Foreskin Issues with 2 1/2 year old

[October Mama]

Hi, everyone. This is my first post - and it's about my son's penis!

We've had penis issues since March and I'm hoping someone here can provide some advice.

I first brough my son in to the doctor in March since there was a blister on his penis and blood in his diaper. The NP we saw thought it was infected so put him on oral antibiotics. 10 days after we finished the meds, his penis still looked swollen and red, and yeast was then determined to be the problem. A month later, it still looked strange so we went back and now we have an antibiotic cream. Today, I noticed a small blister again. What's going on?

Almost all the docs/NPs have retracted the foreskin - with even one doc saying he must be circ'ed since it retracted so easily. : I've seen my son retract the foreskin so I don't think it was too much of a problem but I still hate seeing it.

Anyway, have any of you had similar issues? I know diapers can't help the situation but potty learning still seems a far off dream with some major resistance going on right now. Anything else we should try before I head back once again to the doctors who don't seem to know what to do next?

Thanks much.
OM

[PassionateWriter]

sounds like too much retracting of your son's penis. Im sure others wiser than I can explain the medical issues but no one should be retracting your sons penis other than him.

[nini02]

Originally Posted by October Mama

Almost all the docs/NPs have retracted the foreskin - with even one doc saying he must be circ'ed since it retracted so easily. : I've seen my son retract the foreskin so I don't think it was too much of a problem but I still hate seeing it.

OM

Wow, what?! First they want to cut them if they don't retract...and now they want to cut them because they DO retract. Jeez.

Sorry mama...I hope you get it figured out soon!

[Fellow Traveler]

Originally Posted by October Mama

Hi, everyone. This is my first post - and it's about my son's penis!

We've had penis issues since March and I'm hoping someone here can provide some advice.

I first brough my son in to the doctor in March since there was a blister on his penis and blood in his diaper. The NP we saw thought it was infected so put him on oral antibiotics. 10 days after we finished the meds, his penis still looked swollen and red, and yeast was then determined to be the problem. A month later, it still looked strange so we went back and now we have an antibiotic cream. Today, I noticed a small blister again. What's going on?

Almost all the docs/NPs have retracted the foreskin - with even one doc saying he must be circ'ed since it retracted so easily. : I've seen my son retract the foreskin so I don't think it was too much of a problem but I still hate seeing it.

Wow circ when they are too tight circ when they are too loose. Boy they sure do like those circs.

Originally Posted by October Mama

Anyway, have any of you had similar issues? I know diapers can't help the situation but potty learning still seems a far off dream with some major resistance going on right now. Anything else we should try before I head back once again to the doctors who don't seem to know what to do next?

Thanks much.
OM

I am a bit stumped. Often, a sore/red foreskin can be a sign of separation in some boys, most don't have any signs. But you say he is already retractable. I should add at this point that even though he is retractable you shouldn't be retracting to clean at this point. Just treat it as you did before it was retractable. Some other things that could be causing this irritation is soaps (bath ect) and detergents (clothes). Have you ruled them out yet? Finally if you do go back to the Dr. you should insist on a culture this would tell you if it is really and truly infected. If not it might still be yeast but I am not sure how to test or deal with that I am sure someone else will come along to fill in the blanks and add more detail. Hope this is a little helpful.

[thixle]

Okay, from just what you posted, and I don't think I am too far off... I'm not in medicine, and I don't even have a son, but I've really become involved in this issue, so I've done a lot of "homework."

I first brough my son in to the doctor in March since there was a blister on his penis and blood in his diaper. The NP we saw thought it was infected so put him on oral antibiotics.

Did the doc swab and culture? If not, no proof of infection, and he was probably give broad spectrum antibiotics (which usually don't work anyway- it's much better to use specific antibiotics after a culture)

10 days after we finished the meds, his penis still looked swollen and red, and yeast was then determined to be the problem.

Yep, happens in girls all. the. time. You take antibiotics, you get a yeast infection. Starts when the antibiotic is strongest/ full course. Usually 10 days with broad spectrum antibiotics.

A month later, it still looked strange so we went back and now we have an antibiotic cream.

Strange how?

Today, I noticed a small blister again. What's going on?

Grrr... I can't find the photo. I've seen photos of intact infants/toddlers with a smegma pearl under the foreskin. Some look just like a blister with white stuff under it. But I can't find them??? Maybe they got removed? Anyway, it is a normal part of the seperation process to have these smegma pearls, although many boys (and girls for that matter) never get noticible ones.

Almost all the docs/NPs have retracted the foreskin - with even one doc saying he must be circ'ed since it retracted so easily. I've seen my son retract the foreskin so I don't think it was too much of a problem but I still hate seeing it.

Don't let them do it. Easier said than done, I imagine. My dd's labila adhesions were broken in the blink of an eye and i was just stunned. Doctors and their fascinations with children's genitals ::

Anyway, have any of you had similar issues? I know diapers can't help the situation but potty learning still seems a far off dream with some major resistance going on right now. Anything else we should try before I head back once again to the doctors who don't seem to know what to do next?

Don't worry too much about diapers, but let him go naked or in training pants for air circulation as much as you can.
Hope he likes yogurt cause eating as much yogurt as he can everyday will help balance the bacteria and pH. You can also smear yogurt on (or have him). BTW, no one but him should retract. It can cause microscopic tears. I've seen people flip their own eyelids inside out, but that's not something you want someone else to do TO you, kwim? Too sensitive for anyone but the owner to know how far is too far. Anything you smear on the tip will work it's way in as far as it needs to and that is all.

So basically, I don't think there IS an infection... and if you are really worried about it, take him to a doctor that will do a swab culture, without retracting (just be a very gruff mama! Tell the doc the truth- you are sick of people messing with his penis and want to know what is going on)...
Okay, so I don't think infection, but antibiotics=yeast. If the yeast is cleared up, leave it alone and see what happens. You can add some vinegar to his bath water (just a squirt) to get the pH inhospitable to yeast. It also soothes, and clears up any random "red butt" dd gets.

HTH, have to go!

[October Mama]

Thanks, everyone, for the support and advice. That blister is still there and the foreskin is still red and swollen. Part of me just wants to leave it alone for a while but of course the other part of me is worried. We've been using baking soda in his bath but vinegar is worth a try too.

Thanks!

[October Mama]

Oh and to clarify - the ped didn't want to circ him, he thought he already was circ'ed since his foreskin moved when retracted. Kind of wanted to say it moved because the doctor pulled it but anyway... So, nobody said he needed to be circ'ed but I'm still so suprised how little docs know about an intact penis!

[123]

When my ds2 had rash problems that we couldn't get to go away he also had some swelling and redness on his penis, especially the overhang of the foreskin. We let him run naked (or with just a shirt) as much as possible. After awhile it became clear that the rash and the redness went away when his bottom was naked and came back if he was diapered too much. I got really good at removing his diaper in the morning the minute he peed. It took a couple of months and then he potty trained and we had no more problems.

I don't know if that helps, but from my experience naked time can work wonders. I hope you get it figured out.

[October Mama]

More naked time is also a good idea- just need to roll up the rugs!

I think I'll just wait a bit before heading back to the doctor. So the blister could just be the skin separating to allow retraction?

Thanks again!

[l_olive]

Do you cloth diaper? There have been lots of cases in this forum where moms cleared up red, swollen foreskin issues by stripping their diapers really, really well to make sure there's no soap build-up in them to cause irritation.

[MCatLvrMom2A&X]

You can use monistate OTC yeast cream 7 day kind and see if that helps if it does he has yeast. If it dosnt you can try OTC bacatracin it is a antibacterial like neosporin but safer for genitals, what I used on ds when he had bacterial infection.

If you do take him back to the Dr. insist on a culture to see what you are dealing with because if it is yeast and they prescribe abx that will make it worse and not help a thing.

[Fellow Traveler]

Originally Posted by October Mama

More naked time is also a good idea- just need to roll up the rugs!

I think I'll just wait a bit before heading back to the doctor. So the blister could just be the skin separating to allow retraction?

Thanks again!

Just a few things to summaries what was posted here:

1. Since your son was on ABX it could very well be a yeast infection and I think MCAT, post 11, gave you a lead on how to handle that.
2. It is true that some boys experience soreness and redness of the foreskin which is related to separation. This usually last a day or two; there is a good thread about that which I will bump or just click here.
3. The blister may be a smegma pearl and if that is the case it will work itself out on its own. This too sometimes occurs while the boy is undergoing this separation process.
4. If he get noticeably worse for example significant swelling, difficulty urinating, or develops a fever return to the doctor.
5. If you return to the doctor because of #3 or out of general concern, be sure he does a culture. That will confirm or rule out infection and help you work out what might be going on.

Hope this helps. Let us know how it goes and if there is any other questions you have.

[October Mama]

Thanks so much, jwhispers, for the summary and to all posters. This is most useful and is making me feel better. I'll wait another day and if the blister or swelling is there, I'll head back to the doc but I'm guessing it's the separation process. Wish I had known this before going to the doc evary other week. Thank you all!

[Fellow Traveler]

Originally Posted by October Mama

Thanks so much, jwhispers, for the summary and to all posters. This is most useful and is making me feel better. I'll wait another day and if the blister or swelling is there, I'll head back to the doc but I'm guessing it's the separation process. Wish I had known this before going to the doc evary other week. Thank you all!

That is a good plan. Just keep in mind that the blister may just be a smegma pearl that will eventually work it's way out, it may take more than a couple of days. Also try and rule out any chemical causes i.e. Soaps, detergents ect.

[Lula's Mom]

I'm sorry, maybe I skimmed too fast, but is it a blister on the outer foreskin, or a blister-size lump underneath the skin? If it's underneath, sure it's probably a normal smegma pearl. If it's actually on the outside, that's not normal and should be cultured. When someone says blister I automatically think staph infection. I'd do all the other things suggested too, like naked time and stripping diapers if you use cloth. Besides soap buildup, you can have stubborn yeast living in the diapers so he can't really get over it.

[pigpokey]

How would you get a smegma pearl if you were retractile?

How could the doctor retracting a child hurt them physically if they are retractile?

Seems the OP is saying he's already separated.

Now I don't want anyone retracting DS because it's not a casual thing for a near stranger to do, but since he does it to himself dozens or more times a day (and has since 28 months), I doubt it could cause irritation.

[fruitful womb]

Originally Posted by pigpokey

How would you get a smegma pearl if you were retractile?

Good Question.

Maybe part of the foreskin wasn't ready to be separated and sealed back (partly).

OP: I think I know what the problem is.

Almost all the docs/NPs have retracted the foreskin - with even one doc saying he must be circ'ed since it retracted so easily. I've seen my son retract the foreskin so I don't think it was too much of a problem but I still hate seeing it.

Retracting an infant/child's foreskin will cause micro tears in the mucosal lining. The preputial space isn't ready to be separated from the glans. Every time a care provider tries to retract the foreskin the foreskin looses its elasticity. If done habitually then expect there to be continual problems.
You don't need to worry about genital hygiene on a two yr old. Just place in a tub and let him do whats natural.

It'll run its course when left alone. Treat the yeast infection - I'm not certain on how to apply the treatment. I sure MCatLvrMom2A&X would know.

I'd also give non-dairy acidolophilus to your ds. He can drink it. It'll balance the yeast within his body.

Hang in there. It'll all work out.

hth

[October Mama]

Originally Posted by Lula's Mom

I'm sorry, maybe I skimmed too fast, but is it a blister on the outer foreskin, or a blister-size lump underneath the skin? If it's underneath, sure it's probably a normal smegma pearl. If it's actually on the outside, that's not normal and should be cultured. When someone says blister I automatically think staph infection. I'd do all the other things suggested too, like naked time and stripping diapers if you use cloth. Besides soap buildup, you can have stubborn yeast living in the diapers so he can't really get over it.

The blister(s) are on the outside of the foreskin. Now the one he had two days ago seems to have gone but he now has another on the other side. So the smegma pearls would be under the skin? Hmm... Who would have thought I'd spend this much time thinking and examining and worrying about my son's penis! Since the other blister went away in 48 hours, I'm just going to see what this new one does. I'm starting to think this is just normal for him and not a sign of infection or yeast since we've been treating for those and nothing much has changed. But by Friday, if all doesn't look quite right, I'll go back to the ped but ask for a culture this time. And maybe do some educating myself with them on the normal separation process.

And while my son seems to be pretty much able to retract, I'm wondering if it's not complete yet and these blisters are just the skin working on this?

[MCatLvrMom2A&X]

You can go here and see some things you might come across during the seperation process. http://www.mothering.com/discussions...d.php?t=764732

How could the doctor retracting a child hurt them physically if they are retractile?

Seems the OP is saying he's already separated.

The problem with the Dr. retracting in this case is not because of damage really it is because when they start messing around with it then they come up with "problems" that are not really there. For instance the OP had this Dr. recommend circ because her ds retracted TO EASY : it is just better to keep their hands off that way there are no issues. Plus like you said that is to intamite of a thing for someone to be doing to your ds.

The smegma pearl could form even under a retractable foreskin if the sphincter at the tip is still on the tight side and he dosnt retract it on a regular basis or it could be he has a spot that isnt fully retractable yet. But that dosnt seem to be the case here since the blisters are coming up on the other side now.

Personally when I hear blister I think immediatly of yeast or a sensitivity to clothing, soap etc.

Treat the yeast infection - I'm not certain on how to apply the treatment. I sure MCatLvrMom2A&X would know.

You just rub the monistate all over the penis and scrotum and I would even apply some to bumm as well to make sure you are covering the whole area well.

[titania8]

my son had several blisters like you are describing. they would heal up and new ones would appear. we (the dr and i) assumed it was staph and a round of abx cleared it up. the first time. the next time i used tea tree oil, i added it to the wipes solution and i used it straight on a cotton ball. this seems to help the most but i think i need to strip the dipes too. so i guess my rec is tto. good luck mama.