2nd UTI in intact son

[Elisesmommy]

Hi all.

My 4 month old son Alex was diagnosed with his 2nd UTI. I asked the doc to get a urine sample due to a very foul smelling diaper. There was also a pea-sized yellowish discharge on his diaper where is penis is. He did not have a fever and was not acting sick. But, I've dealt with a lot of UTI's in my past and know the smell. Plus, he had his first UTI in August 2007.

Doc got the lab back and there was 'moderate' white blood cells so she prescribed bactrim. She's sending the sample off for a culture - we'll get that back in a few days.

I'd like to know what might be causing this. He's had the voiding-cystogram and an ultrasound, both came back inconclusive. Doc says that when other risk factors have been ruled out that it could be the fact that my son is intact and that a circ may be necessary if he has a 3rd infection.

When I bathe him I wash his penis really good...I wipe his penis when changing his diaper...is this right, or not? Of course he is breastfed, which I thought was suppose to ward off infections, like UTI. I'm confused and sad b/c I don't want my son to be sick and I don't want to have to get him cut.

Is there a good resource for keeping baby boys clean enough be clean but not to harm him or to do something that would allow bacteria inside? Is there something I'm doing wrong or could be doing better? This is a stretch, but could it be something in my breastmilk???

Anyone else have experience?

[Fyrestorm]

Originally Posted by Elisesmommy

When I bathe him I wash his penis really good...I wipe his penis when changing his diaper...is this right, or not? Of course he is breastfed, which I thought was suppose to ward off infections, like UTI. I'm confused and sad b/c I don't want my son to be sick and I don't want to have to get him cut.

When you say you wash his penis...does this include any retraction? Do you pull back his foreskin at all?

If so this could be contributing. It is meant to stay closed to protect from bacteria.

IMHO circ is never called for in preventing UTIs. Would this same doctor be suggesting circumcising a DD if she had had a few UTIs? I don't think so. Why should a boy be any different.

Hope he continues to feel well.

[carriebft]

Are you retracting his foreskin? or just cleaning the outside? are you using soaps?


If you are retracting, that is a no no and can cause infections and tears in the foreskin.

If you aren't but are using a lot of soap, that can also cause problems.

Also, diet is a big thing. I don't know if what you are eating can affect him, but its definitely possible. I know sugars are a big cause of UTI.

[carriebft]

Also, it is important to note that the studies that do claim a Uti protective effect with circumcision only demonstrate this protection for the first year of life. Thus, cutting your son, if you are going by these studies, would not give him the protection this doctor seems to think it will.

Also, cathing can cause UTIs and bad bacteria growth. Use clean catch baggie.

[carriebft]

Sorry for the serial posting, but I would also add that I would personally follow these steps:

1) not allow cathing for urine testing- only clean catch baggie at first. If that is positive, then go on from there for a cath.

2) Possibly think about starting over with a new doctor

3) Ask any doctor that wants to circumcise what their plan of action would be for a girl with your son's problems.

[Yulia_R]

Sorry, i don't have the time to read responses now.
are you/doctor/nanny retracting his foreskin by any chance?
This can cause infection as it's like ripping your nail off again and again and again, and at some point it sure will get infected...

have you read this A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378
and this
The Definition of "Retraction" & Why it is BAD
http://www.mothering.com/discussions...d.php?t=575627
yulia.

[carriebft]

"washing his penis really good" might really be hurting him. Many women get irritation and infections from using soap at all on their genitals. Even gentle ones.

While your son is an infant and up until he becomes naturally retractable, his penis is really self cleaning. Scrubbing it kills good bacteria, creating a niche for bad bacteria to take over.

[Arduinna]

I'd find a new Dr.

[attachedmamaof3]

Yep! Wash it like a finger. No retraction, no cathing.

Have you considered an allergy to your diapers?

Additionally, as a PP stated, girls get UTI's at much higher rates than boys. I will not be trimming my DD's labia majora in order to "prevent" them. I would view this issue with your son as much the same. Only dr's in the US suggest circ to prevent UTI's; it's pretty ridiculous.

[Yulia_R]

Originally Posted by attachedmamaof3

Yep! Wash it like a finger. No retraction, no cathing.

:

wash/wipe it from outside and from outside ONLY! NEVER RETRACT! it's a HUGE NO-NO...

[Claire and Boys]

all I have ever done is splash my sons penises in the bath a bit and wipe after changing with a clean cloth. No "cleaning really good" needed. Neither of them have ever had a UTI. I think you're being a bit over zealous..

[Elisesmommy]

Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.

[Yulia_R]

Originally Posted by Elisesmommy

Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.

Yes, just like a finger. NEVER EVER EVER EVER retract, NOT EVEN A LITTLE BIT. THAT IS EXACTLY WHAT CAUSES INFECTIONS, SCAR TISSUE GROWTH AND PERMANENT NERVE DAMAGE.

PLEASE READ THIS
have you read this A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378
and this
The Definition of "Retraction" & Why it is BAD
http://www.mothering.com/discussions...d.php?t=575627
yulia.

[carriebft]

Yes, retraction, even just a little, is bad bad bad. The American Academy of Pediatrics clearly states that retraction is not necessary to clean and that is it damaging. Many RNs and docs in the USA are just stuck in old ways and cycles of bad information.

I would definitely cease retracting him. In addition, the soap is probably hurting him. I know that some women and men can handle soap on their genitals, but many cannot. Just like some little kids can handle bubble baths and others get genital irritation from them.

I would follow your son's lead. Right now he is suffering from some kind of bacteria growth. While the RN's child might have not had any problems, it is definitely a big possibility that your son's skin and body are just different....so I would try switching it up a bit. (and def NO on the retraction)

Try some probiotics as well.

Also, use a bag for urine catch-- I can send you a study if you would like that demonstrates that the risk of infection through cathing is too much and that for intact boys, the false readings on bags and caths are nearly equal and should be read the same, and that bags are prefered beucase they are less traumatic and risky.

ill post it here when i find it in my archives real wuick.

[Elisesmommy]

BTW, he's only been cathed once, when he had the cystogram @ radiology.

We've used the bags for all the urine collections.

[carriebft]

Originally Posted by Elisesmommy

BTW, he's only been cathed once, when he had the cystogram @ radiology.

We've used the bags for all the urine collections.

Excellent! in case you need it anyway, heres the study on bagged caths for intact boys:

http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

CONCLUSION: In uncircumcized boys, both CVU and CathU were prone to contamination. Though the contaminating bacterial counts were lower in CathU culture, the false-positive rates were high with the lower cut-off CFUs. Contrary to previous recommendations, CathU should be interpreted similar to CVU to avoid false positive diagnosis of UTI.

[Papai]

Sorry but your son's urological issues cannot be attributed to the foreskin alone. There is something else at work.

I would suggest switching urologists if his only advice is to circumcise your son.

[blsilva]

Originally Posted by Elisesmommy

Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

Yep!
FWIW, I didn't know that either when I first came here.
I'm so sorry your having trouble, but there is a lot of good info here. And I, too, would be looking into the possibility of a new dr if he suggested circ for UTI's. THe fact is that there are far better options. Little boys who are circ'd and little girls have UTI trouble, too, and they manage to treat it without cutting off body parts. They can do the same for your son.
Good Luck!

[attachedmamaof3]

Originally Posted by Elisesmommy

Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.

JUST like a finger.

[Quirky]

Read up on this page:

http://www.cirp.org/library/disease/UTI/

It's entirely possible that his second UTI is really an extension of his first; those tricky little buggers hole up inside the body and it's VERY hard to get rid of them with abx. I would definitely work on getting lots of good probiotics into him.

But your doc is completely out to lunch on the circ thing. Stop retracting, stop using soap every day, make sure the flora get back into balance, and treat any UTIs just as you would with a girl.