ped says that DS needs a circ

[bev]

We just came from our sons 12 month doc. visit. The ped says that he will need a circ. She says that the foreskin is too tight, opening of only about 3mm when it should be at least a 1/2 inch. I dont agree with her. But she has also made me start to worry. I want to do the best for my son. He has never had any problems before this. I never push his skin back to clean, I just leave it alone. Of course the ped did try to retract his foreskin but not forceably, and now I am worried that maybe she has damaged something. She has referred us to a urologist, I dont think we are going. But how do I know I am making the right decision?
Thanks for your help. BTW ....I was referred here by some ladies at breastfeeding.com.

[SagMom]

Re: ped says that DS needs a circ

Originally posted by bev
She says that the foreskin is too tight,

"Too tight" for what? He's a baby--it's supposed to be tight. It will loosen over time (maybe a year, mabe many years) until he is able to retract it himself. Is your son having any problems? (You didn't mention any other issues in your original post, so I'm assuming the answer is no.)

If it was me--I'd be thinking, "If it ain't broke, don't try and fix it." Since you're worried though, perhaps a visit to an intact-friendly doc for a second opinion would be helpful.

[Mallory]

As the foreskin gets ready to retract there are two things that happen- it loosens from the glans and the muscle at the end srteches out too.

Many boys are not retractable until 5 or 10 years old. There is no reason to worry about your 12 month old not being retratable. The other day my 3 1/2 year old had pulled his foreskin back against his penis (not retracted, just back) to ask me what that was inside and his is hardly 1/2 inch yet. This seems like a very strange thing for her to say. Does she have specific measurments for other body parts? Does she get worried if he is not a specific height or isn't flexible enough?

Her forcibly pulling back on it could be a problem. Did it hurt him when she did it? If not he then there is probably nothing to worry about.

I also would look for a new doctor, even if his foreskin was too tight (which is not something you can say at 12 mo) circ is not the answer. There are several other things a teenager or adult man can do to encourage his penis to retract before circing. The fact that she says you should circ for this problem (which is not even a problem) shows me that she has no knowledge about an intact penis. If I was going to stay with her, I would at least be bringing plenty of reading material to her (probably every time I went in )

[Frankly Speaking]

Bev:

The information you have recieved above is correct. There are two types of phimosis or "tight foreskin." One is the normal phimosis that EVERY boy has and the other is pathological phimosis that is caused by repeated (many or constant) infections. If your son hasn't had repeated or constant infections, he does not have pathological phimosis, just normal phimosis. Here is a site that shows pictures of what is normal and what is not:

http://www.mja.com.au/public/issues/...w10610_fm.html

At the age of 12 months, it is virtually impossible that your son would have pathological phimosis. Even if he did have the beginings of it, the appropriate treatment would be betamethesone cream, not surgical amputation and treatment with antibiotics for the infection.

The fact that you would have to come to a site like this for accurate medical information says volumes about your pediatrician. If the information is readily available to consumers of medical services, it is certainly available to medical providers. The question is why your doctor does not know this information? If the doctor is so uneducated in this area, what is her education level in other areas? Is it possible that you are putting your child's health at risk in other areas because of this doctor's failure to keep up with current medical technology?

I know those are some really tough questions but they are some that really need to be considered. Ignorance in the medical profession can have disasterous results. I think I would go with the other suggestions and find a new pediatrician. I would also tell the current one exactly why you are doing it. You may save someone else's son from her ignorance by prompting her to educate herself.




Frank

[Jellybean]

Hey Bev. Welcome. I'm sorry about your ped. But, it's the same everywhere. My son's ped told us the same thing at my ds 15 month appt.

Like everyone has said, get yourself to a new ped. (I am still looking. )

There is no reason that a boy needs to be retracted at 12 months. And even if (and that's a big if) there is a problem, there are other, non-surgical methods that will correct it. (I'm sure she didn't mention this.)

Throw out the number to the urologist, and throw out your present ped, too!

Good Luck!

[Sarah]

Hi Bev- Here is my idea- write a little letter to your ped. It would go along these lines.

***************************
Dear Doc,

The other day you recomended that my son should be circumcised because his foreskin opening was so small. I think that the old expectations like this put on normal phisiology is the reason why so many people have heard stories about people who had to be circumcised. I have learned that it is not unusual for a boy a year old to have a tight prepuce.

I have done some research after our visit and I would like for you to review it at your leisure, and we can talk more about it at the next visit. I do not this there is any need to rush at this time, and if my son does indeed have pathological phimosis, I would be interested in exploring the some of the conservative treatments I learned about which appear to be highly sucessful.

This page provides a collection of medical journal articles from around the world. I was very relieved to find this page because preserving my son's genital integrity is a high priority in our family. I think after you review the pages that we can decide when and what further treatment would be apropriate.

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

***********************************

I just shudder to think of how many boys may have been circumcised because of this doctors ideas about retractability. I think instead of just abandoning this ped, maybe you can educate her and make a big difference.

Love Sarah

[momto3boys]

Hi. My ds is 2 1/2 and maybe has 6mm opening. He was just looked at for a check up(at 2 yo) and ped says it looked completely normal. No need to retract yet.

I was recently looking on another circ board and came across a post that directed us to the babycentre.com/uk board. It's a baby info board from Britain. It was so interesting because there was virtually no info on circ except in the bathing your boy section. The first paragraph was how to bath intact boy. No retraction. They even went on to say something like"even if retractable don't really do anything to it. Allow the natural process of cleaning to take place."

The next paragraph was about how to care for a circ baby. They had to have a pop up window to explain what circ was.

Amazing that 2 civilized cultures have such different instructions on baby care and medicine.

My son at 12 months had maybe 3mm opening. Very small. And thank God for that. He is probably not out of a diaper yet and that tight prepuce is ideal to keep poop and pee out.

This is what is so wrong with dr's here. They are not even taught anything about a foreskin. but they sure know how to diagnose a problem with it. Something's not right.

http://www.babycentre.co.uk/expert/

[momto3boys]

Sorry. You'll have to do a search at the top of the page for circumcision.

Or try this.

http://www.babycentre.co.uk/REFCAP/115.HTML

[Xenogenesis]

My recently turned two year old's foreskin opening is teeny-tiny. I've never attempted to guess how big it is but boy am I sure glad (now that he potty trained) that it is snug enough to protect him from sand, etc. from entering directly into his urethra. Owie. The following is a quote from a fully-referenced, excellent article along with the link to see the rest of it. There are many interesting points you might find useful. I encourage you to make a copy to peruse at your leisure and perhaps pass it on when you're done with it.

"The tightness of the foreskin is a safety mechanism that protects the glans and urethra from direct exposure to contaminants and germs. The tight foreskin also keeps the boy's glans warm, clean, and moist, and when he is an adult, it will give him pleasure. As long as your son can urinate, he is perfectly normal."
http://mothering.com/10-0-0/html/10-...rcson103.shtml

[Frankly Speaking]

I went to the BabyCentre UK site and navigated to the discussion boards. There was not a single post about circumcision or about penis problems. Amazing!


Frank

[Xenogenesis]

Is not BabyCentre kinda a *mainstream* sorta board? Kinda like *go with the flow, don't argue about it* kinda board? Correct me if I'm wrong....

[Mahaylea]

Wow I feel kind of weird to think your doc is advising you to circ because your 12month olds foreskin is only 3mm..I know for a fact my sons opening is tiny and he is 9.5months..My other sons opening was tiny until he began retracting 'his own' foreskin on his own..I can't believe you have been recommended to do this..

I think you should get a new doc who is open minded and knows what the heck they are talking about with intact boys at this age..

Good luck..

[bev]

Thanks for all of the info and help. We have decided to ignore the ped. and not to go to the urologist appt. After reading everything I could find I believe everything to be normal. I am going to continue w/the same ped, because she is a preemie speacilist. But when it comes to the topic of my sons penis, I am going to tell her not to touch it. And that I totally disagree w/ her. I also printed out lots of articles to take w/me on his next check-up. Thanks again for all of the help.

[BlueDogGirl]

When my DS was born, we were still unsure if we would circ him or not. The doctor at the hospital advised us to NOT do it because his forskin was too tight!

[Frankly Speaking]

Blue Dog Girl:

I'll have to tell you that I have been at this a good long while and that's the first time I have heard that! Usually, it's the other way around. I strongly suspect the doctor didn't want to circumcise your son and used that diagnosis to not do it. What a gem! hang on to him for dear life!



Frank

[nightowl1234]

You have gotten some great advice...

...good for you that you are educating your ped.
We all have to do that. Isn't it amazing? You would think the AMA would do that job. I've read posts from a few physicians that are upset that they have not been properly educated on the subject of the prepus.
Well, good luck to you and you baby boy.

[Nemmer]

Originally posted by BlueDogGirl
When my DS was born, we were still unsure if we would circ him or not. The doctor at the hospital advised us to NOT do it because his forskin was too tight!

Out of 7 boys in my DH's family only one is intact. The doctor told MIL that he "didn't have enough foreskin" to circ. But, she also received the instructions to retract and wash it at every diaper change, therefore he has had numerous infections throughout his life. We were unsure whether to circ or not (a year ago -- we are fully convinced not to now), and decided to circ because of this BIL's experience. We had no idea how rare his experience is.

Thankfully we found a ped who is fully anti-circ, so we know our future boys will be well taken care of. And even with our son, she tends to take the less invasive route of caring for his circ (ie. don't touch his adhesions -- lets see if they resolve themselves). So, I'm sorry you have to have that conflict with your doctor, but it sounds like you are doing a great thing by educating her.

[TiredX2]

Just another mom saying:

I have a 21 month old son and NO WAY is his opening 1/2 inch! And, believe me, he is *perfect*

Kay