Dr wants toc irc my boys sore pee pee!

[tjmc]

My very nearly 3 yo has complained for the past 6 months of a sore 'pee pee'. He actually holds it & dances around crying so is quite obviously in pain. I took him to the dr who has said that he needs a circ. My husband also had one at 2 for the same thing. Obviously I want to avoid this but does anyone else have any experience of this? How long will it take til he's not in pain & what happens if I leave it & it doesn't correct itself? I know that is a silly question becaue you assume the body does what it needs to do but I am scared as his Mother of making the wrong choice for him.

Also having just read the 'Please help' question posted here I wonder if my son was retracted as he was born prem & they did a catheter to him. I walked in on him absolutely screaming & I am praying that that is not why! Perhaps his penis is sore from that procedure??

Thanks for any advice

[HarperRose]

Take him to a urologist for a 2nd opinion. It may just be a UTI. Easy to fix WITHOUT surgery. I mean, honestly, how many of us have dealt w/ UTI's and not needed surgery? Right? Get a 2nd opinion from a urologist.

[MCatLvrMom2A&X]

At 3yo odds are going to be high that the pain he is having is going to be seperation starting to happen.

Some questions Is it always sore or does it seem to come and go? If it comes and goes then seperation trauma is the likely cause. If It has been this way all the time for the past 6 months then he needs a swab culture on it to see if there is a bacterial infection present. The swab is very simple the Dr or nurse swabs the very tip of the foreskin without retracting or pushing it back at all if infection is present then it will show up without pushing it back. As a matter of fact messing with it if a infection is there can cause it to spread.

Does he have trouble peeing when it is sore? Have you seen swelling or discharge?

I can tell you right now that he does not need circ. The only true reasons for circ are frostbite, gangrene, cancer and irriparable damage from a accident.

Any Dr. that wants to circ for a sore penis is suspect. : Odds are high that if you do take him to a urologist they will recommend circ. After all they make their big money from surgery. Not telling you that you shouldnt take him but be aware a urologist can be just as uninformed about intact penis care as a regular dr.

Your poor dh was victum to a cut happy dr he shouldnt have been circed just for a sore penis I am so sorry that happened to him.

[bluetoes]

I would look for a 'cruchy' pediatrician that you would be sure isn't pro-circ, i.e. have an understanding and actually care that foreskin just shouldn't be chopped off willy-nilly (no pun intended).

Hopefully it's a bit of irritation that a simple dab of neosporin a few times a day will cure.

[A&A]

Oh no! Your son has a very red, swollen or inflamed foreskin! Classic symptoms of a dread foreskin infection, right? Well, maybe but probably not. But, how do you know?

Often its not most of the time, it can be something called separation trauma that is a normal part of development in boys. The foreskin is exquisitely sensitive and very similar to the eyelids and lips. Just like a minor bump on the lip can cause it to get very red and swollen with what we call a "fat lip" the foreskin responds the same way to any physical insult. As the boy's foreskin prepares for separation of the bond to the glans, it is not an even process with spots remaining adhered and areas around it fully released. With the boy pulling at it and with erections, these spots get pulled and slight tears in the inner mucosal foreskin or surface of the glans result and the response of the child's body is redness or swelling. This redness or swelling can be significant and alarming but the situation is not serious. The symptoms will improve greatly or completely subside within 24 to 36 hours and everything will go back to normal just as a fat lip will. Watch your son for 24 hours from the first symptoms and if you see significant improvement, continue to watch

But, what if it is an actual infection? Simply, the symptoms will not subside within the 24 to 36 hour period. That is not something to be overly alarmed about as these infections are simply minor skin irritations and will cause no long term damage as long as they are treated promptly and treatment within a couple of days is well within the range of prompt treatment. The only thing to watch for is any restriction of the urine stream such as a weak stream or a fine thin stream. If this situation develops, immediate medical attention is needed.

If it does turn out to be an actual infection, insist that the doctor take samples for a culture. This is the only way to assure that the pathogen (bacteria or fungal) is accurately identified and the only way that you can be assured that the proper medication is prescribed. When the doctor takes samples for a culture, he/she will swab the end of your son's penis with two cotton tip swabs, one for bacteria and one for fungals. (yeast) It will take two to three days for the results of the test to return and the doctor will probably give you a prescription for a medication based on a visual examination of the symptoms but you should call the doctor about 3 days later to make sure that the medication is effective on the particular pathogen. If not, you will be given a new prescription that is effective.

With the proper medication, you will see results within a couple of days. However, even with a culture, not all medications are effective all of the time and if you do not see a complete abatement of the symptoms within five days, call the physician for an alternate treatment. Although the symptoms disappear quickly, the prescription will probably instruct treatment for 10 days or so. Be sure to administer the prescription for the full time. Although the symptoms may be gone in two or three days, some of the pathogens may remain that can flare up again if the treatment is ended.



Frank
I grant free and unfettered permission to post this (Red, Swollen or Inflamed Foreskin?) any where on the internet ~Frankly Speaking~

--------------------------------------------------------------------------------------------------------
PS. It should not be necessary to retract in order to get a culture. And it his highly unlikely to be a UTI unless he has a fever and it hurts when he actually pees. Most likely it is bacterial or fungal--that's why a culture is necessary.

[MCatLvrMom2A&X]

I forgot to add what seperation trauma is. As the boy grows the foreskin will start to release from the glans this can happen any time from birth to adulthood. When it starts a lot of times the area/s that are released will be raw. It takes about 24/48 hours for this to heal and the buring to stop.

This is normal any pain that lasts longer than 48 hours or that is interfering with him urinating should be checked out. A swab culture should be done to see what if anything is there causing a problem.

If your ds is potty trained you can tell him that he can pull back on the skin a bit and this will help to keep the urine from getting under the foreskin and buring.

Does the pain seem to happen when he pees or just at random times or can you tell?

Like I said above he does NOT need circ what he needs is a Dr who knows what he is doing.

Neopsporin should NOT be used on the genitals it can be very irritating. If you need to put something on it then use Bactracin it is like neosporin but is safe to use there.

[A&A]

And from Dr. Fleiss (pediatrician in L.A.--foreskin expert!)



Sometimes the tip of the foreskin does become reddened. During the diaper-wearing years, this is usually ammoniacal dermatitis, commonly known as diaper rash. When normal skin bacteria and feces react with urine, they produce ammonia, which burns the skin and causes inflammation and discomfort. If the foreskin were amputated, the inflammation would be on the glans itself and could enter the urethra. When the foreskin becomes reddened, it is doing its job of protecting the glans and urinary meatus.

Circumcision will have no effect on diaper rash. Change your baby's diapers more frequently and use a barrier cream until the rash clears. Harsh bath soaps can also cause inflammation of the foreskin. Use only the gentlest and purest of soap on your child's tender skin. Resist the temptation to give your child bubble baths, because these are harmful to the skin. Never use soap to wash the inner foreskin because it is mucous membrane, just like the inner lining of the eyelid.

Foreskin infections are extremely rare, but if they occur, one of the many simple treatment options is antibiotic ointment along with bacterial replacement therapy (Acidophilus culture). We don't amputate body parts because of an infection. Most infections of the foreskin are actually caused by washing the foreskin with soap. Leave the foreskin alone, remembering that it doesn't need any special washing, and infections will be unlikely to occur.

[MCatLvrMom2A&X]

Also having just read the 'Please help' question posted here I wonder if my son was retracted as he was born prem & they did a catheter to him. I walked in on him absolutely screaming & I am praying that that is not why! Perhaps his penis is sore from that procedure??

Any damage done back then would have healed by now as long as he hasnt been retracted or messed with since.

[MCatLvrMom2A&X]

Some links you may find helpful.

http://www.mothering.com/articles/ne...uncircson.html

-Your son's foreskin is red, inflamed, itching, and uncomfortable. It has an infection and needs to be cut off.

Sometimes the tip of the foreskin does become reddened. During the diaper-wearing years, this is usually ammoniacal dermatitis, commonly known as diaper rash. When normal skin bacteria and feces react with urine, they produce ammonia, which burns the skin and causes inflammation and discomfort. If the foreskin were amputated, the inflammation would be on the glans itself and could enter the urethra. When the foreskin becomes reddened, it is doing its job of protecting the glans and urinary meatus.

http://www.coloradonocirc.org/myths.php

Myth: "My son has a problem with his foreskin, so he has to be circumcised."
Fact: In the vast majority of cases, problems with the foreskin can be treated without resorting to amputation (circumcision). If your doctor recommends circumcision without first trying every conservative treatment available, protect your son from incorrect recommendations and find a new doctor that is more knowledgeable about intact male anatomy.

http://www.cirp.org/library/hygiene/

The separation of the foreskin from the glans penis
Separation often starts around age 3-4 but it may not be complete until much later. A child temporarily may report some discomfort or pain while urinating during this period. The discomfort will stop when separation is complete. The foreskin may still not be retractable at this point because the opening is still narrow. With increased growth and maturity, the ballooning will end when opening of the foreskin widens.

This isnt the whole statement I snipped it because of copywrite so please go read the whole thing. Note to some boys may never balloon while others will both is normal.

[HarperRose]

Outstanding responses. I really love how informed everyone here is. I haven't needed the info here in quite some time, but I know where to come.

I suggested a uro. because we had a good experience w/ a very anti-circ urologist when ds had a red tip at 2.5 yrs old.

[MCatLvrMom2A&X]

It is hard to find anti circ peds and urologists I dont know of any around here.

[HarperRose]

Originally Posted by MCatLvrMom2A&X

It is hard to find anti circ peds and urologists I dont know of any around here.

I honestly think we got lucky. It was a referral from the Med Clinic (urgent care). The Med Clinic seemed kind of dumb to the whole intact penis thing.

[vaughnmama]

Call Marilyn Milos with NOCIRC. She referred me to a foreskin friendly doc in Portland so he could refer me to a more trustworthy pediatric urologist in regard to my tot's hidden penis. PM me for her phone number, or check the nocirc.org website for contact info.

Don't give in to your doc or your DH (if he agrees to circ) because you will be haunted by it. I am tortured by what was done to my boys and that I was too passive.