Very frequently a mom will come here describing some painful experience her son is having when he urinates. 97% of the time this is just normal separation. Especially if there are no other symptoms of UTI present such as frequent urination, fever, etc.
The experience of pain or sting during urination will be more intense when the foreskin separates suddenly, as was the case for my son. Usually there will be some type of swelling and/or ballooning that occurs as well. The foreskin might separate all at once on one side and then slowly detach as the pressure from the urine knocks the connections loose. This means that the pain can go on for a few days. For my son the entire foreskin took about a day to knock loose, then the glans took about 3-4 days to smooth over and for him to not experience pain when urinating.
It is unclear why some boys experience this separation symptom more suddenly than others. For my son I believe that the cause was some early manipulation of his foreskin by a doctor. This is just another reason that doctors should not manipulate the foreskin for any reason. For other boys it could be that they are a little hard on themselves during self-exploration which starts the ball rolling sooner.
One of the remedies we have for this is to have the child pee in a cup of water however this does not often work for young boys. If the foreskin opening is still very narrow, the water will not be able to mix with the urine and dilute it so that it does not sting. For these boys, they will just have to weather the experience.
Also, the foreskin might not separate all at once and this symptom may come and go until complete separation has occurred.
The sting may be worse during times of the day when the urine is more concentrated. For my son it was bad all day. I've never heard him scream and cry the same way. It can be very painful. Sometimes a boy will be reluctant to pee to try to avoid the pain.
So point is that painful urination, even when it sounds very painful is likely to be normal separation. Especially if there are no other symptoms of UTI. Swelling is a good indication that it is separation but may or may not be present. Other symptoms that can be present are smegma discharge, ballooning and a small amount of blood.
Hope this helps other moms. I know I was super freaked out when this happened to my son b/c he was in excruciating pain. Just try to comfort your babe and wait and watch. As I said before it took my son about 5 days to be out of pain so it can be a rough few days. Unless you see other symptoms that could indicate UTI I wouldn't run to the doctor. They really are not familiar with the development of the intact boy and often do more harm than good.
Two good threads:
Thank you so much for this post.
DS is eight years old, and the pain began for him at least a couple of weeks ago. However, it wouldn't occur during urination, but seemed to happen intermittently with no obvious cause. He would cry out suddenly and jump up, but the pain would only last for a moment or two.
Initially, I had no idea what was going on. I was having him hop in the tub and the warm water seemed to help. After it happened a few times, I started to really worry - but there isn't a lot of information online. I knew that his foreskin had not yet retracted, and I had never been concerned, as I thought that he still had lots of time for that to happen. But I began to wonder if he was getting erections, and if his foreskin was tight and that was what might be causing the sudden pains?
Anyway, I took him to the clinic one night when he was very distressed and was basically told that he was fine. They checked for a UTI, but did not seem concerned about his foreskin. At that point I was worried about phimosis, not a UTI. As he is older, I haven't been with him while he urinated for years, but I went in the washroom with him to fill a cup for the UTI test and witnessed ballooning of his foreskin. I wasn't very concerned about that, as I had read that it was a normal part of separation.
After a few more days of pain, I took him to his pediatrician, who also basically said nothing is wrong.
Still, this is going on so long. I have been encouraging him to gently move the skin on his penis, but not to force anything or do anything that hurts, and several days ago he said that something had come out into the toilet (smegma, maybe? I didn't see it). Still, the pain is there. I can see no lumps or sore spots on his penis. The pain is not in his testicles and was not confined to urination, though it seems to be more of an issue during urination now. Today, he was afraid to pee because it hurt, so I had him sit in the tub with water to urinate. When he stood up, there was a couple of drops of blood at the tip of his penis.
I am so stressed out about this. I want so much to ease his pain, but I am terrified that I am not doing the right thing. I don't want him to force retraction, and I don't want to just ignore the situation because he is hurting. During separation, how much retraction should be occuring? DS cannot retract AT ALL, and I cannot see the head of his penis at all - the opening of his foreskin is miniscule. Is this okay at his age?
How much longer is this supposed to go on? :(
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