Help, ped urologist says to forcibly retract

[siddie]

My 4 and a half yr old ds has an intact foreskin that retracts approx. 20% now. HIs foreskin is loose and balloons a little while urinating. There is a small opening or loose area on the left side of the foreskin. About a month ago, ds pointed out to me a small raised area (about .25 or .5 cm) on the left side of his penis under the foreskin that is tender. It doesn't seem to bother him, he only says yes it is sore if we ask. He does develop smegma if he skips a bath but he will tell me he has white stuff and his penis hurts so I put him in the shower and help him to rinse off and he is fine.

I took him to the regular peds who said she thought it was smegma under the foreskin but referred us to the ped uro who confirmed this and said the foreskin needed to be retracted to clean it out/prevent infection and offered to forcibly do so in ( ) the office today if we would hold him down. I of course said no but now my dh who was present thinks we need to help our son retract it litle by little every day or it will get infected. My ds says he doesn't want to do it, his penis is okay now. I am afraid dh may think it is necessary to follow the doctor's instructions. Help me to convince him not to injure our son. I have printed out a lot of info from the net for him to read but my dh is much more mainstream than I and of course thinks the doctor knows more about this than I do. What can I say to him to prevent him from trying to forcibly retradct?

[Sarah]

How long has the raised area been there? There have been several moms who have posted here in a panic about a "smegma pearl" (usually noted as a visible lump under the skin or an assymetry) and usually within days of noticing it- it goes away on it's own.

I think that if your son says it's ok... that it would be really cruel to terrify him with a forced retraction. Tearing anything is going to open him up to infections and adhesions- not the other way around.

The Fleiss article mentions this- have you read that?

If he has penile adhesions which need medical attention (not my opinion)... but if someone DID think these were something that needed to be resolved RIGHT NOW... he could be treated with steroid ointment which would help the adhesions release without tearing. And if any additional prying had to be done- that should be done with some anesthetic.

Love Sarah

[Frankly Speaking]

Yes, forcible retraction is definitely needed. That urologist needs to be forcibly retracted from your son's life for good!

Your son does not need to be retracted period. His foreskin will become retractile when it is ready and it is not ready. While some children will appear to be retractile "instantly," it is actually a process and not an event. Just like when he reaches puberty and his voice changes, it does not change over night. It happens over a period of a couple of years. When I started growing chest hair, the first indication was a ring of hair just around my nipples, (very embarassing) not a fully carpeted chest of hair. So it is with retraction. The entire process will take maybe as much as several years. The restriction around the opening is it saying it's not ready yet but that it's working on it. Some day down the road, it will be loose enough to slip over the glans and it will seem to be almost instant.

It reminds me of a science class demonstration in school. The teacher had a ball and ring. The ball would almost go through the ring but not quite. However, he held the ring over a bunsen burner and heated it and suddenly, the ball slipped through quite easily. At this point, your son is "heating the ring" and some day soon, his glans willl slip through quite easily. Just like we wouldn't have thought of trying to stretch the ring to allow the ball to slip through, you shouldn't try to stretch your son's ring. It may take several more years for him to become completely retractile but it is a process, not an event.



Frank

[colaga]

That urologist needs to be forcibly retracted from your son's life for good!

[siddie]

The bump has been there for over a month. The urol. said he has adhesions where the foreskin attaches to the head of the penis. Isn't that normal at this age? I think I have convinced my dh that we need to leave it alone for now. Thanks for your replies. We definitely will NOT be going back to that urol. His nurse immediately told us we need to circ our son now while he is young BEFORE we saw the doctor and with the lump sight unseen.

[Sarah]

Holy Cow- What the nurse said... you need to report that to the state medical board! That is totally uncalled for!! Totally unprofessional! Please report that incident and write to the office too!

As for adhesions- it's not normal, and it's not abnormal either... it's just one of the many various ways that boys may individually develop. Most babies don't have the adhesions anymore after they are a year... about 20% of boys do have adhesions that last longer and don't represent a problem.

Maybe you would feel more confident if you read the oster study at cirp... it's old, but I think that the findings are relevant and do show that it's OK to wait.
http://www.cirp.org/library/general/oster/

[Benji'sMom]

This is what I read in the book "Circumcision: The hidden trauma" by Dr. Goldman. Can't think of the first name of the author right now. Smegma is not dirty and doesn't need to be cleaned and doesn't cause infections. It's a natural lubricant along with dead skin cells. (Women have it, too, actually.) It becomes a little bead "a pearl," as someone already said, and works its way out of the foreskin gradually. That's totally normal. It doesn't need to be cleaned out.

I think your doctor has some old fashioned ideas about care of the intact penis. My mom felt that the foreskin needed to be retracted and smegma cleaned out because she read it in a book when my brother was a baby, many years ago.

If you retract it, you'll just cause him physical pain and it will have to heal. I think your instincts are right on!