Swelling and redness in an intact toddler

[Collinsky]

My son is 13 mos old and his penis is quite red and swollen, and has been since yesterday evening. I am keeping him clean and diaperless, but wondering what the problem could be? There is no discharge, and it's not so swollen that he can't pee. But it looks terrible.

I didn't know if this was the right forum but it seemed like this would be where to get the info on what might be going on and how I can help.

[carriebft]

It could be a lot of different things. When you say "keeping him clean" does this mean with soap? sometimes that can be the cause (bubble bath too).

Does he seem to have pain with urination?

Have you tried warm baths? thats usually my first go to if something seems wrong.

[mamasophy]

My 1st approach would be the warm bath (no soap) /diaper free time. My son had something similar at the same age, turned out to be separation (ie normal). Just give him lots of warm soaks, make sure he can pee - you may start to see a white discharge (smegma). As long as he can pee and isn't in a lot of pain, he's probably fine.

[Collinsky]

I'm keeping him clean with water only. He hasn't had a problem with our soap in the past, but it seems like it would be irritating to him now. I'm not thinking it caused it - but I won't rule it out since I just don't know. I will give him some warm baths today and see if that helps.

It doesnt' seem to be tender to the touch - I'm not poking it LOL but he every now and then will check it out and it doesnt' seem painful to him. He also doesnt' seem to be handling it more/differently than he has in the past. Just normal toddler "hey what's this" and then on with his life.

I am having some trouble deciding if urinating is painful for him or not. He peed last night before bed and didn't seem to mind; however he woke up once in the night crying to nurse, and he had peed. This morning he woke up crying to nurse, and he had peed again. So the crying could have been the "Hey, you're facing the wrong way, mom!" cry because he always nurses at those times, or it could have been because the peeing hurt.

We're diaperless, and last night I put him in cotton undies and put a pad under him. Would baking soda in the bath be a good or bad idea? I ask because it is what fixed the problem when my daughters had irritation.

I didnt' think separation would happen this early? And would it cause skin of the penis to swell down the length or just the foreskin?

[Lula's Mom]

Yes, baking soda in the bath is a good idea. I hope he is better soon.

[kldliam]

just to be clear, you are describing swelling and not ballooning right?

[Collinsky]

It seems pretty clearly like swelling. I'm not even sure what ballooning is? If it's where when an intact boy/man urinates, his foreskin balloons out before the urine flows out, that's not it.

[Yulia_R]

Could anyone (doctor, day care worker, etc.) retract him?

[MCatLvrMom2A&X]

My ds got a bacterial infection his whole penis swelled from base to tip of foreskin it was very read and very painful. He could still pee just fine tho and he didnt cry when he did. His whole penis swelled to 3 times the normal size if not more. He also started to have a smelly green discharge. His wasnt just normal seperation tho it could have all started by him starting to seperate and then sticking his finger inside (his dirty little finsger he had been outside playing) and he started a new habit that day, instead of pulling he pushed his finger inside.

[ShanaT]

DS has the same problem

Originally Posted by kldliam

just to be clear, you are describing swelling and not ballooning right?

What is ballooning?

I was checking the forum because my DS (17 mo) has a very swollen and sore penis. It looks like a little red balloon. He was inconsolable yesterday and DH was panicked so we took him to the emergency room where they retracted him and applied an antifungal and antibiotic. Now the tip is irritated too. He cries when he pees, but doesn't have a fever and is happy the rest of the time.
Any help would be appreciated! I feel awful for the little guy.
I can't get him to sit in a soda bath to save my life.

[MCatLvrMom2A&X]

ShanaT:
Ballooning happens when the foreskin starts to seperate but the tip is still non-retractable. When the boy pees the foreskin balloons out sometimes doubling in size and then goes down when the urine drains out. It is a normal process that happens when the seperation process starts and will resolve itself when the process is complete.

By them retracting your son it made the issue worse never allow that to happen. Did they do it to fast for you to stop them or did you just not know that this was something that should never be done?? Please read the Warning to parents of Intact sons sticky at the top of the forum.

A bacterial infection should be treated with topical antibacterial cream and possibly oral abx. The cream should only be applied to the tip of the foreskin and around the outside. Retracting can make micro tears that allow the bacteria to spread.

If they didnt do a culture they should have it is really the only way to know if it is fungal or bacterial. If it is fungal, yeast, then the abx will make it worse so by putting both on there they defeted the purpose of the antifungal med.

I am not saying you are at fault for them retracting him. It is just so upsetting to me that medical "professionals" would do that since it is a big huge :

I am not surprised he cries when he pees now since he no doubt has tearing were they tore the glans free from the foreskin

It could have even not been a bacterial or yeast infection it could have been that he was just starting the natural seperation process sometimes the foreskin gets red and irritated. If it is that then it will clear on its own within 12-24 hours.

If it is yeast then a OTC cream like monistate 7 day will clear it up. If it is bacterial then he will need to use a antibacterial cream like Bacatracin OTC.

I am sorry your little guy was so mistreated in the ER. I wish I could say I was surprised but unfortunatly we see it all to often here. It really breaks my heart to see little boys abused this way .

[l_olive]

First of all, DON'T RETRACT! If it's separation or an infection -- whatever -- retraction will, quite likely make it worse! I get so pissed off when I hear of a doc or ER retracting an unretractable child. Oh yes, we think it's infected, so let's cause lots of tearing to introduce the infection into! Perfect logic, huh?

Anyway, here's something I posted on another thread about our recent experience. She if anything sounds like what you're seeing.

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

My ds went through something that sounds much like this just a couple of months ago.

Turned out to be separation starting. There was a large lump under his foreskin on one side -- enough to look pretty scary -- and he cried a little that it hurt. When he'd urinate, it would swell even further and he said it stung.

I plunked him in a warm bath and he quickly forgot about it although it was still swollen. A couple of hours after the bath, I noticed a very odd odor coming from him, and sure enough, there was a pretty sizeable amount of tan-colored stuff in his underwear.

Turns out that this is classic separation trauma. As the foreskin separates from the glans, it doesn't always do so evenly, and this forms little pockets where smegma (normal sloughed skin cells) can form into little balls -- sometimes called "pearls" -- that are between the glans and the foreskin. When he urinated, the urine collected there, too, and then when the urine drained out, it washed the smegma with it.

This went on for a couple of days, then it cleared up completely. His foreskin still balloons when he urinates, sometimes, but he hasn't had another "pearl" or swelling.

If this sounds like what your son is experiencing, I'd just suggest lots of time in a warm bath and lots of hugs. I told my son that it was just like getting his grown-up teeth. Sometimes there's some discomfort involved, but it's just all part of the growing up process.

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

From what I understand, if it had been an infection, it would not have cleared up so quickly and easily on it's own, and the discharge would quite likely have been greenish or yellowish in color -- not white or tan-colored.

--Olive

[ShanaT]

Originally Posted by l_olive

Turned out to be separation starting. There was a large lump under his foreskin on one side -- enough to look pretty scary -- and he cried a little that it hurt. When he'd urinate, it would swell even further and he said it stung.

I plunked him in a warm bath and he quickly forgot about it although it was still swollen. A couple of hours after the bath, I noticed a very odd odor coming from him, and sure enough, there was a pretty sizeable amount of tan-colored stuff in his underwear.

Thanks for your reply.
It does sound familiar particularly the lopsidedness (which I thought was a bug bite), but with terrible pained screaming like I'd never heard from him. I also CANNOT get him to sit in a warm bath. He won't do it and fighting in a slippery bathtub isn't a good idea. It definitely hurts him when he pees. I hope it resolves as quickly as you say. I am certainly not going to retract him again, and didn't expect for them to do it at the emergency room.
In my own defense, though, not necessarily to you but to others, if we spent all our time researching how we should handle emergency situations that may or may not happen, we wouldn't have a lot of time left for mothering. Now I know, but all I can do is feel lousy about it and stay out of the ER (with 2 boys I can only hope to be so lucky).
I have an older DS and he never had anything like this happen.

[l_olive]

I'm sorry. My anger is directed at the medical professionals who should know better -- not at you. I'm sorry if I wasn't clear with that.

Your son really doesn't like baths? How about a soak in the wading pool outside? or a special in-the-kitchen-sink bath playing with plastic dishes? Something out of the ordinary?

I hope you have as quick and easy a resolution to this as we did.

--Olive

[ShanaT]

Originally Posted by l_olive

I'm sorry. My anger is directed at the medical professionals who should know better -- not at you. I'm sorry if I wasn't clear with that.

Your son really doesn't like baths? How about a soak in the wading pool outside? or a special in-the-kitchen-sink bath playing with plastic dishes? Something out of the ordinary?

I hope you have as quick and easy a resolution to this as we did.

--Olive

He normally likes baths and loves the water, but not right now. It must burn.
I'm angry at the professionals too. I have less and less confidence in them in general.
Thank you.

[ShanaT]

DS is fine today, still a little swollen but normal color and its not bothering him at all.
Thanks!

[Collinsky]

Originally Posted by Yulia_R

Could anyone (doctor, day care worker, etc.) retract him?

No, he is with me all day long and I would not let anyone do that.

[Collinsky]

My son's penis seems to be much better!! Thanks to all for their input.

Shana_T I hope your boy is feeling completely well soon. Poor little man!

[l_olive]

I'm so glad for both of you that your sons are feeling better.

s