*sigh* UTI, urologist needs education

[jenP]

So, my DS presented with a swollen scrotum and hard mass inside... went to family doc who sent us to children's urology clinic, had an ulrtasound, cath'ed and finally found his epididimys was inflammed due to a bacterial infection. So now he's on abx and doing fine. But the urologist, who seemed like a really nice guy otherwise, said stupid stuff like "this is caused by his foreskin" and "uncircumcised boys are 4 times more likely to have UTI's" and "we need to discuss your reasons for leaving him uncircumcised." Okay, of course I totally expected stuff like this from a urologist. No surprise. And I gave him my spiel, starting with "can we stop saying 'uncircumcised?' I did not 'neglect' to circumcise him!" and touching on the 4times thing is really, in the most FAVORABLE study, a difference from 4 in 100 to 1 in 100, not so alarming and huge a difference as "4 times as many" sounds, and ending with how I and how a friends daughter had multiple UTI's and no one ever suggested cutting anything off, and what do you suggest cutting off from circumcised boys who get UTI's??
So after my spiel, he says, "Hey, I'm on the same page as you. I try to convince parents to leave it alone. But I even have European parents who after a UTI decide to just circ him."
Well, gee, I wonder why even European parents would circ when he tries to tell them to leave it alone, AFTER he told them the foreskin "causes" infections???
Sigh. I'm just so tired, and have so much going on in my life, and now I need to dig up articles and write a letter and educate this man. But I feel it is really neccessary as he seems to have slight intactivist leanings... (at least compared to his colleagues in the practice with whom my friends have had dealings, yoi!) with the right data presented to him and an awareness of how his words imply things to parents... he could do better to help little boys and the men they will become. He is in a good position to do a lot of good so I really want to give him some studies and write him a nice letter.
Sigh, so why did MY boy have to get a UTI? I'm not even telling anyone because I don't want to hear from any other ignorant busybodies how it would be "cleaner" and I could have avoided this if I had just cut off a chunk of his dick when he was a newborn.
Ugh, and now we have to schedule a test for kidney reflux. Poor guy.
Thanks for the support, y'all!!

Jen

[InDaPhunk]

My 2 cents is that he knows all the info already, but leaving kids alone won't make him any money, so he goes with what works for his car payments.

[Ruthla]

Ugh. Of all people, I would expect a urologist to be familiar with the function and care of a penis! I've never had a gynecologist suggest a double mastectomy when I presented with breast pain!

[jenP]

Originally Posted by InDaPhunk

My 2 cents is that he knows all the info already, but leaving kids alone won't make him any money, so he goes with what works for his car payments.

I get the feeling that he has some instinct telling him that the default position is preferable, I think he is corrupted by his colleagues that constantly blame the foreskin for everything; perhaps he feels that though it is "nice" to leave it alone, alas it is all too often "neccessary" to remove it. Or that is is nice to keep it, but if the parents really want to cut, well, it DOES help prevent some infections. I'm hoping putting things together and pointing out the illogic will help. After all, like you said, I'm sure he's seen the facts, but it depends on how it's presented and how you are looking to interpret. As in, "Wow, uncirc'd boys have FOUR or FIVE times as many UTI's as circ'd! That dirty foreskin must trap bacteria and cause disease!" vs. "hmm, I wonder why in the US 1 in 100 circ'd boys get a UTI in the first year of life and for natural boys it is 4 in 100, but this difference is not seen in other countries? What is putting these US boys at additional risk?"
So, maybe one Mom pointing out some things and asking him to really think about it could make a little opening in his mind. Maybe he'll start arguing with the real "hackers" in his practice, challenging their "everyone knows the foreskine causes disease" mentality. Who knows.

Jen

[jenP]

Originally Posted by Ruthla

Ugh. Of all people, I would expect a urologist to be familiar with the function and care of a penis! I've never had a gynecologist suggest a double mastectomy when I presented with breast pain!

But don't you know breasts cause breast cancer??

Jen

[Ruthla]

Originally Posted by jenP

But don't you know breasts cause breast cancer??

Jen

[Quirky]

You could write a cover letter and burn a CD to go with it, and include:

http://www.nocirc.org/statements/breastfeeding.php (has a great sidebar on UTIs)

http://research.cirp.org

http://www.cirp.org/library/anatomy/cold-taylor/

http://www.cirp.org/library/anatomy/taylor/

The web video "The Prepuce" from www.doctorsopposingcircumcision.org

http://www.cirp.org/library/statements/ (medical organization statements)

[warrior mama]

I just wanted to send you a

[pdx.mothernurture]

I think I'd feel like saying something like, "If my son were a daughter, would you recommend amputative surgery or would you treat her conservatively, with antibiotics, and perhaps recommend further testing if the infection recurred? Please, don't descriminate against my son because he has a foreskin. He's supposed to."

Jen

[pdx.mothernurture]

Originally Posted by jenP

I wonder why in the US 1 in 100 circ'd boys get a UTI in the first year of life and for natural boys it is 4 in 100

I'm sure others can confirm whether this is right or not, but I think that even if the results of Wiswell's crappy UTI study were true, it would give intact baby boy's a 1/100 risk of UTI and circed babies a 1/1,000 risk. But even his study failed to take breastfeeding into account-which is a known cofactor-and it's my understanding that his circed group was composed of healthy, full-term babies but his intact group was composed of some babies that were only intact because their health was to fragile to circ, including premature babies and infants who'd been catheterized.

Jen

[jenP]

Originally Posted by sunflower_mommy

I think I'd feel like saying something like, "If my son were a daughter, would you recommend amputative surgery or would you treat her conservatively, with antibiotics, and perhaps recommend further testing if the infection recurred? Please, don't descriminate against my son because he has a foreskin. He's supposed to."

Jen

That's pretty much what I did say, except the part about discrimination. Actually, when he said "we need to discuss your reasons for leaving him uncircumcised," the first thing I said was, "you trained in the U.S., didn't you?" and when he said "yes, why?" I said "because only here would we say, 'oh, he has a UTI, better amputate part of his penis!" then I went into the part about what would you cut off a girl or a circ'd boy.

Jen

[jenP]

So, those of you with experience, what about this vcug testing? Seems it is standard to test for it after one UTI, whether boy or girl, then if there is reflux, go on prophylactic abx for about a year and retest. Needless to say, I don't like the idea of such an invasive test, nor do I like the thought of abx for so long. OTOH, if I don't test I guess there's the risk of another uti infecting the kidney which could cause scarring and long-term damage. Either way it is yucky. Do I wait and see if he gets another UTI or go with the testing now?
Of course maybe I should just put him on the abx permanently now since I've refused to cut off that disease-causing thing on his penis...

Thanks for the help and sympathy!!

Jen

[acrathbun]

So, those of you with experience, what about this vcug testing? Seems it is standard to test for it after one UTI, whether boy or girl, then if there is reflux, go on prophylactic abx for about a year and retest. Needless to say, I don't like the idea of such an invasive test, nor do I like the thought of abx for so long. OTOH, if I don't test I guess there's the risk of another uti infecting the kidney which could cause scarring and long-term damage. Either way it is yucky. Do I wait and see if he gets another UTI or go with the testing now?
Of course maybe I should just put him on the abx permanently now since I've refused to cut off that disease-causing thing on his penis...

I think it is the new standard. I have a daughter w/ kidney reflux. She had corrective surgery. It is acceptable to refuse the abx. You can still take a wait & see approach.

Just my 2cents.

[Bm31]

I wouldn't trust him one bit. He only switched gears after you told him the facts. He may know it's wrong, but he had other idea$ in his head first.

A big thumbs up for all the parents here who've had the courage to keep their sons intact. The "medical" discrimination you too often have to face is a travesty. I've seen enough stories where, time after time, these so-called professionals would have to get to the real root of the problem with a girl or circ'd boy. Yet, when it comes to an intact boy they almost demand blood payment in the form of your child's foreskin before they'll go any further. And for good measure they love to imply any problem (sometimes not even that subtle) is the parents' fault. Shame on them for their lazy professional ethics. :

Oh, and a big WAY TO GO to you, Jen, for being so well-informed!!

[Frankly Speaking]

Jen, you did an admirable job with that guy! I wish I could always have that presence of mind. In all honesty, I think he is a two faced liar and he saw dollar marks all over your son's penis. It's only after you started reciting the facts to him that he started back peddling. It seems that he knows this but saw a chance to profit off of your son's flesh. That's disgusting!

I disagree with the VCUG after a single UTI at less than a year old and certainly disagree with prophylactic antibiotic regimines after a single infection. I know there are those out there that are advocating it but I just don't agree.



Frank

[jenP]

Originally Posted by Frankly Speaking

Jen, you did an admirable job with that guy! I wish I could always have that presence of mind.

Thanks! It was all because of what I've learned here! You taught me to WATCH the heck OUT for 'medical professionals' and taught me all the answers to their bogus claims so I could stand up and strongly advocate for my son.

Originally Posted by Frankly Speaking

In all honesty, I think he is a two faced liar and he saw dollar marks all over your son's penis. It's only after you started reciting the facts to him that he started back peddling. It seems that he knows this but saw a chance to profit off of your son's flesh. That's disgusting!

EEEEEWWWW indeed! Thought he could tell me the infection was caused by a foreskin and I'd line right up to hack it off, eh? Just try to get near my son with a knife, buddy, and see who ends up losing part of his penis. Grrr. the nerve.
Well, still, I'll give him the benefit of the doubt and try to educate him. Even if he is as you say, it can't hurt to rub his face in how wrong he is. Maybe if every mom did that... it would start to change.

Originally Posted by Frankly Speaking

I disagree with the VCUG after a single UTI at less than a year old and certainly disagree with prophylactic antibiotic regimines after a single infection. I know there are those out there that are advocating it but I just don't agree.
Frank

Yeah, it just doesn't sit right with me either. I think I'll look for a second and third opinion before doing it.
Thanks!
Jen

[jessjgh1]

Well, here's the rub. With circ we only know that it might decrease UTI's because we can compare intact to circed.

This comparison is completly unethical and unnatural to BEGIN with.

IF we removed men's breasts (becuase men's breasts have little purpose/function) and compared the rates of breast cancer in men without breasts and men with breasts OF COURSE THE AMPUTED MEN WOULD HAVE A LOWER RATE OF CANCER.

Perhaps, this is something a 'doctor' might 'GET'.

Jen, glad you are willing to go the extra mile here!

Jessica

[jessjgh1]

Oh, I meant to add that Jen, better for you to deal with this than another mother who wouldn't have questioned this urologist. Your son will stay intact, another person may have been scared by the doctors terminology.



Jessica

[pdx.mothernurture]

Originally Posted by jenP

Just try to get near my son with a knife, buddy, and see who ends up losing part of his penis. Grrr. the nerve.

:



Jen

[jenP]

You know, THIS is why RIC is so accepted. Because, hey, it's just good preventive medicine. It would just have to be done later, anyway. Everyone knows someone who was so "crunchy" they didn't circ, and then he got an infection and had to have it done later, when it hurt more....
This is why no one really thinks ric is something to get all upset over. Just a parent's choice as to the best medical care for their son after all.


Jen