need help....

[goobergrl6]

Ok so I am going to c/p what I posted to some friends but here is where I need help. Saunday my son 915 months old) woke up and the tip of his penis looked like a balloon. Like someone had just inflated it. I did not take him to the ER since we had a well baby visit on Monday at 10 and I do not trust the ER. I know the pediatric urologist will most likley recomment getting him circ'd and I am not sure how much figting I will have to do to say no. We are pretty sure it was caused by him having such runny diarea for the last few days and I think he slept in it and it got up in there. Just a freak accident. I am not putting my son thru a circ for a freak accident. I was kinda mentioned at the hospital but I said I wanted to avoid a circ and they just were like ok then just tell him that. So one one hand I hope I can say no circ and he will be like ok then but then again I want to be prepared. SO I am googling people that have had the same thing and not been circed from it. So if anyone has any stories or know of any if you can pass that on I would love to have them to being with me..... he is the story of what happened yesterday. Also they instructed me to pull back the forskin to clean it and I asked if that was really necessary and they said yes because of the infection. What do you all think? So far I have not touced it.

Went o out pedi in the am and Dr. Reed took a look at it and was very concered and was glad we did not go to the ER.(great comfort huh?) He wanted us to see a pediatric urologist ASAP but of course we do not have any here so that ment a trip to Children's in DC. He called the pediatric urologist there and described what he was seeing and the uroligist said he thought it was Paraphimosis and told Dr. Reed some things he could do to try and relieve the swelling but he was not comfortable doing that. So he called the local urologist that he likes to see if he could get him in today or was even comfortable doing it and he said no to take him to Children's. Meanwhile the children's doc called back saying have her bring him. So I take him up there, change his diaper and it is deflated! I was happy and pissed KWIM? So we go in anyway figured Dr. Reed undid it by pure chance. So we get seem and the attending thinks it is a simple yeast infection and I tell her ummmmm no so she agrees to check with my doc and the urologist. (turns out she was wrong and the experts were right.....big shock). So anyway they want blood work and a urinealasis(sp) and urine culture. So that means a cathader. well he is so swollen then cannot even get a newborn one in there! It was so awful! He just screamed for like 30 mins while they tried. SO she gave up for then and we went on to blood. Another 30 mins of her trying to find a vein before she poked him but still having to hold him down and stuff. Finished that and we waited for the results and for him to pee int he bag they put on him. 2 hrs later and no pee. Turns out they HAD to have the cath for the culture so we try again! This time after like 15 mins they get the new attending on duty and he is able to get it in somehow. Wait for the UTI results and they come back positive but they do not know if he really has one or if they got some infection on the way to the bladder since his penis is all messed up. So they gave us an official diagnosis of balanitis/phimosis. We go back in 2 weeks to see the urologist. Though I am going more along the lines of the paraphimosis.

[buckeyedoc]

Do you mean the tip of his penis was actually trapped outside of the foreskin (paraphimosis) or the foreskin itself just was ballooned up (like it does with urine) or swollen? Paraphimosis can be serious, but an infection or phimosis wouldn't be a huge deal.

The only infection thing we ever went through was DS#1 getting an awful diaper rash from a really acidic poo blow-out when he was one year old. The rash went across his scrotum and up to the tip of his foreskin (which is on the long side) and created a painful ulcer there. We were prescribed Bactroban cream by the pediatrician, and it went right away. There was no discussion of circumcision, as it wasn't a true or serious foreskin problem.

I hope your little one is all better now. If it were me and the doctors really felt like it was an infection, I would go along with the medical treatment (antibiotics, etc.), but I would not go along with circumcision for one bout of balanoposthitis or normal infant physiologic phimosis. I also think that if serious paraphimosis happens, it can be treated with a dorsal slit instead of circumcision.

[glongley]

Well. it's hard to sort all this out without actually seeing what you were seeing. BUt a few comments:

First, was your son at all retractable before this occurred?

If not, it's probably NOT paraphimosis. For it to be paraphimosis, you or he or somebody would have had to retract his foreskin back behind the rim of the glans, and have it get stuck there - you would be seeing his glans. If this isn't the case, it's not paraphimosis.

AS far as the tip of the penis looking like a balloon:

There is a phenomenon called "ballooning" in which, in some intact boys, when urinating, released urine temporarily distends the foreskin before exiting the opening of the foreskin. It is a sign that some separation has taken place underneath, but that the outlet is still tight (a normal situation). As the foreskin opening eventually loosens, this phenomenon goes away over time. I have heard of a few cases where this was so extreme that the urine couldn't exit on its own, but most of the time, the deflation happens immediately after the ballooning. This may or may not have been what happened with your son, but I can't tell from your description.

You did say the TIP of his penis looked like a balloon, so this may be different from the more generalized ballooning described above. Sometimes local irritation (perhaps from the extensive diarrhea he had had) can lead to swelling in the tissues of the foreskin themselves (i.e. NOT urine UNDER the foreskin). The foreskin is very delicate tissue, like the lips, and just like a small cut on the lip could lead to disproportionate swelling (a "fat lip"), so can the foreskin sometimes appear alarmingly swollen. This may or may not be a true infection (bacterial, yeast, or otherwise), it may just be mechanical or chemical irritation (say from feces or from rubbing on a wet diaper), and will go down as the source of the irritation is removed and the tissues heal.

I'm sorry for everything that you all had have to go through. Circumcision is very likely completely unnecessary, and any suggestion of this should be treated with skepticism, and a second opinion. If you haven't read the MOthering article "Protect Your Uncircumcised Son" - on all the reasons why a doctor might say an intact boy "has to be circumcised" and the reasons why this is not true - PLEASE DO! This is a must-read for parents of intact sons, and will give you the knowledge and confident you need to protect your son from unnecessary intervention. It should be in the Stickies section above, or here's the url:
http://www.mothering.com/articles/ne...uncircson.html

Your son can probably benefit from frequent warm tub soaks at this point. Change the diapers frequently and keep the area as clean as you can, and let him run around without diapers if you can. DO NOT try to retract him, or clean underneath - this will only irritate the tissues more and run the risk of INTRODUCING infection.

Let us know how things are going.

Gillian

[goobergrl6]

The foreskin was ballooned up around the head. He could still pee and everything. Even now I can not see the head of his penis but it is still very red and swollen. Nothing like it was the other day though. It was so big and streached and infalted. You could tell it was really streaching the foreskin.

[goobergrl6]

He foreskin had never been retacted before yesterday. Yesterday was purley an accident when they were trying to put in the cathadar. He was soooo lubed up it just slipped down. I was watching the whole time and she was not trying to do it at all. I have NO intenetion oh letting them circ him so I just wanna go in there with as much ammo as possible. Thinking about it now I really should of taken some pics of it so I had them but oh well.

We are working on keeping it as clean as can be and he is getting soaks 2x a day. Of course if would be really helpful it he would not have diarea while soaking in the tub! LOL! Kinda defeats the whole keep it clean purpose of the tub!

[trmpetplaya]

Keep it as clean as possible. I assume they gave you antibiotics to give him for the UTI (if it came back positive then he has one), just make sure he takes all of them

It's definitely not paraphimosis and there isn't any reason (at least none that you've posted) that he should have a circumcision. If he had gangrene, frostbite, or cancer on his foreskin then a circumcision would be in order.

If you have a room with tile or linoleom then I would just let him go around diaper-free for a couple days and air out. It's really no harder to clean up a tile floor than to change a nasty diaper. Or if you're in a warm place you could go outside, but unless you're in the southern hemisphere that wouldn't work so well... If you were interested you could head over to the Elimination Communication forum and check out some of the late beginner threads and even introduce him gently (no rewards or punishments) to a potty while he's airing out

love and peace.

[stacyann21]

There is a phenomenon called "ballooning" in which, in some intact boys, when urinating, released urine temporarily distends the foreskin before exiting the opening of the foreskin. It is a sign that some separation has taken place underneath, but that the outlet is still tight (a normal situation).

: That wouldn't concern me at all. It certainly isn't an indication for circumcision!

[goobergrl6]

Yeah I read about the ballooning but this was not when he peed. It was constant. Looked just like someone had taken an air pump and blown it up! Glad everyone agrees it should be no biggie to tell the doctor no. Dh and I are both figuring it is just from the wet poop lately and not something that will keep happening. We will just be super careful each time he gets the runs while still in dipaers to keep it from happening again.