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Small peehole

post #1 of 12
Thread Starter 
Well, this is weird for me, being a resident here...

Last night, I noticed for the first time ever that Miles (4.5 months) has a tiny little peehole. When his foreskin is relaxed, it looks all bunched up and like a normal foreskin, but when I gently pulled it up a little, I saw that the hole is tiny and off-center (if he were looking down at his own penis, it would be on the left, like 8 o'clock, and a little towards the top. Where the hole should be looks sort of smooth, maybe a little like a bubble, but not infected or red or anything. He has no trouble peeing and soaks many diapers a day, and I have never heard him cry or be upset, but I also have never seen him pee without a diaper on, so I don't know what the stream looks like.

Anyway, I emailed Frank in a panic, and he said it is fine, but I am worried that this will not open up. I guess I have to just wait and see, but it still worries me. It looks like the second set of pictures labeled "true phimosis" seen here: http://www.mja.com.au/public/issues/...w10610_fm.html

So please reassure me. I have an appt for a well-baby on Tuesday, and my ped has been very foreskin-friendly in the past, but ds1 didn't have this. His penis was always slightly retractable (I could always see a little bit of the glans.) I don't know if I should point it out to her, and then get on the "will this urologist be foreskin-friendly" train, or if I should just let it go. Is there some little slit they could make to make it bigger, or would that damage the preputial sphincter? Obviously you all know I would not have him circ'ed b/c of this but I am wary of doctors.
post #2 of 12
If he can pee okay, what's the concern? Does this clear up eventually like developmental phimosis?
I think I'm not clear on what's going on here. Is the preputial ring adhered to the end of the glans? It seems like in a 'normal' boy, the very end of the foreskin is not adhered to anything, but the preputial ring keeps it tightly closed. Then the rest of the foreskin is adhered to the glans. Does that sound right?
But in this situation of pathological phimosis of an infant, is it that the part of the foreskin that isn't normally adhered to anything is adhered to the end of the glans?
Sorry to be uneducated or obtuse.
post #3 of 12
If he is peeing ok, and isn't in any pain, I'd leave well alone. It's obvously functioning ok, so why look for a problem?
post #4 of 12
Thread Starter 
b/c it looks like the pic of true phimosis, and it looks like scar tissue - smooth and irregular. and the hole is so tiny.
post #5 of 12
If he's peeing fine just wait and see.

post #6 of 12
my ds (also a Miles, 6 months) has a peehole sooooo teeeeeny that I can hardly see it! And his is off-center too don't worry mama!

They actually thought he had hypospadia but he doesn't. Everybabybody looks a bit different
post #7 of 12
Thread Starter 
that is good to hear, daekini. thanks for the reassurance
post #8 of 12
Don't forget to read the article! I'm sure you did, but let me point out a few quotes:

"many boys are circumcised for (pathological or physiological) phimosis before the age of five years, despite (pathological) phimosis being rare in this group".

So it's pretty rare, right? Your son may have "physiological phimosis", or non-retractable foreskin, but that's normal. My son looks like the 2nd set of pix too but the doc has no problem with it at his very young age. I'd recommend that you not pull it back even to check any more, just to make sure it doesn't get any tiny tears.

another quote:

Spilsbury and colleagues define phimosis as "narrowing of the preputial orifice leading to non-retractability of the prepuce". Such a definition would result in many boys under the age of five years being diagnosed with a condition for which surgery is considered to be justified.

and another.... I like this one!
...."phimosis" does not equate to "pathology", and "pathology" does not always need surgery.

post #9 of 12
Hi Lilli, just another Momma here to reassure you. My second ds is like this too. My first one looked like the top group of pics but my second looks very much like the second.

He has no "pout" but I have figured it out to be that ds2 has had a detatched foreskin since birth(I know this because he has always ballooned when he pees), so his foreskin is just not able to fold in on itself like that. In order for the foreskin to look like the #1 pic, the surrounding skin still needs to be attached to the glans.

The preputial ring (the ring of tissue that keeps the foreskin constricted to keep all the gross stuff out) is still tight, which might give the illusion of him having acquired phimosis, but unless there was some sort of trauma(repeat retractions or infections) there is no way for there to be scar tissue.

Like the other posters have stated, as long as he is peeing alright, he is fine

Can you tell that I was worried about this too I tend to research the h&!! out of things that worry me

I hope I made sense to you and was able to ease your mind a bit.

post #10 of 12
My 2nd ds's penis looked just like the one in the 2nd pic when he was a baby. He's 2 now and fully retractile (does it himself.) No problems whatsoever.
post #11 of 12
Oh! I just read calngavinsmom's post. Maybe this is what was going on w/ Jake as well? His penis looked normal, like the first sset of pics, when he was a little baby, but after a while, it looked like the 2nd. Maybe his adhesions just dissolved early? And since no one ever tried to retract him (other than a stupid nurse when he was a newborn. I had to physically remove her hands twice all the while telling her not to!) I just didn't realize it till now since he retracts himself. btw, he has a fairly short foreskin. It completey covers his glans, but if he gets naked right after waking up in the morning (if you KWIM ) it's only half covered. Maybethe shortness and early retractability together make it look funny.
post #12 of 12
Something that I noticed with ds 15mo is that when he isnt going pee the hole is super tiny and when he is it get a whole lot bigger

My thoughts even if the forskin is has a really small opening there is no need to bother it now unless he is having trouble peeing. There is every chance that it will resolve as he gets older and grows into things better.
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