Very very long foreskin. Help! - Mothering Forums

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#1 of 30 Old 03-09-2006, 07:00 PM - Thread Starter
 
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Hey guys. I am a long time lurker but very infrequent poster. Maybe I should introduce myself?
I'm Hannah, mom to two sets of twins; Milo and Owen, and Levi and Nina.

Milo is not circumcised. Owen IS circumcised. Owen was born with moderate-severe hypospadias and was circumcised to repair that. I regret it. Not the circumcising him part, as I feel that would have had to be done regardless. more the fact that I didn't push for other options and circ as a last resort. But Milo was left intact and ho boy was THAT a fight with everyone. It was the one and only time the words "They're my goddamn kids NOT yours" has left my mouth!

Anyway, fast forward to now and 3 month of Levi. Obviously he was not circumcised at birth. But he has an extremely long foreskin. It has to be retracted to clean because it is so long. Not retracted past the tip of the penis, more like rolling it inside out. I don't know the best way to describe it. But when he poops (and boy is he a pro at that!) it gets all up inside and in the beginning we left it alone, until he DID start having problems and had his first UTI at 3 weeks and his second at 7 weeks and I am thinking he might have the beginnings of one now. He has also had yeast issues. My pediatrician who is anti circumcision and in fact doesn't even perform them and has never once retracted Milo (or now, Levi) says that we need to be cleaning the gunk from the overhang. I brought up circ and she said not to worry about it now. My thought process was can they just take most of the overhang and not retract at all and still leave plenty for him to grow into? She says she has never heard of someone doing that and that it can probably be done but there might then be issues with the scar sealing itself shut.

I don't want Levi circumcised, that is not my intent at all. But I am just worried that these UTIs are going to be a common thing and we might end up having to do it.

Any advice?
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#2 of 30 Old 03-09-2006, 07:19 PM
 
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He'll grow into it. Don't worry about it.
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#3 of 30 Old 03-09-2006, 07:22 PM - Thread Starter
 
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But what about all the infections he is getting now? And if he is going to grow into it, I don't know any woman who will be able to marry him! His overhang is longer than his entire penis. It's that long. I have never in my life heard of anyone having a foreskin this long and my doctor has never seen it either.
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#4 of 30 Old 03-09-2006, 07:33 PM
 
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Your perceptions of his possible future sexual attractiveness aren't really important here, sorry to be blunt.

There is absolutely no correlation between what his foreskin to penis ratio is now to what it will be when he's a grown man.

Removing the end of the foreskin removes the ridged band, which is physiologically an important part of sexual stimulation and function. Even removing just a small portion of the end of the foreskin will also cause damage to the frenular delta, which is probably the most important part of the penis for pleasure and function.

Many girls have very long labia. At some point, there is going to be some girls whose labia is VERY VERY long. But would you trim her labia? How do you know how long they will be when she is grown? The genitals on both sexes go through RADICAL changes during puberty. You cannot predict what his foreskin will look like when he's eleven, and certainly not when he's 25. And it's really not your choice to make. If at 25 he thinks it's ugly and doesn't like it, it would be up to him to modify it or not. Would you presume to shape your daughter's genitals to better meet your expectations?

As far as the UTI's go, girls get them far more frequently than boys, at all ages. But we don't trim their genitals to reduce infection (although some studies suggest that trimming labia can help reduce UTI in females), we treat the infection. Boys typically outgrow common UTI after 12 months of age. The best treatment you can give him is to continue to breastfeed him (I know you are having problems with that, but here's another reason to stick with it). Babies who are breastfed have fewer UTI's than babies who are not, regardless of genital intactness.

As for retracting it, I would dissuade you from that. I doubt he needs to be retracted to be cleaned, and would guess that it is causing irritation.

With a child with recurrent UTI, you may want to check for kidney reflux.

HTH,
Lindsay
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#5 of 30 Old 03-09-2006, 07:42 PM - Thread Starter
 
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I don't mean I think it's unattractive (wow, that's a weird thing to think about!) and I don't care if his future partners think it is. What I was responding to was when the pp said he would grow into it. I meant that, to be frank, he would be, ahem, very well hung.
I don't want to circumcise him. I know how horrible circ is, which is why I was at odds with my entire family to not circ Milo. But I am looking at it from a health perspective. To have such frequent problems is not good.
When I say retract it, I mean we roll it inside out and rinse it with plain lukewarm water. We never pull it back from the tip and we never excessively groom it or use chemicals of any kind. He has never objected.
I will talk to his doctor about kidney reflux. Also what about the mad yeast infections?
I am glad I don't have a pro circ doctor or this would be a huge nightmare.
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#6 of 30 Old 03-09-2006, 07:44 PM
 
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Originally Posted by LeosMama
As far as the UTI's go, girls get them far more frequently than boys, at all ages. But we don't trim their genitals to reduce infection (although some studies suggest that trimming labia can help reduce UTI in females), we treat the infection. Boys typically outgrow common UTI after 12 months of age. The best treatment you can give him is to continue to breastfeed him (I know you are having problems with that, but here's another reason to stick with it). Babies who are breastfed have fewer UTI's than babies who are not, regardless of genital intactness.

As for retracting it, I would dissuade you from that. I doubt he needs to be retracted to be cleaned, and would guess that it is causing irritation.

With a child with recurrent UTI, you may want to check for kidney reflux.

HTH,
Lindsay

I had chronic UTIs until i was 18 years-old. Nobody ever thought to cut anything off of me!


Perhaps while DS is in the poop up his forskin phase, you could swish him around in the sink instead of pulling back his forskin, which may be irritating and prolonging the UTIs.

Mom to three 14 y.o. rock star grrl, 5 y.o. knight in spazzy armour and baby Juniper, born still @39 weeks 4 days 2-3-10 .
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#7 of 30 Old 03-09-2006, 07:48 PM
 
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My understanding is that pulling it back at all is retracting.

I'd be worried about doing it too far and hurting him. Have you tried just swishing it out in the bath?

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#8 of 30 Old 03-09-2006, 07:52 PM
 
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Well, good for you for not wanting to circumcise! Especially with family pressure.

I don't have too many helpful ideas - I'm guessing Frank will. Because he always does.

If he's getting re-current infections, what you're doing now may not be working. Are you sure that when he poops there is actually fecal matter getting inside of the foreskin? That's never happened to my son (as far as I know), so I'm not sure what I would do if it did. I've never really been concerned about the inside of his foreskin, and just wash the outside of his penis. What does your dr. say about cleaning it? I'm glad she's anti-circ, you're right it would be a nightmare otherwise.

I hope someone else has some more info, I just didn't want to read and not respond. It's so great to hear from a mom who's looking to help her child without circumcising him.

I love your children's names - very different and beautiful. My sister almost named her son Levi - I've always loved that name.

Take care,

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#9 of 30 Old 03-09-2006, 08:01 PM
 
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How much overhang are you talking about? Can he toss it over his shoulder, or wrap it around himself like a belt, or what? I suspect that he has a bit of overhang, like many children do, but it is not "extra" any more then the foreskin itself is "extra". Some children have longer foreskins, some have shorter foreskins that barely cover the glans...all are within the range of "normal", and I'm willing to bet if he had a ultra-rare birth defect like megaprepuce (which, by the way, doesn't just mean a long foreskin), your doctor would have already used that term, talked with you about it, and it would be being addressed.

The tip of the foreskin tapers, and the skin usually sticks to itself. It just doesn't make sense that he's getting feces up inside it at three months. Especially when it's regularly rinsed with an outgoing stream of sterile urine.

Also, at the tip of the foreskin is the preputial sphincter/ridged band. If you shorten his foreskin (which would be a form of circumcision), this part will be the first to go and then the tip of his foreskin will no longer contain that structure and will loosely hang open.

At three months, you shouldn't be retracting and it's likely that 'turning his foreskin inside out' to clean/rinse is causing irritation and the opportunity for introducing bacteria/infection.

You said if he grows into his foreskin, that would make him very 'well hung'. He's three months old. Even if he has four inches of foreskin extending past his glans, and he grows into it, that would make his penis average sized in adulthood.

As far as yeast infections go, yeast thrives when there is imbalance in the body or auto-immune problems. Overzealous hygiene, excessive refined sugars, diabetes, etc can contribute. If a woman had a slightly deeper than average vagina, or slightly longer labia, I don't imagine she'd have any higher risk of yeast infection. Why would a boy with a bit of foreskin overhang be at a higher risk?

I guess I just don't understand.

Jen
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#10 of 30 Old 03-09-2006, 08:02 PM
 
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I would stop rolling it back because that is retracting even if you might not think it is. Swish it in water or give him a bath when he gets poopy. I'd also really treat the yeast. Yeast is sooo hard to get rid of. So hard. Talk about the kidney reflux too, UTI's can be an indicator (sp?) of that and if it's not corrected, the child will eventually need kidney transplants.

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#11 of 30 Old 03-09-2006, 08:31 PM
 
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I agree w/ everything Jen said, but I will add 1 more.

Reagarding thrush: Liam and I battled constant thrush for months. It wasn't until I figured out his last food allergy that we finally got rid of it. And I mean within a few weeks of cuting wheat out and doing nothing else. Wheat was his hardest FA to figure out b/c he has a delayed reaction when I eat it. It takes up to 4 days for him to react, so when I would cut it out and add it back in, I would think it was ok to eat b/c after a day or so he hadn't reacted. In our case, allergies were causing a suppressed immune system. SOmething like that has to be at the root of recurrent thrush. Not necessarily a FA (although that's most likely) but something. Just a thought

Oh, and also, how much of an overhang are we talking here? Even among my 3 boys I've seen a lot of difference. Damien's has remained pretty constant w/ about a half inch overhang, looked like a lot when he was a small baby, but looks pretty normal now. Jake's has varied from about an inch to nothing. (The inch was when he was REALLY fat and had a buried penis--he basically had his foreskin sticking out and that was it, no penis inside. ROFL! He'd had a penis when he was born and the ped never said anything, so I didn't think much about it. Now I've actually had people comment on the size of his penis. It's not much smaller than his older brother's. ROFL! His overhang is ony about 1/4 of an inch, but I won't be surprised if that changes.) I didn't realize foreskins could change greatly in size until I had him. Liam's is slightly more than half an inch, maybe 3/4 of an inch. And I have a ruler next to me, so I'm sure my lengths are right. LOL! Liam's overhang is at least as long as his penis if not longer (well, at least the part that's not buried in his pubic fat. lol) Looks pretty normal to me. I have seen a lot of intact little boys, though. I worked at a daycare in an area w/ a less than 10% circ rate. There are huge differences int eh length of the overhang.
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#12 of 30 Old 03-09-2006, 09:29 PM
 
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well, i don't have any real advice, but you may want to check out ec (elimmination communication) and this way he won't have poopy dipes.
just a thought, tho i can't even imagine how busy you must be with 2 sets of twins
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#13 of 30 Old 03-09-2006, 09:59 PM
 
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If he's had 2 UTIs and he's only 3 mos old, he needs to be evaluated by a pediatric urologist. He could have Kidney Reflux. It may have nothing to do with his foreskin at all. I am really surprised your pediatrician has not suggested this. Was he hospitalized for his first UTI?(he was only 5 weeks old)
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#14 of 30 Old 03-09-2006, 10:12 PM
 
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Good for you for sticking up for your sons! I'm sure they will grow to thank you for that

Good news for you and your guy. Even in the studies that showed circumcision made a difference in UTIs, (some studies showed a difference, some did not) there was only a difference in the first 6-12(depending on the study...some say 6, some12) months of life, after that the stats were the same.

Secondly, I don't think there can be "too much" foreskin. All body parts vary in size and shape, but they are all that way for a reason. Here is a link in which the baby has a very long foreskin, and he is still considered normal:
http://www.cirp.org/library/normal/

I hope things improve for your little one.

Take care,
Tara

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#15 of 30 Old 03-09-2006, 10:42 PM - Thread Starter
 
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Originally Posted by calngavinsmom
Good for you for sticking up for your sons! I'm sure they will grow to thank you for that

Good news for you and your guy. Even in the studies that showed circumcision made a difference in UTIs, (some studies showed a difference, some did not) there was only a difference in the first 6-12(depending on the study...some say 6, some12) months of life, after that the stats were the same.

Secondly, I don't think there can be "too much" foreskin. All body parts vary in size and shape, but they are all that way for a reason. Here is a link in which the baby has a very long foreskin, and he is still considered normal:
http://www.cirp.org/library/normal/

I hope things improve for your little one.

Take care,
Tara
Oh Levi's is longer than that. I would say it's probably a little over an inch when flacid.
When we change his diapers, we try to kind of fold it up. We double it back and tuck it between his penis and scrotum (yes, it's that long) so that when he poops, it's out of harm's way. Sometimes it holds, sometimes it doesn't.

EC is out of the question. No way I even want to attempt it. It won't work for us.

I could try not rolling it back, but we did that for the first several weeks of his life and he was having problems. Although I can't really say that the problems have stopped.
I don't want him circumcised. That was not my intent posting here and I feel like people think that I am trying to justify a circ. I'm not. I'm just trying to find out what others have done in this circumstance, if anyone has had this problem before.
I will ask the ped about kidney reflux. Thanks. I don't think she's mentioned it before, but with four kids to keep track of I don't always pay that close attention!
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#16 of 30 Old 03-09-2006, 10:43 PM
 
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I would definitely not cut anything off your ds, no matter what! Just to add to the suggestions from PP, I would add in probiotics to try to combat any imbalances that are leading to yeast infections, etc.

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#17 of 30 Old 03-09-2006, 10:58 PM
 
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When we change his diapers, we try to kind of fold it up. We double it back and tuck it between his penis and scrotum (yes, it's that long) so that when he poops, it's out of harm's way. Sometimes it holds, sometimes it doesn't.
From your description, it sounds like you are trying to fold it over to keep the poop out, but wouldn't that keep the pee in? And maybe be causing some of the irritation?

And I wouldn't worry about his adult penis size- his penis and foreskin will grow at different rates throughout his growing life.

I would also look seriously at the yeast issue. It can really be insidious. Has he had any antibiotics since his arrival?

I know bf babies poop nearly with every diaper change at that age and imagining taking all his clothes off to bath him 7 times a day (especially in the winter!) seems crazy.....but maybe something else would work to get him cleaned off without manipulating his foreskin? Maybe a peri bottle filled with warm water and GSE and Dr. Bronner's soap to rinse him off with onto a cloth prefold (don't know if you CD) or a towel?

Good luck!
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#18 of 30 Old 03-10-2006, 01:24 AM
 
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folding itlike that seems like it would keep the pee in!! My son's penis at birth, and until probably 6 mos old, was mostly foreskin, we couldn't see any solid penis in there anywhere, but our doctor seemed unconcerned. we never cleaned it through retraction or anything, just outside. Now his foreskin "overhang" at 1 year old is probably an inch to an inch and a quarter. He's never had a UTI. I agree witht he PP's who said take him to a ped urologist, sounds like kidney reflux to me. Oh, and stop retracting him, you're probably just making it more irritated.

as far as the yeast, try grapefruit seed extract at every diaper change, it will work in a day or two.

hth

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#19 of 30 Old 03-10-2006, 02:51 AM
 
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my ds has a inch of overhang if not more never measured it but it is long. What I have always done if he has a messy poo and it gets on there is simply wipe it off as good as I can by starting at the base of his penis and kinda stretching the skin toward me very gently I know this dosnt hurt cause the little bugger can about stretch it out hisself to his almost belly button.

It is impossible to know how much retraction or pulling back (both mean the same thing) is to much. A babies skin is a thin as paper and it can cause microscopic tears that are allowing bacteria in contributing to the yeast. I would definatly stop the rolling it under as this dosnt allow the urine to pass as freely as it should and clean out whatever might have gotten in there. The tip of the forskin has a spencter and this usually stays kinda tight unless they are peeing. That keeps everything out.

Urine is steril as it leaves the body and it will wash out any left over poo that may be in there.

Stop any and all cleaning by pulling back any on the foreskin. Do like I described above for awhile and see if that dosnt help a little. With the yeast I would do nystaten(yeast cream) to get it under control. Give it a week or so and you should see a improvment.

He definatly needs to be tested for kidney reflux if he has had 2 UTI's already. I know it is an invasive test but in this case I think it is warented. Just be 100% sure if u have it done he is not retracted. It can be done by the dr either just fishing for the uriter opening.

Also have the ped do a swab of the tip of his foreskin and see if anything grows he may have a bacterial infection instead of yeast. And the only way to know for sure is to see what grows with the swab. This is done by swabing the very tip of the foreskin with a q-tip like thing. NO pulling back is needed and should not be done.

Pulling back on the foreskin even a tiny bit fits the definition of retraction. It just should NEVER be done.

 
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#20 of 30 Old 03-10-2006, 04:16 AM
 
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so sorry he has had 2 UTI's so far

infants grow out of the tendancy to get UTI's because as their tubes grow longer it reduces the chance of bacteria to work its way up

with 2 UTI's so far it may be wise to talk to a urologist. Be warned that he or she may advise circumcision - my sister's son's urologist advised this and now they are so glad that they said no way If you choose to have any tests please look into the things you can do to ease the discomfort. Definitely do not let anyone retract. I believe that these tests involve the use of a catheter, and that can introduce bacteria into the urinary tract!

then later a doctor confided that a foreskin had nothing to do with UTI's but that getting bacteria up there did!

swish swish swish

and my sister did start EC and her son did not get another UTI

probiotics

that's all for now
Good Night and Good Luck
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#21 of 30 Old 03-10-2006, 05:24 AM
 
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If I had recurrent infections I'd treat myself for it. Naturally would be preferred. Have you added anything to his diet for the prevention of infections, like a probiotic?

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#22 of 30 Old 03-10-2006, 12:39 PM - Thread Starter
 
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Thanks for all the advice guys!
We live out in the boonies, big time. But I did call his pediatrician as soon as they opened this morning and she referred him to a urologist. It's 45 minutes away, but he's seeing him on the 16th. I'm glad he could get him in so fast.
I never thought about the urine getting caught up in there. Boy am I an idiot! Although he seems to pee just fine.
Okay, I'll try not cleaning it out. Do you think putting a piece of guaze or something similar over his penis will protect it a bit more from getting poo in it, or would it make things worse?
I hope the urologist doesn't recommend circ. We won't do it regardless, but it would just be easier not to have to fight that battle!
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#23 of 30 Old 03-10-2006, 06:33 PM
 
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I hope you can find a solution to the infections but just to add apoint about 'long foreskins'

My MIL didn't like the 'overhang' of my dh's foreskin as a PREM 27 weeker back in 1973 so she had him 'tidied up' (her words).

Well his frenulum is intact and he still has a good amount of foreskin but guess what it doesn't cover the end of his penis unerect. Duh.
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#24 of 30 Old 03-10-2006, 08:03 PM
 
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Oh, I wanted to mention the possibility that the 2nd UTI may have been the first one that never really went away completely. Was your son tested to see what the bacteria was and given a medication specifically meant to treat that? If not then maybe he has really only had one UTI, and a relapse. This may be something to discuss with the urologist. A urologist may be test happy and I encourage you to do all the information gathering you can and you be the one to decide what the next best step is.

Also know that it is not necesary to catch a urine sample by catheter to be tested. A sample can be collected by wiping baby down, nursing, and catching the next pee which is usually pretty quick, in a sterile cup. In some instances a catch by catheter may be the best choice. Definitely ask them to think outside the box.
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#25 of 30 Old 03-10-2006, 08:19 PM
 
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Originally Posted by TwoSets
Thanks for all the advice guys!
We live out in the boonies, big time. But I did call his pediatrician as soon as they opened this morning and she referred him to a urologist. It's 45 minutes away, but he's seeing him on the 16th. I'm glad he could get him in so fast.
I never thought about the urine getting caught up in there. Boy am I an idiot! Although he seems to pee just fine.
Okay, I'll try not cleaning it out. Do you think putting a piece of guaze or something similar over his penis will protect it a bit more from getting poo in it, or would it make things worse?
I hope the urologist doesn't recommend circ. We won't do it regardless, but it would just be easier not to have to fight that battle!

Glad he could be seen so soon. Just be very vigalent and dont allow the urologis to retract. I wouldnt put anything over his penis to try to catch the poo it could hold bacteria close to the skin. Just wipe it off like you would a finger from base to tip and that will get all the poo out that needs to be gotten out. If any is left (dont think there will be since the sphincter wont let any truly inside there) the next time he goes pee it will wash it out. The foreskin is naturaly designed to keep things OUT. After all men survived thousands of years with a foreskin. I would print out this to take with you: Intact Care Agreement so that the urologist will know u are serious about protecting your little guy. To many here have came back from the urologist with stories of how the dr tried to retract and recommended circ : I hope you get a foreskin friendly one.

 
SAHMlady.gifread.giflovin' trekkie.giffan intactivist.gifwinner.jpg to loveeyes.gifenergy.gifDD 10/00 & superhero.gifmoon.gifDS 10/04 ribbonpb.gifIf your ds is intact, keep him safe, visit the Case Against Circ forumnocirc.gifCirc, a personal choice, Your sonsyes.gifbrokenheart.gif11/98brokenheart.gif6/99ribbonbrown.gifanti-tobaccoribbonyellow.gifThyroid cancer survivor. With cat.gif& goldfish.gif & (Boxer)dog2.gif wishing 4 whale.gif&ribbonwhite.gifsigncirc1.gifselectivevax.gifdelayedvax.gif

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#26 of 30 Old 03-11-2006, 12:40 AM
 
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Just another thought here. In that pic someone posted above, the foreskin looks really flat and loose. My ds's have all had foreskins that long, but they are "puffy." THey don't get that loose flat look until they're retractile, ime. I'm wondering if he is in fact one of the rare babes who was born retractile or became so at a very young age.

Even if that's true, I don't think he would need invasive cleaning. ANd it certainly wouldn't cause UTI's!

My ds2 had mild kidney reflux when he was born. It was found via U/S before he was even born. He had a very mild case, grade 1 unilateral. Caused by a small kink in his ureter. He outgrew it w/ no treatment. He never got a UTI from it. Your ds may very well have a slightly worse case and while he is likely to outgrow it, at least somewhat, he may need treatment until then. I think the standard is prophylactic antibiotics for a few months to see if it gets better, then surgery if it doesn't. Just some thoughts.
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#27 of 30 Old 03-11-2006, 12:42 AM
 
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Oh, and be VERY vigiant if he needs to have a cath! The nurse tried 3 times to retract ds and I had to physically remove her hand all 3 times! Unreal! And then she had the nerve to tell me that if I didn't start retracting to clean he'd get get all sorts of infections. That and I'd be sorry I didn't circ and that the medical establishment goes back and forth in recommending it when I told her it was no longer recommended.
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#28 of 30 Old 03-11-2006, 05:31 AM
 
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TwoSets, How wonderful that you have been blessed with twins twice!

The long foreskin is something that you have no need to worry about. Babies have big heads compared to their body size but their body grows faster than their heads. Think what we would look like if our bodies didn't grow faster! Same with a penis and foreskin. Your son's penis will catch up with the foreskin later. Trying to get it shortened now could definitely cause problems later.

I suspect that your son has been getting antibiotics for the UTUs and that is probably the reason for the yeast infections. Yeast infections are common after antibiotics and when the antibiotics end, the yeast infections will too.

I'm surprised your doctor hasn't recommended any tests after two UTIs. Usually after the second, they will recommend ultrasound tests. But on the other hand, at your son's age, UTIs are pretty common and very young children usually outgrow them. UTIs are especially common in premies if that's the case with your son.

I understand what you are doing with cleaning. With your son's foreskin, the preputial sphincter is well inboard from the tip of the foreskin and you're just pulling back to the preputial sphincter. As long as you don't force the preputial sphincter at all, I see no harm in this. Just be very cognizant of any indication of pain. Usually, anything that gets into the tip is just in the tip and urine will usually flush it out. Just be very careful!




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#29 of 30 Old 03-11-2006, 10:33 PM
 
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Quote:
Originally Posted by TwoSets
Oh Levi's is longer than that. I would say it's probably a little over an inch when flacid.
That's not long. My 18 month old's is at least that long.

~Nay

Reneé, 34 year old mom to Antonin 8/04 and Arianna 9/06  (6 weeks) 5/08. Married to Matt since 6/03 .  
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#30 of 30 Old 03-12-2006, 01:15 AM
 
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Twosets,
I don't have any great advice for you, but I just wanted to lend you some support in whatever decision you make. I have 3 1/2 year old twin boys - one born with mild hypospadius and one not. We chose to repair Oscar's hypospadius with the foreskin even though it was not a medical necessity - not an easy decision. If I were you, I certainly wouldn't waste a moment of guilt feelings on a moderate hypospadius repair! And Henry has a pretty long intace foreskin. I need to read through this forum a little more carefully and educate myself on retraction issues, etc. - it seems that there are many knowledgable women here. I hope Levi's infection issues are resolved quickly, and hang in there woman - two sets of twins - shoo!

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