My trusted pediatrician said today that my 14 year-old son will probably need to be circumcised. - Mothering Forums

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#1 of 41 Old 02-14-2012, 06:06 PM - Thread Starter
 
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My son was born in 1997, and I elected not to have him circumcised. 

 

He confided in me that he has recently become sexually active with his girlfriend. While talking about the use of condoms, the risk of pregnancy and disease, and the emotional connectedness that sex brings, I asked him if his foreskin had retracted yet. He said it didn't. So I took him to the pediatrician to have a check-up.

 

Today she said he'd probably have to have a circumcision, and referred us to a pediatric urologist. That appointment is three weeks away. 

 

I'm reading that 90% of boys' foreskins retract by the time they reach puberty on one website, and 45% by age 14 on another. I don't know whether to trust the pediatrician and urologist, or do my own research--seems that nobody knows what to do with an intact penis these days! Who knew I'd have THIS problem on the other end? 

 

Any pointers? 

 

 

 

 

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#2 of 41 Old 02-14-2012, 06:37 PM
 
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Why does it need to retract? Is it causing him pain or something?


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#3 of 41 Old 02-14-2012, 06:50 PM - Thread Starter
 
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Well, I know the penis was designed to have a foreskin that retracts. I'm no engineer, but the concerns would probably be reduced sensation, maybe a tight foreskin getting stuck behind the glans, scar tissue developing around any adhesions, risk of infection if things aren't moving properly. Apparently the foreskin can tear during sexual intercourse, usually at the frenulum, if there is this "design flaw." This would lead to scar tissue and pain. 

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#4 of 41 Old 02-14-2012, 08:19 PM
 
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Please do not have your son circumcised simply because he doesnt retract.  There are many many other options.  Why is this doctor suggesting radical surgery off the bat?  I'd say the first line of defense is a simple steroid cream.  Go to Cirp.org , there are many resources there for treating a non-retractable foreskin.  Check out The Whole Network's intact friendly doctors list, http://www.thewholenetwork.org/5/category/all/1.html , contact Doctors Opposing Circumcision because they many know of intact friendly urologists or contact Marilyn Milos RN and founder of nocirc.  There are so many resources out there.  We live in a circumcising culture, and most physicians arent taught the importance of the prepuce or alternatives other than cutting it off should an issue arise.  That said, I had a partner at one time who could not retract fully, and had no desire to. There were no issues because of it.


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#5 of 41 Old 02-14-2012, 08:22 PM
 
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Here you go: http://www.cirp.org/library/treatment/phimosis/


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#6 of 41 Old 02-14-2012, 09:06 PM
 
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Like a pp said not retracting is no reason to circ. There are men out there who never retract and lead healthy sex lives. Having said that did this Dr. mention anything to you about steroid cream and stretching or even less invasive treatments like a small slit in the foreskin? Him not retracting and having sex there is a slight chance of paraphimosis so I would be a bit worried about that but to even consider circ at this point is really jumping the gun because there are other ways to fix this without your ds going through what will be a very painful surgery and loose the foreskin.

Please read the links provided by the pp and if it where me and if (and that is a very large if) I decide to go to the urologist appt. the first thing out of my mouth would be "My ds is intact and cannot retract, we have no intention of circing I need you to tell me the other options for making this better" if the Dr. didnt tell you about the cream or the simple slit I would say thank you and walk out the door.

At your ds's age an the fact that he is sexually active stretching with the steroid cream is not only easy but over 90% effective in fixing phimosis.


 
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#7 of 41 Old 02-14-2012, 09:54 PM
 
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He probably doesn't need one. My son was born in Decatur, Ga in 1996. It is pretty high circ area..... your doc may not know the best options available. Do more research, see what the urologist says but don't cut until you KNOW that's the best course.. most of the world's men are intact.
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#8 of 41 Old 02-15-2012, 07:57 AM
 
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Like the pp's said, circ is a very aggressive treatment for a very simple problem like phimosis.  At his age, a steroid cream with stretching should be very effective.  As a last resort, a small dorsal slit could be made so he would be able to easily retract and not lose his foreskin.  It would also be a lot less painful than a full circ. But none of this is a problem unless your son thinks its a problem.  If sex is uncomfortable or he would just prefer it to retract, then go ahead with treatment, other wise I wouldn't even worry.  And how great that he feels he can talk openly with you about all of this!  I never felt that comfortable with my mom and I'm a girl!

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#9 of 41 Old 02-15-2012, 08:13 PM
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Don't worry, your son does NOT need a circumcision for his non-retractable prepuce. First off, he hasn't completed puberty at age 14 and continued growth, and hormones may help with his prepuce becoming retractable. Simple manipulaiton and attempts to gently retract his prepuce when erect and stopping  Before  it becomes painful can help stretch the "phimotic ring" or tip of his prepuce. I've read that steroid cream is effective in about 90% of cases. The other 10% can undergo a minimally invasive surgical procedure that fixes the problem Without amputating the prepuce along with the sensitive frenulum and all the mucosal tissue and nerve cells (Meissner's corpuscles). Below is a link to an Excellent article from a 2008 urology journal discussing a surgical technique "prepuceplasty" to resolve "phimosis" without removing any tissue!  Print it off, read it with your son and take it to the urologist indicating you would like this method done IF the stretching and steroid cream don't work. The only complaint I have with the procedure discussed in the article is that it is being done on children before they finish puberty. Lastly, you are a GREAT mom for being able to speak with your son so openly about sex educ. and his developing body. Best regards & many blessings to you and your son.

http://www.biomedcentral.com/1471-2490/8/6

 

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#10 of 41 Old 02-16-2012, 08:01 AM
 
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The Norm UK website is great for intact men who my be having problems and are thinking about circumcision. 

 

http://www.norm-uk.org/

 

Particularly these pages :

http://www.norm-uk.org/phimosis_clinical_guidelines.html

http://www.norm-uk.org/circumcision_alternative_treatments.html


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#11 of 41 Old 02-16-2012, 10:45 AM
 
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check your PM's...please..

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#12 of 41 Old 02-17-2012, 10:53 AM
 
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SpringBabyMama  Good for you for having such an open relationship with your son.  All the advice and links given above are right on.  Your doctor (and likely the urologist) are working on information and beliefs that are several decades out of date.  It is virtualy 100% certain that your son does not need to loose his foreskin.  Please print out the info from www.cirp.org/library/treatment/phimosis/ and www.biomedcentral.com/1471-2490/8/6  and ask them why none of those options (that preserve the foreskin) were not offered.  Also, as pointed out, your son is quite young. I do know that my nephew did not become retractable until about 16, and it happened almost overnight. His Dad came home from working away for a week to be greeted with "Hey, Dad, look - mine's just like yours now!"  Please, also, be aware that many doctors here place little value on a foreskin. It is, however, a very useful, functional and valuable organ, whose loss does compromise the person's (and his partner's) sex life for ever. I'm sure you know that already, or you would not have kept DS intact.

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#13 of 41 Old 02-21-2012, 02:09 PM
 
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OP, can you think of any other situation or medical condition where amputation is the FIRST treatment offered? Invasive surgery should be considered only as a last resort, after all other treatments have been tried and failed.

 

Circumcision as "normal" is so ingrained in our culture that even doctors don't think of is as the surgery that it is. They are not trained to treat an intact penis, and jump right to circumcision as the answer to any any all penis problems.

 

In countries where infant circumcision is rare, the percentage of males who have a medically necessary circumcision is extremely small. American penises aren't different, but American medical training (at least in this area) is.

 

You've gotten good advice above - I hope you don't rush into unnecessary surgery!


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#14 of 41 Old 02-21-2012, 02:18 PM
 
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Can you really have sex with a non-retractable penis? (maybe a stupid question?)

 


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#15 of 41 Old 02-22-2012, 01:15 PM
 
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Quote:
Originally Posted by sosurreal09 View Post

Can you really have sex with a non-retractable penis? (maybe a stupid question?)

 

From what I've read, you can.  I think I even remember someone posting there that their husband was non-retractible & they have a fine sex life.  I have no first hand experience, however.

 

Sus

 

 


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#16 of 41 Old 02-22-2012, 03:37 PM
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Some boys don't retract until age 17 or later.  There is NO NEED to cut off his foreskin.  I'm really surprised you think he's old enough to have sex but not old enough to decide what else to do with his penis. 


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#17 of 41 Old 02-22-2012, 05:37 PM
 
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Originally Posted by A&A View Post

  I'm really surprised you think he's old enough to have sex but not old enough to decide what else to do with his penis. 



This is really unnecessary.  She never said she thought he was old enough to have sex, just that he came to her and she gave him the information he needed.  She's looking out for his well-being in every way possible.  14 year olds often have sex whether we want them to or not, but they are still immature and need guidance with decisions regarding their health.  I think it's completely reasonable for her to concern herself with his health at this age.  If she had punished him for having sex and then stuck her nose in his business regarding his genitals, he probably would have never confided in her again, then listened to some doctor at age 18 and gotten his foreskin hacked off without having the proper info.

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#18 of 41 Old 02-22-2012, 07:08 PM
 
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OP:  A HUGE thumbs-up thumb.gif that you have such a good, open relationship with your son that he felt comfortable enough with you to discuss this with you!  That speaks volumes about how you've raised him, how much he trusts you, and the foundation of your relationship with him.  My hat's off to you

 

Also, OP (or anyone else who needs to know), if he had unprotected sex and you wanted him tested for STI's, he can have it done confidentially and for FREE at the health department as long as he makes his own appointment (can't be mama calling) or a school nurse makes the appointment for him (that's the way it works in my state, anyhow).  We have private insurance, but if you want your child tested and they are asymptomatic (as males are for so many STIs), you have to pay out of pocket.  It's well over a grand to test for everything.  Health departments are wonderful, methinks.

 

Good luck to both you and your son, SpringBabyMama.


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Quote:
Originally Posted by bandgeek View Post
 If she had punished him for having sex and then stuck her nose in his business regarding his genitals, he probably would have never confided in her again, then listened to some doctor at age 18 and gotten his foreskin hacked off without having the proper info.


how does the son feel about the situation? is HE concerned that he's not retractable, and has he done any research on whether or not this is a problem? i would say that at 14, and sexually active, he is on the cusp of being a young adult. no, not 18. but old enough to be having sex... so old enough to be a voice (the deciding voice?) in this dilemma.

 

IF the son doesn't want his foreskin amputated at this point in time, maybe he IS regretting telling his mom about the sex.... which led to the question of retractability... which led to the doctor's visit... which led to the doctor's call for circumcision.... which led to ??? the point where the question is now.

 

from a purely economical point of view, if he's able to have sex, the penis obviously works. if he's having sex and not getting infections, the foreskin is obviously doing alright. if he's having sex without retraction, then retraction is obviously not necessary for him to have sex. (i do believe from watching the videos on "Sex the Way Nature Intended" that the foreskin's retractability is a nice bonus that adds to the sexual enjoyment of both partners... but it seems that having sex with a non retracting foreskin penis would be more equivalent to having sex with a circumcised penis -- ie, no additional lubrication coming from the male, no extra "glide.") my point being... from a purely economical point of view: If It Ain't Broke, Don't Fix It. 

 

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#20 of 41 Old 04-27-2012, 02:06 AM
 
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Quote:
Originally Posted by sosurreal09 View Post

Can you really have sex with a non-retractable penis? (maybe a stupid question?)

 

 

Yes. My dh's doesn't retract (due to scar tissue from repeated early retraction). He's tried the steroid cream, which loosened it some, but he has a lot of scar tissue. We have 4 kids, so I'd say it works fine.

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#21 of 41 Old 04-27-2012, 10:20 PM
 
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OP, thinking of you and your son.  What did you decide to do?


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#22 of 41 Old 04-28-2012, 11:44 AM - Thread Starter
 
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*UPDATE*

 

Went to visit the pediatric urologist, and he did an examination and said that yes, indeed he does have phimosis--He said it was "true phimosis" not the more common kind that goes away with development. He said there is a tight white ring of scar tissue at the opening of the foreskin. (I haven't seen it, but apparently it's a prominent white ring.) 

 

He prescribed a topical steroid cream, which my son is supposed to apply once in the morning and once at night. He said this usually resolves things, but that his situation looked like it might not resolve on its' own.

 

He said there are other options, slitting the skin, in a minor way, which my son seemed to favor, if we decide to go that route. 

 

For now all I'm doing is trying to get him to actually apply the cream. (Nothing more awkward than following your 14 year-old kid around with a tube of steroid cream for his penis...I keep leaving it in more and more obvious places: bedside table, bathroom sink. It's now next to the bathtub. He's totally not applying it regularly, because I have asked. Twice.)

 

We're supposed to go back after six weeks of treatment with the ointment. I don't know what we're going to do. I'm leaning towards the wait-and-see approach. He's only 14. Maybe if he applies this on and off for the next few years, it will resolve on it's own. The only way someone is taking a knife to his penis is if he asks me for it, and he's mature enough to make a life-long decision. I'm not sure that's going to happen before he's 18. Playing it by ear...

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#23 of 41 Old 04-28-2012, 01:38 PM
 
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My husband has phimosis and he has never had any issues associated with it.  He'll be 30 this year.  It's true phimosis, obviously, as his foreskin never did retract.  So, even if your son's foreskin never does retract, circumcision isn't necessary unless he is having some sort of medical issue associated with it.  

 

For the record, in case anyone is curious he's also never had any hygiene issues associated with it, either. :)

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#24 of 41 Old 04-28-2012, 05:09 PM - Thread Starter
 
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Thanks for your response. I am glad to hear it can be a 'normal' thing for a man to have a non-retractable foreskin. Why hasn't it retracted, I wonder? I guess I'm a little sad. I hoped that my son would have an intact penis that functioned the way it was designed to function~with a nice little retractable foreskin. :( I didn't know that penises could develop a hard white ring of scar tissue that could prevent them from retracting. How did it get there? No one talks about this stuff. I think it's pretty rare, but maybe it's why circumcision became a tradition in earlier cultures. I have no idea. I've been laissez-faire with many of my parenting decisions, with mostly beautiful results. I guess I'm feeling a little guilty--that I may have put my son in this situation. Wish I had more support. My mother told me I should have circumcised at birth...I haven't even mentioned the latest development, I can hear her 'I told you so' already...

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#25 of 41 Old 04-28-2012, 05:47 PM
 
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The only way he could have a scar ring is if he had a long term untreated infection or if someone retracted him repeatedly over time.

There is a ring around the end of the foreskin it is a sphincter and if you push the foreskin back before it is ready the ring will turn white so it may not even be IMO scar tissue. Obviously your ds isnt that concerned about being retractable or he would be more diligent in applying the cream. For me if it where my ds I would let him be and not take him back to the Dr. and if when he is older and more involved in his body and there is still and issue then I would try to steroid cream again.

Steroid cream actually is only supposed to used after puberty is well established on for an adult man with issues. Using it before then usually does not work since his body just is not ready to retract yet.

 
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#26 of 41 Old 04-28-2012, 05:59 PM - Thread Starter
 
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"Scar ring." I didn't know that's what it was called. New information, thank you. 

 

There have been no infections that I am aware of, unless they were silent. He never complained of pain, itching, discomfort of any kind.

 

Is it possible that my DS tried to retract it, because of something I said or something his Dad said? I can remember when he was little, mentioning that he should pull it back to clean it. 

 

As I said, I'm leaning towards the "let it be" approach. How many men have this problem, I wonder? I'd never even heard of it!

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#27 of 41 Old 04-28-2012, 06:24 PM
 
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I dont know any real numbers but I know I have read enough about it online to think that it is not exactly common but happens a fair amount. There is one website that I use from the UK that talks about it and since they dont circ there they have good advice on dealing with it.

True phimosis can only be diagnosed after the boy is well into puberty and ready to be an adult. Any time before 18 you cannot diagnose it unless you know for a fact there was damage done in some way.

 
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#28 of 41 Old 04-29-2012, 06:26 AM
 
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Yea, my husband never developed a scar ring.  His foreskin "sphincter" is just too tight to pull over the head of his penis.  All of the literature, and personal information I've heard regarding foreskins is that you shouldn't retract to clean it.  As an adult he'll pull it outward while he's showering to rinse it (the foreskin), but that's about the extent of the cleaning. We've been together for 12 years and he's never had any issues with UTIs and whatnot.  

 

Personally speaking I'm not really educated on the whole thing, I'm just learning from personal experience.  I wish they would teach us a bit more here in the states regarding circumcision (or rather, why it's unnecessary unless in certain medical situations), but I guess that's why we have literature and online communities like this one to share stories.  I hope whatever outcome your family comes to your son is comfortable!    Also, don't feel guilty.  It can happen to anyone. :)


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#29 of 41 Old 05-20-2012, 01:30 PM
 
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Quote:
Originally Posted by SpringBabyMama View Post

Well, I know the penis was designed to have a foreskin that retracts. I'm no engineer, but the concerns would probably be reduced sensation, maybe a tight foreskin getting stuck behind the glans, scar tissue developing around any adhesions, risk of infection if things aren't moving properly. Apparently the foreskin can tear during sexual intercourse, usually at the frenulum, if there is this "design flaw." This would lead to scar tissue and pain. 

 

'but the concerns would probably be reduced sensation"

 

Maybe.  However, at his age, sensation is not a major driver.  He's going to be able to participate and enjoy sex even if it does result in reduced sensation.  A few years ago,  A woman wrote me asking for advice about her husband.  He was 32 years old and his foreskin had never retracted.  He very much enjoyed sex and had fathered two children with her.  It appeared it was more of a problem for her than for him.

 

I wrote back with a solution for his (her?) problem that involved no surgery and no medications and no doctor visit.  He really had little interest!

 

The liklihood of adhesions is virtually nil.  With no adhesions, the chance of scar tissue is also virtually nil.  There is virtuall no risk of infection.  The preputial area is bathed with two enzymes, langerin and  lysozime that virtually "eat" infectious pathogens the same as with girls.

 

Tearing of the frenulum is also uncommon.  The frenulum is an elastic tissue made to stretch, not tear.  Bringing this up makes me wonder where you're getting this information.  It is common at websites advocating circumcision.  Have you been to one of those sites?

 

 

Frank

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Originally Posted by philomom View Post

He probably doesn't need one. My son was born in Decatur, Ga in 1996. It is pretty high circ area.....

I suspect you would be very surprised how low the circumcision rate is in Deadcatur, GA.  The circumcision rate is low in all of the Atlanta area. (Decatur is a suburb of Atlanta)  Even being involved in this issue and living in the Atlanta area for more than 35 years, I was surprised.  The Atlanta metro area is a very progressive area.

 

 

 

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