Backstory: I have a 2mo son who is my first uncircumcised boy.
At our first well-baby checkup, our doctor looked at him with great concern, saying that the opening in his foreskin was very small, and that he had phimosis since it was not retractable at all. He recommended that we circumcise him to prevent future infections and gave me a referral to a urologist. He also asked if my son had had any trouble urinating. He definitely hasn't had any problem urinating--plenty of wet diapers, and I have been peed on during diaper changes, so I know that he produces a healthy stream of urine (ha ha!) with no apparent discomfort. He has no redness or irritation that I can see. I care for him by normal wiping at diaper changes, and my baby bathtime routine is just water at this age, maaaybe shampoo on their hair but not on their body. I have done my reading on what a normal uncircumcised newborn should look like, and he looks COMPLETELY normal. My understanding is that newborns have *physiological phimosis*, not *pathological phimosis*; i.e. the foreskin isn't supposed to retract at this age anyway.
So I decided to go to the urologist appointment anyway, partly to get a second opinion, and partly so that our doctor (who really is wonderful) won't continue to ask me about it. The appointment is tomorrow. But my worry is, what if the urologist thinks that the fact that a 2mo is not retractable (with no signs of distress or infection) is a reason for circumcision too?! I don't really have any other doctors in this are I can go to. I would of course like to know if there really were a problem, but all signs point to there not actually being a problem. Any advice for me? Thank you!
Sounds like you know that your baby is fine, and healthy and normal. Not a bad idea to go to the urologist like you said, just to see if there is anything of any real concern. I think if the urologist expresses concern about not being able to retract (and of course, be very vocal about him not trying to retract anyways!) perhaps you could have some information along with you that supports why you don't understand what the problem is - something about how that is completely normal at this stage for your baby. If they are concerned about the size of the opening, that might be something different (I'm not familiar with that), but as you said, not being retractable is completely normal, and protective. Chances are the the urologist will be much more educated on this topic, or at least I hope so! I have a friend who is a urologist in Germany and he is very pro-intact boys since that is his area of expertise, so hopefully that isn't just a cultural phenomenon :)
I think the only problem your son has is a foreskin-ignorant primary care doctor. Since the vast majority of medical texts do not discuss the functions/purpose/normal development of the foreskin, this doctor has never learned it.
It is normal for the hole to appear very small. If you watch him pee some time, you'll see that the stream is pretty wide. The only time this is a problem in a newborn is when there is no urine output. You said that's not the case.
The organization Doctors Opposing Circumcision likely has material on their website that you can take to your appt w/ the urologist and/or to the reg doc the next time. Hopefully if it comes from other doctors, they'll respect it. Other medical associations in other parts of the world may have stuff you can take too or at least links you can provide. I can assure you that in the majority of the world, most baby penises aren't in need of circ for the reasons you were given.
Congrats on your intact son! From reading here over the years, I think the most you have to worry about w/ his penis is what others think should be done with it.
PS - If you go to the urologist, I'd be interested to hear what happens, so please share, if you're willing!
The main thing is that your son is having no trouble urinating and doesn't seem to be experiencing any pain or problems. Right? So, if there's no problem, there's no problem.
You said the first doctor wanted to prevent "further" infections. Did your son already have an infection in that area?
Your son doesn't need to see a urologist, he needs a ped who actually knows what normal male anatomy looks like. The average age of retraction is 10 1/2 and the longer is stays tightly closed the better, as it keeps it clean. As you observed he pees a good stream, because the end of the foreskin has a sphincter muscle that closes down when he isn't peeing, which your Dr would know if he was at all educated. All your son need to do is pee, retracting is for sex only, and I don't think he has that in his immediate future! If you plan to saty with this same Dr I would print off the AAP care guide and highlight the relevant parts and make him read it.