paraphimosis treatment?

[provocativa]

My friend called me this evening, she took her son to the ER this morning. As she described what had happened, it sounded like self-inflicted paraphimosis. She could not remember the medical term, but said that her son had been masturbating a lot, and had injured his foreskin, resulting in half the glans being exposed. Apparently she did not notice what was going on until infection had set in . . . . the ER doc set up an appt. with a pediatric urologist, who he said would probably recommend circumcising. I tried to talk her out of this (which she doesn't want, as she didn't circ to begin with) but I am afraid the doctor will sway her. I'm guessing they'll tell her there will be scar tissue/adhesions, and have already said that this will happen over and over again- he'll inappropriately retract it and then it will get infected. Is this true? Can reinfection/ reretraction be prevented? Oh, I forgot, he is 3 years old, and not completely potty trained. He doesn't wear diapers at home, but I don't know about nighttime and outings.

[Quirky]

Before she makes ANY decisions I would have her contact Dr. Paul Fleiss as well as Marilyn Milos of NOCIRC. Marilyn can be contacted through www.nocirc.org and I have Dr. Fleiss' email and phone number somewhere if you PM me.

Here are some references on paraphimosis from www.cirp.org (reprints of medical journal articles). It looks as if there are several conservative treatments that do not involve circ if there is a reoccurence:

http://www.cirp.org/library/treatment/paraphimosis/

http://www.cirp.org/library/treatment/phimosis/devries/

Here's an article from a British paper about a woman whose son had paraphimosis: http://www.cirp.org/news/guardian28may2000/

http://www.cirp.org/library/treatmen...osis/reynard1/

[Frankly Speaking]

It doesn't sound like paraphimosis since only half of the glans being exposed. Paraphimosis is when the preputial sphincter is pushed behind the glans which would expose the entire glans.

I also don't suspect he was masturbating at 3 years old. At that age, there is no reward to masturbating. I suspect he was just fiddling with it which is common among boys.

Paraphimosis also doesn't result in infections.

That being said, we don't know what happened. It sounds like he retracted to the point that the normal and natural adhesions tore and either his foreskin swelled as would be expected or it got red, also to be expected. With this swelling and redness, it appears that the doctor did a shoot from the hip diagnosis of infection. Whether there was really an infection or not, we will probably never know. However, a torn adhesion would be an entry point for an opportunistic bacteria.

Just for informational purposes, there is some at-home treatments for phimosis that can avoid a rush to the emergency room. The first thing to try is to simply move the foreskin forward. If that doesn't work, grasp the glans between two fingers and the thumb and compress it and move the foreskin forward over the compressed glans. This will normally work but if it doesn't, chill the penis with ice to make it contract and try the two fingers and thumb again. If that doesn't work, pack the penis in sugar. This will reduce swelling and can allow the foreskin to move forward.

Keep a constant eye on the penis and watch for any signs that there is inadequate blood flow. If there are signs like the glans turning blue, get him to the ER as fast as possible.

Now, that being said, I have only seen one report of paraphimosis in the 5 years I have been involved with this issue. It is very rare. This may be the second case, I suspect it's not though.


ETA: I suspect that after the first episode of paraphimosis, there will be a significant impression on the child and it is very unlikely that there will be a second episode.



Frank

[provocativa]

Thanks so much for responding quickly. I think I was maybe wrong about the terminology- I have a daughter, and only know about the circ debate because hubby is intact, and we would never circumcise. I hope I can get this info to her in time. It does sound fairly violent- he was screaming in pain, etc. The doc was conservative about his estimation of infection- I don't remember the details- but may have given her a script to fill later if it didn't clear up.

[mattemma04]

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