Question on circumcised penis...

[Mommy&Will]

:
Coming into this forum with trepidation.... but I know those of you here are knowledgeable and I hope will help me with no flames...

My ds is circumcised and at his 4 month dr. appt. the doctor grabbed his penis, pulled back his foreskin and rubbed around the penis as to move the skin back "so it won't grow back." This was a new doctor for me, and I was surprised. I've never ever had a dr. do this before, with either ds.

Have you heard of this and why would she do this? Thank you.

[earthmama007]

No, I don't know why the doctor would have done that. If that was his reason it does not make a lick of sense to me. There is never a reason to touch a baby's penis circumcised or not unless there is an infection present or a culture is in order. I am guessing this wasn't the case. Did your son cry or seem hurt at all? If not, he is probably fine. If he did then he could have suffered some trauma with adhesions. Just another thought. Somene else will probably be by soon to help. Please don't be timid to come here in the future !

[boingo82]

Were you given after-care instructions telling you to retract the remaining foreskin at diaper changes and apply vaseline? You should have been..

It sounds like the doc was checking for adhesions, which seem to occur in at least 10% of circumcised boys.

In a newborn, the foreskin is attached to the glans (head) of the penis by a membrane similar to the one that attaches your fingernail to your finger. Normally this membrane slowly dissolves over several years and the boy's foreskin is eventually retractible. That can happen anywhere between age 3 and 18, depending on the boy.

When they circumcise, they use a probe to break apart that membrane so they can remove the foreskin. Usually nowadays they leave some foreskin, because the tighter circs they used to do caused a lot of problems in adulthood.

The glans "knows" it should be covered, and so that remaining foreskin tries and tries to reattach itself to the glans. If just the membrane reattaches, it will likely dissolve by itself, just as if the boy was intact. If the scarline attaches, then you have an open wound growing to an open wound, and it will never come apart. Then your son has problems like skin bridges to deal with.

So likely your doctor was checking that the remaining foreskin had not reattached itself to the glans..

HTH.

[Frankly Speaking]

Relax! We don't flame when Moms come here with honest and sincere questions. Our interest is in providing help for children.

Emily is right on target with her reply. I'll add a little bit.

First of all, it sounds like you were not given proper care instructions for your son. That's not unusual. Almost all circumcisions are done by obstetricians and the pediatricians are left to handle all of the problems. That is probably why pediatricians are far less supportive of circumcision. Obstetricians just don't see all of the problems they cause and thus are unlikely to give proper care instructions. this should be hospital policy to provide the instructions in printed form but it appears they leave that up to the doctor and no one does it. After a circumcision, an occlusive dressing such as Vaseline should be applied daily until it is clear that adhesions are not forming. There is no time line and I know one mother who is still battling them with her 7 year old. These problems have become very common lately because as Emily said, the style of circumcisions has changed to avoid the problems caused by the old style tight circumcisions. They have simply exchanged one set of problems for another set as you have witnessed.

You didn't completely describe how the "pulling back" was done but many physicians will forcibly rip the foreskin back. This can rip the inner lining or tear chunks out of the glans and can leave terrible scaring. I apparently was ripped back like this as I have part of the inner lining permanently adhered to my glans and it occasionally causes me burning pain that can ruin a good night's sleep. If the remnant foreskin was gently pulled back, there was no problem but if it was forced back, the doctor was absolutely wrong and could have caused your son infections and permanent injury.



Frank

[LadyWulf]

Believe me. The folks here do NOT flame mothers who have circed their sons. I wasn't flamed at all in the slightest whatsoever. This is one of the most supportive and informed group of individuals i have ever had the honor of knowing.

[Sarah]

Julie- This is what worries me... (not that I am criticising you) ... but why would you need to come to us to ask us what the doctor was doing? How should we know? (well... we do know... but that's not my point) ... on the other hand- it was the doctor's JOB to tell you what she was doing... not only to tell you and explain clearly- but to have your PERMISSION to proceed!

This tearing of adhesions can be very painful, damaging and traumatic to a child and should be avoided, and if the adhesions absolutly have to be seperated- a child should have pain relief... and a parent should have given consent.

This article explains a little about what the adhesions are about:

http://www.cirp.org/library/complications/gracely1/

also, earlier this week another mom posted with question on a similar line:
http://www.mothering.com/discussions...d.php?t=199068

What I usually suggest that people do is to make a stink of some form so that eventually, if enough people complain, something changes in the system.

No one should consent to a circumcision without knowing what the risk of adhesions is.
So the informed consent process before the circumcision needs to be changed at the hospital level.

No one should not know the proper care to avoid adhesions in a circumcised child... AND... since so many people circumcise believing that the circumcision is easier hygenicly than intact- the AFTERCARE needs to be presented BEFORE the consent form- so that people have the full picture before deciding falsely that circumcision is easier on parents and babies.
Once again- reform the informed consent process.

Proper aftercare instructions need to be given, any less than that is failing their duty. Aftercare of a circumcision is more than just watching for blood and waiting for the ring to fall off... it goes on for quite some time.
This is truly grounds for a lawsuit against the circumciser. The problems in consent and aftercare.... Even if you don't want to do a lawsuit- you may want to document this for your son in the case that he would like to do a lawsuit of his own when he is 18. The fact that the consent process behind his own circumcision was so flawed would really help his case against his circumciser.

lastly- no one should have a doctor who takes it upon themself to do some hocus pocus manipulation without explaining what they were doing. I think you should call the doctor back and ask about it- find out what she was doing and what she was trying to achieve. I think that a lot of doctors have difficulty being honest about it because they and their peers are in it too deep.

I hope that your son is feeling OK, from the sound of it- the retraction did not hurt him?

Love Sarah