It has happened again as it has so many times before. A distraught mother has come here reporting that a health care provider has forcibly retracted her son. The typical message is “It happened so fast I didn’t have time to say anything. Has my son been injured? What do I do now?”
The foreskin is bonded to the glans (head of the penis) just like the fingernails are bonded to the nail beds with the same tissue, synechia or the epithelium layer. Unlike the fingernails, the layer between the foreskin and the glans will break down over time and the foreskin will release and become retractable. This forcible retraction is exactly the same thing as peeling the fingernails back and is just as painful. Just like the fingernails, there is nothing to be gained and it is just as damaging. These uneducated health care providers think there is something inside the foreskin to see when there is absolutely nothing. Even in the case of infection, there is absolutely no reason to pull the foreskin back. Anything that would be apparent from the inside is readily apparent from the outside. That is because the foreskin is a wonderfully sensitive area and just like the lips, if there is anything wrong on the inside, it will manifest itself to the outside within a matter of mere hours. Just like the fingernails, if there is a problem, it is treated either from the outside or internally with oral medication. You don’t pull the fingernails back to treat a problem and you don’t pull the foreskin back to treat a problem.
As mentioned above, this forcible retraction can happen in the blink of an eye. It can happen far too fast to stop it once they have started. The only way to stop it is before it starts. Even if the provider appears to be foreskin friendly, every time you take your son in, warn them that they are not to retract his foreskin for any reason, not even if there is a problem. This warning should be done with conviction and clarity so that there is no chance of misunderstanding. Be especially clear when communicating with personel in the ER. It may help you to know that retraction is not necessary to collect a urine sample. Stay at your son’s side during the entire examination and be prepared to act quickly and decisively. If there is any discussion about why it should be done, stop the examination until you are certain you have a complete understanding with them. If you are not sure you have their complete understanding, take your baby and leave. Consider that if they are wrong on this issue, they will probably be just as wrong about other health care issues. I would also recommend printing out the AAP’s guidelines for the care of the intact penis to take with you:http://www.medem.com/search/article_..._typ=NAV_SERCH
If you are coming here because this has already happened, relax a bit. Just like the fingernails will repair themselves if they were peeled back, the foreskin will also repair itself. The human body has a wonderful ability to heal injuries. Just leave it alone to do it’s job. Watch closely for a few days for infection and act appropriately if infection does develop. Any problem can be easily handled with antibiotics and your son should not suffer any long range complications. Usually, only repeated trauma from premature retraction will end up causing problems.
If this has already happened to your son or if you have to stop the doctor or nurse from forcibly retracting your son, you should take action. If this doctor or nurse does this to one intact child, they are doing it to all intact boys and you can be instrumental in protecting them and getting the word out to the entire medical profession. The typical doctor or nurse is unlikely to pay any attention to a mother instructing them on how to run their business but we have a powerful ally.
The attorney for Doctors Opposing Circumcision, John Geisheker, will send a letter to the doctor/nurse/hospital pro bono (free) on your behalf telling them what they did was wrong and the consequences. It isn't a letter stating you'll sue but it is fully referenced and ought to get their attention.
Email him at email@example.com
Before you contact John, you will need the following information:
The name of the doctor or nurse who did this, the name of his/her practice and their (snail) mailing address.
The name of the hospital where the doctor has privileges, (the hospital where they practice) and the mailing address. (even if it didn’t happen at the hospital)
The name of the CEO or Administrator of the hospital. (even if it didn't happen in the hospital, find out where the offending doctor has privileges and send it to those hospitals)
The name of the hospital's risk manager.
The name of the head of the department (OB, peds, emergency, etc.)
Letters will also be sent to:
The state medical board in your state.
The Joint Commission on Accreditation of Healthcare Organizations (hospitals fear them like a boogeyman)