Need some help

[Iri920]

This morning my son who is 2 and intact woke up this morning screaming saying his penis hurt. When I took his diaper off it was swollen and it hurt when he peed. So I took him to the doctor, not our regular doctor since we're visiting family, who referred me to an urologist. So he told me the whole his skin is too tight and the hole is too small so urine can't get out so it's getting infected crap. He immediately recommended circumcision and when I told him no he said he could make a slit in the skin so the foreskin would retract and he wanted to do it right then. I was nice and just kept giving him excuses until he finally prescribed an antibiotic.

I still don't know what's wrong with him though. He does have some puss in there and it really hurts him to pee. I've been trying to give him some cranberry juice in case it's a UTI, I've given him a warm bath with just water, I put a little antifungal cream on the tip, and I gave hime the antibiotics. Is there anything else I could be doing? Does anyone know what this could be? It just breaks my heart to see him in so much pain when he pees.

Iri

[dynamohumm6]

Did the dr do a culture?
Seems like the first thing they should do (that's what they do when a woman presents with an infection of the genitals, no?) in this case.
to you & your little one

[Iri920]

He tried to get a urine sample at the end of the appointment, but my son wouldn't go.

Iri

[guestmama9908]

Hey Iri,

I'm a Pedi Nurse. A Doctor needs to take a special q-tip for culturing that comes in a medium and take a culture from the tip of your DS's penis. Then they could tell what you are actually dealing with.

I have no idea why a Physician would recommend creating a wound in the presence of possible infection. It just makes no sense to me. Why on earth would he want to open up and expose more vulnerable tissue to whatever infection might already be present? :

And in my humble opinion a Urine sample was unnecessary.

HTH. I would get a second opinion.

[Quirky]

Good for you for standing your ground against that QUACK! Geez louise, it is so frightening that a urologist is so ignorant about the intact penis.....

My guess is that either a) there's an infection, in which case you definitely need a culture, or b) maybe he has some separation trauma going on. When the foreskin adhesions release, it can be uncomfortable and get swollen just because the whole area is so full of blood vessels, just like the lips, which swell up at the slightest insult. Sometimes the adhered areas don't all release at the same time, so one part might be free and the other part might rip apart and create a sore spot, especially if he's been pulling on his penis enthusiastically. If he's got an adhesion or two that are raw, it can really hurt to pee against it too, just as if you got a cut on your labia and pee got on it.

[Microsoap]

Terrible laziness...

When you VERY WISELY EXCLUDED circumcision as an option, they suggested making a tiny slit in the foreskin to relieve some tightness. That is called a "dorsal slit" and THAT is a MOST EXTREME measure that should be taken (full circumcision not even being an option!). It's very, very disappointing and frightening that lazy doctors (and this isn't JUST an American/Canadian thing! I'm sure in France, a doctor would suggest it) first response is to remove the problem area! Would YOU accept them cutting off ANY part of the exterior of the ear if IT were sore/red/swollen/bleeding??????? I would chide them for not first recommending stretching techniques (first) and/or w/ steroid creams (second).

This makes me PETRIFIED for more naive parents who WOULDN'T even (((question))) a doctor and let them go ahead w/ a full circumcision!

[MCatLvrMom2A&X]

It might be yeast if that is the case abx will make it worse. You can try putting some OTC yeast cream on it and see if that helps. It is totally scary how he jumped right to circ and then cutting a slit in it :

The opening is supposed to be small in the first place. Swelling would make it even more so.

I would keep doing the no soap soaks in the tub and try the yeast cream. If he isnt much better by tomarrow take him to your dr and insist on a culture. It is done by wiping the tip of the foreskin only NO retraction. This is especially important since pulling on the foreskin can cause more trauma and micro tears and allow the pathagen to get in there more.

I am sorry you little guy is in pain

[Iri920]

Originally Posted by CalenandEllasmomma

Hey Iri,

I'm a Pedi Nurse. A Doctor needs to take a special q-tip for culturing that comes in a medium and take a culture from the tip of your DS's penis. Then they could tell what you are actually dealing with.

I have no idea why a Physician would recommend creating a wound in the presence of possible infection. It just makes no sense to me. Why on earth would he want to open up and expose more vulnerable tissue to whatever infection might already be present? :

And in my humble opinion a Urine sample was unnecessary.

HTH. I would get a second opinion.

Yeah he difinately didn't do that. At this point I'm ready to take him to the emergency room sisnce he hasn't stopped crying for almost an hour.

Iri

[Iri920]

Originally Posted by Microsoap

When you VERY WISELY EXCLUDED circumcision as an option, they suggested making a tiny slit in the foreskin to relieve some tightness. That is called a "dorsal slit" and THAT is a MOST EXTREME measure that should be taken (full circumcision not even being an option!). It's very, very disappointing and frightening that lazy doctors (and this isn't JUST an American/Canadian thing! I'm sure in France, a doctor would suggest it) first response is to remove the problem area! Would YOU accept them cutting off ANY part of the exterior of the ear if IT were sore/red/swollen/bleeding??????? I would chide them for not first recommending stretching techniques (first) and/or w/ steroid creams (second).

This makes me PETRIFIED for more naive parents who WOULDN'T even (((question))) a doctor and let them go ahead w/ a full circumcision!

He did mention at one point a steroid cream so I could stretch the skin out, but he couldn't prescribe it because he's too young.

[minkajane]

Please don't let anybody try to retract his foreskin! That will just make things worse.

I had a similar problem with DS. His foreskin got all swollen and raw. I took him to the ped, who immediately said if it was recurring, he'd probably need a circ (over my dead body!), flat-out refused to culture it even when I asked, tried to bully me into giving him oral abx (which I refused without a culture), then prescribed both an anti-fungal cream and an antibiotic cream (kind of counter-productive, don't you think?).

Turned out to be a yeast infection caused by a food allergy. The yeast infection could've been easily diagnosed with a culture.

I hope your DS feels better soon.

[minkajane]

Originally Posted by Iri920

He did mention at one point a steroid cream so I could stretch the skin out, but he couldn't prescribe it because he's too young.

Exactly - he's too young! He doesn't NEED to be retractable at this age. Please run away from this "doctor" - FAST!

[MCatLvrMom2A&X]

Be aware that the dr's at the ER probably wont be any more knowledgable about the intact penis than the other Dr. was. You must be vigilant and prevent any retraction or messing with the foreskin other than the swab at the very tip.

Telling them no retraction may not do the job you must say do not touch his penis.

Steroid cream is something that should only be used on older boys/teens and men and only then if they are having a problem with a tight foreskin that simple stretching isnt helping.

[guestmama9908]

Originally Posted by Iri920

Yeah he difinately didn't do that. At this point I'm ready to take him to the emergency room sisnce he hasn't stopped crying for almost an hour.

Iri

I'm not trying to scare you or anything. If you decide to take him to the ER then you definitely need to take a copy of the AAP policy on Intact care. You are liable to run into alot of cut happy docs in the ER as well. They will more than likely insist on all sorts of tests, including a urine sample via catheter.

I was a Pedi ER nurse for 3 years. It is pretty much a given that a young boy your sons age with his symptoms will end up with a catheter. Most people DO NOT know not to retract!

If you go make sure you go prepared to fight
1. retraction
2. the suggestion that he needs to be circed.

Molly

[l_olive]

Are you sure he's not just ballooning when he urinates? This is a completely normal part of the separation process, but a little scary looking. I know because it just happened to my ds last month, and it upset him greatly to the point that he'd cry for quite awhile everytime he went to the bathroom.

There was stuff that looked like pus that drained each time the balloon went down, but it was really just built-up smegma. Again, completely normal. And the whole thing resolved itself in about two days.

I just kept him clean, let him play in a warm bath as much as he liked (and he can stay in there for hours if I let him), and it fixed itself.

Oh, and by the way, the opening in his foreskin is still very, very small even though the separation process has begun. I understand it can still take a long time for the process to complete and the opening to release.

I know it's scary when it happens to your own child, but please, please, please don't let the docs talk you into something that you know is wrong!!! There is no other part of the body that I know of that they lop off at a whim. Every single part of your son's penis is there for a reason, and it's all important to him!!!

Hugs to you mama, and to your son.

--Olive

[blsilva]

I have no advice, but I just wanted to say good for you for standing up to that doctor!!! Its hard to go against someone who seems to know everything. And to you and your ds. Whatever is going on, I hope he is feeling better soon!

[eepster]

You mentioned that you are visiting family out of town. Could that have something to do with it? For instance have any relatives bathed him for you? They might have retracted and cleaned underneath with soap.

[Iri920]

Originally Posted by eepster

You mentioned that you are visiting family out of town. Could that have something to do with it? For instance have any relatives bathed him for you? They might have retracted and cleaned underneath with soap.

We're staying with my parents and they don't believe in circumsision (sp?) so I'm sure it wasn't that.

I did end up going to the ER because I couldn't stand him screaming anymore. He's doing a lot better now and the swelling seems to have gone down a bit. They got a urine sample, just peed in a cup, and everything was fine. They prescribed some antibiotics, Keflex, and want me to go to a Urologist ASAP. Of course I just smiled and nodded. On the check out papers it stated Phimosis as the injury/illness I probably shoud've just waited it out, but I was by myself with my poor son and a crabby baby and I panicked.

I'll keep a close eye on it and hope he's better tomorrow. Thank you everyone for your support! I was kind of second guessing myself after this morning so it was good to hear that.

Ack I was just reading the discharge papers and on the very papers it states that the skin usually doesn't retract until 3-5 years and sometimes not until adolescence and that this is normal. It also emphasises to not try to force the foreskin back as it can lead to injury and scarring. I'm just pissed that the doctor has obviously never read this since she did try to pull the skin back and I had to take her hands away. And she kept on insisting that it wasn't normal and that it needed to be fixed.

Iri

[esmlranch]

I am so glad this thread was here. We are dealing with a situation ourselves and with uneducated Drs. My ds is 20 months old. He has had an ongoing problem with his penis. It started with the head of the penis being bright red, then he spiked a high fever, then he had pain when urinating. This was over the course of 5 days and in progression as listed above.

My trusted Ped found no yeast initially, there was no pus or wound and felt that the fever was unrelated. We were treating with sits baths.

When he began to have pain with urination it was pretty intense and I ended up taking him to the ER because I was afraid it was a UTI. It was Sunday evening.

Well, the Dr there stated bluntly that "this would come to circ" and that his "foreskin was too tight". He did push on the foreskin, but did not seem to do it forcibally. They took a urine sample (ds was able to pee in the bag) and prescribed an antibiotic that I did not fill.

The culture was negative. We can't figure out why it is hurting him to pee. It still does inconsistently. We are still doing sits baths.

What do you think could be going on? I was afraid I would have to circ, but what I am reading here is that it is perfectly normal to have a tight foreskin at his age, and for many more years. Whew. That ER doc really had me all freaked out. Has anyone else experienced this type of situation? Should I just keep doing the baths?

[jen816]

I just thought I might throw out the possibility that he is beginning to retract. When my 3rd ds was a little over 2 years, he had an episode similar to what you described where he was screaming when he peed. He was still in diapers and I did notice that there was some pus on his diaper. His penis was slightly swolen. I took him to the dr and they did a urine test. It came back fine. I wasn't sure what to do, so I just let him soak in the tub for a very long time and made sure he was drinking LOTS of fluid. By the next night he was fine and I didn't think any more about it.

Six months later it happened again, only this time he was going on the potty. I was getting ready to take him into the dr again when he called me into the bathroom and what do you know, he had pulled his foreskin all the way back! I was quite surprised. I also noticed that his glans was extremely red where the adhesions had recently released. I'm sure it hurt a great deal when urine touched that spot. He hasn't had an episode like it in the 2 years since.

I hope your ds is feeling better soon!

Jen

[eepster]

Originally Posted by Iri920

We're staying with my parents and they don't believe in circumsision (sp?) so I'm sure it wasn't that.

My parents are very anti-circ too, and my dads intact. However my mom thought you were supposed to retract to clean. I had to explain to her that it was just part of the '50s hygene hysteria, and just as douching turned out to be a really bad idea so was retracting baby boys.