if it happens again insist upon a swab to see exactly what if anything is growing then treat with the proper abx if needed. If the Dr mention circ again ask them what they would do if it was a girl having infections I am sure they wouldnt even think of cutting something off.
Also how have they been caring for his foreskin up till now? have they been retracting to clean, using soap? If so that can cause issues. They need to find a foreskin frinedly Dr. to do that the best way would be to contact Maralyn Milos, RN the founder of nocirc she can maybe help them find one and she can also give them advice over the phone.
Rediculous how Dr's jump to circ over something like this.
Check out this link and also get another opinion. I would absolutely make sure no caregivers are retracting the child bc this is the number one cause for infections. The penis, if left intact, is self cleaning. It is possible that the child has a yeast issue due to an imbalance such as food allergies or recent antibiotics. In this case you can try warm water and apple cider vinegar, just a capful, in the bath. If the infection is due to a scratch it may be that the child had a bi of bacteria on his nails and it got into a microscopic or larger scratch. That happens too ad would happen whether intact or circed. I have also noticed that my son thinks erection "hurt" as does separation. The thing is these feelings are odd and the children cannot really explain it bc it is new ad they are too young to have the language to explain it. Now I will also say that separation can feel a bi like stinging from what I have heard from older boys and men but urinating in warm water when he must urinate often eliminates the feeling and of course the feeling goes away in days. I will also leave the link for the lost list..basically there are several immunologically necessary parts of the penis that are gon forever if a child is circumcised. I for one would no consider circ an option bc my children NEED those parts to be healthy and normal. Good luck and best wishes!
Coconut oil can help clear the infection up. You can also rub garlic oil on the soles of the feet to help as an antibiotic. I would also consider diet. Wheat can cause lots of health problems. I also agree with what was said about if someone or the child has retracted the foreskin it can cause an infection as it tries to heal itself. I would also check into what kind of laundry soap you might be using if he is potty trained and wears only underwear. If it is training pants or diapers that are not cloth I would stop using them.
Sounds to me like he is being forcibly retracted. It is REALLY rare for a child his age to have a foreskin that retracts from the head of his penis. Forcing back the foreskin to clean at that young of an age is really bad and causes infections and scar tissue. My suggestion would be to get a doctor who knows how to care properly for an intact penis. Also, keep him diaper free as much as possible. Give him as many baths as he wants. NO SOAP on the foreskin. DO NOT RETRACT TO CLEAN. And a warm bath with baking soda. If that doesn't clear it up. Get a cream to put on the tip. Do NOT retract the foreskin. Leaving his penis be and no more forcing back the foreskin to clean, the foreskin will heal itself. Good luck. He doesn't need a circumcision. We don't circumcise our girls when they get an infection.
Some children do need to be circumcised, but it's very rare, especially at that age. I'd definitely get a second opinion, preferably from an intact male doctor. If the recommendation to circumcise comes from doctors who believe that all babies should be circumcised, then you definitely need to find new doctors.
Only two countries in the world circumcise more than 50% of baby boys btw - the USA and Israel (other countries circumcise but usually around puberty or adolescence, or occasionally around the age of seven).
It would be very unusual to be able to retract at that age. This is some advice on retraction.
AAP - "Care of the Uncircumcised Penis"
"foreskin retraction should never be forced. Until separation occurs, do not try to pull the foreskin back — especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin."
Canadian Paediatric Society
"Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old, or even until after puberty. Never force it."
RACP policy statement on male circumcision
"The foreskin requires no special care during infancy. It should be left alone. Attempts to forcibly retract it are painful, often injure the foreskin, and can lead to scarring and phimosis."
Thanks for the advice for my nephew.. Talking to my sister it was definitely infected. Very pussy and bleeding on the outside of the foreskin. The doctor said it is very rare. It is seems that the outside of the foreskin is cracking and the infection is happening in the cracks. The doctor said they were worried that it will continue to crack and scar tissue will form which may make it very uncomfortable and painful in puberty when retraction does happen. My sister is worried that might have to do this in puberty when it might be much more traumatizing so is thinking of doing it now. I will pass on what you all are saying though.
Thanks for the update.
The bolding is mine. This is the kind of thinking that leads to circumcision in the first place: trying to prevent what MIGHT happen. I realize that this is not your child, but please, try to impress upon your sister that it's possible there may be a future problem but that doesn't mean *it will* happen. Perhaps discussing this with your sister as if this child were a girl, may help? As in, if this were a girl, would the dr. suggest she be circumcised because when she becomes sexually active, the skin may be scared & then she'll have issues. Or that, when she has a baby & the skin needs to stretch, that the scar tissue would prevent it? If that were the case, then there'd be even more c-sections due to mothers tearing and/or receiving episiotomies during birth. Most likely, they would not suggest circumcision for a girl.
Also, what proof do we have that a circumcision performed on a two year old is any less traumatic than one performed on a teenager? I don't think we have any.
Maybe you could suggest she come here herself?
She's lucky to have an informed, caring sister like you. I hope this little boy can heal *and* keep his foreskin. I do believe it is possible.
One last thought: maybe your sister would contact Marilyn Milos or Doctors Opposing Circumcision for a second opinion? I hope she would do that before choosing genital surgery for an infection.
I could be totally off base here but the cracking sounds like a yeast infection to me. Could that be the root cause, and if he's still in diapers and/or the yeast isn't being treated, it's causing open wounds that are getting infected? I'd tell the doctor to worry about what's causing the infection and stop pushing a totally un-needed surgery.
My DS went through this right around that same age. Nobody even suggested circ, although I would have found a new doc if they had. Ultimately I don't know what the cause was, whether it was a scratch that festered or if it was just natural separation that got dirty/infected through fecal contact or what... a little judicious application of a topical antibiotic ointment at every diaper change for 2 days cleared it right up, and it hasn't reoccurred.
Make sure he's not being retracted by anybody, treat the infection, and unless it's reoccurring, I wouldn't worry much beyond that. Borrowing trouble like it might possibly produce scar tissue or it might possibly cause problems down the line is just plain silly at this point. How many kids with constantly scraped knees do you know whose ped has suggested amputation of the patella because it'll be easier than just dealing with any scars that may happen?