Help for intact son's appt w/pediatric urologist today? - Mothering Forums

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#1 of 21 Old 06-21-2007, 12:53 PM - Thread Starter
 
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I don't even know if this is the right place to post this, and while I've lurked for a while, I've never even posted before. But here's the thing - my 2-year-old son has blood/phlegm stuff coming out of his penis (how's that for blunt?). He was moaning about having to urinate and would wince and cry and then sigh with relief and when I checked his diaper, looked like a bloody snot. Yowzah! I took him to Urgent Care last night, and they set up an appointment with a Pediatric Urologist since his white blood count was ok (despite throwing up and looking like he was going to pass out) and the doctor admitted to not being experienced with an intact boy. I've been lucky that my ped has said she doesn't have a reason to touch his penis, but I think the urgent care doctor started to retract him. I've been reading here, and if you even see the tip of the head, that means he retracted him, right? Ack! When I started to say something about not retracting him, he backed off and that's when the P.U. came up (he suspected a skin infection besides a bladder infection - under the foreskin?). So now I'm going to see this guy today, who the Urgent Care doctor said has WAY more experience with intact boys than he did. But I just wanted to know if there were any articles or information I could print out to take with me. I know, generally, the stuff I need to know. But I don't have any documentation, other than my own instincts (which, when it comes to my son's penis, start to feel really inadequate).

Side note - he is usually cloth diapered but last week we went to a family reunion and we disposabled him all week. Could that cause an infection?
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#2 of 21 Old 06-21-2007, 01:20 PM
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most important make sure you read this http://www.mothering.com/discussions...d.php?t=129378
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#3 of 21 Old 06-21-2007, 01:27 PM
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I hope you’ll get a response from more knowledgeable ladies than I am. But I just wanted to advise to avoid catheterization at any cost. They can take a urine sample by attaching a bad to his penis. If you do end up needing to cath make sure you make it VERY clear that you son isn’t to be retracted at all (and say it like you REALLY mean it). Watch closely. If they can’t do it otherwise, find somebody who can, even if you need to go to the hospital so an experienced NICU nurse (they usually have more experience with intact penises) can do the cath-ing.
yulia.
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#4 of 21 Old 06-21-2007, 01:42 PM
 
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From what I've read on here make sure they do a culture for infection and do not let them retract him. I wish I had more info for you! Good luck!

OUR DAUGHTERS ARE PROTECTED SHOULDN'T OUR SONS BE TOO! :
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#5 of 21 Old 06-21-2007, 02:10 PM - Thread Starter
 
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Originally Posted by Yulia_R View Post
Watch closely. If they can’t do it otherwise, find somebody who can, even if you need to go to the hospital so an experienced NICU nurse (they usually have more experience with intact penises) can do the cath-ing.
yulia.
thank you for that info. And I had read that post before (thank you!) and I guess I'm just a little slow - I wasn't sure if retracting meant the whole head or just the tip (though what I get from that post is that even seeing the tip is retraction). Just got another call from the doctor - he had an abnormal BUN result - protein in his urine. She said it could be just because of his UTI, but it could be more. I'm supposed to tell the PU and have him request the results. I want to avoid catheterization - they sent me home with a bag last night and I have the sample for them.

Gah - penises are so complicated! (though I guess I'll be singing a different tune when my daughter hits puberty?)
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#6 of 21 Old 06-21-2007, 04:39 PM
 
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Side note - he is usually cloth diapered but last week we went to a family reunion and we disposabled him all week. Could that cause an infection?
If your son is sensitive/allergic to the chemicals in disposables, he could very well have become irritated and developed an infection from the irritation. I would be investigating this aspect closely as a cause for your son's penile ailments.

Cindy

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#7 of 21 Old 06-21-2007, 04:57 PM
 
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If you read the Definition of retraction sticky you will see what he did was indeed retraction

The first thing that should be done is a culture to see what grows it is probably a bacterial infection. A culture is very simple it is like the swab they do on your throat for strep. NO RETRCTION not even a tiny bit. If it is a infection it can cause it to spread.

I hope the PU isnt cut happy and will do what needs to be done. Please update when you get home.

 
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#8 of 21 Old 06-21-2007, 06:24 PM
 
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I've noticed that often when someone is posting here about an infection they had recently been out of town, so I would tend to think it is related.

Timmy's Mommy WARNINGyslexic typing with help of preschooler, beware of typos
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#9 of 21 Old 06-21-2007, 06:37 PM
 
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Yea maybe it has to do with sitting for longer in a wet diaper. The way a car seat fits would definatly rub things badly.

 
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#10 of 21 Old 06-21-2007, 07:52 PM - Thread Starter
 
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Crap. Crapcrapcrap. I wish I had had time to read this before I went. He did not do a culture. He examined him (rubbed his belly) and then looked at his penis. And I think HE retracted him too (although my son just laid there like nothing wasa bothering him). At least, he manipulated the foreskin enough to tell me that his opening is extremely small (he said something about it being 2 points) and being a reason the infection occurred. I said I had read on AAP that intact boys are NOT more likely to have UTIs and he said, 'Well, this is true. But his opening is significantly smaller, which could cause a problem.' He said it could continue to be a problem and that they might recommend circumcision and at that point I very clearly said I did NOT want my son circ'd. He said that it was my choice, and that we'd see how he did on the abx.

I'm trying to think what else he said/did. I did ask him what his general position on circumcision is and he said he thought it was appropriate for medical reasons or religious ones. But "medical reasons" is pretty vague, no?

As it stands, I'm supposed to return with my son in a week with a fresh urine sample so they can see if the kidneys have returned to normal function.

My gut feeling is that this is UTI, possibly caused by the disposable diapers, and equally possibly caused by his absence of routine bathing during that week (husband thought son had showered with me, and vice versa, while all the while he was, apparently, playing with cousins). While his comments about the small opening give me pause, I wonder if it's just something that will naturally enlarge, as I was under the impression. My other gut feeling was that I wasn't comfortable with this doctor - it felt like he was rushing me. And I hate that I am wondering if this "specialist" retracted him. Gah!
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#11 of 21 Old 06-21-2007, 08:26 PM
 
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The opening size is fine as long as urine can come out of it :

The opening of the foreskin is a sphincter like the anus is when it is not in use it closes down to prevent stuff from getting in there and when urine comes out it relaxes.

This Dr. is one that is not up to date What is the name of the abx he gave you?

If the Dr. pushed your ds's foreskin back any at all toward the body he did indeed retract.

 
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#12 of 21 Old 06-21-2007, 08:31 PM - Thread Starter
 
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What is the name of the abx he gave you?
It was actually the first doctor who gave us Keflex (?) for the UTI.

When he first mentioned the small opening and said something about how it forces more prepulsion (or something?) I said, "Oh, so, like, he's gonna get distance when he aims for something?" And he said, "Uh...well...yeah, but it could also cause back-up blah blah blah." Dude, I was kind of joking around here. I'm looking for the POSITIVE. Lemons to lemonade, eh?

And he does urinate just fine. I'm going to let him run around sans diaper this week and see if I can see him actually urinate. And if he seems to have an unusual turbo stream. I doubt it.

BTW, thank you so very much for holding my hand today. This is stressful!
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#13 of 21 Old 06-21-2007, 08:36 PM - Thread Starter
 
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If the Dr. pushed your ds's foreskin back any at all toward the body he did indeed retract.
Damn. And what about pulling the skin away from the body? Like aso the reverse of retraction? Geez, I feel like my son was violated. And I was right THERE.
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#14 of 21 Old 06-21-2007, 08:37 PM
 
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Keflex is what the Dr gave me for ds when he had the bacterial infection. Yes it is very stressful I never thought it would happen to ds since it is kinda a rare thing.

I am 99% sure ds's was caused by him sticking a dirty finger in there He had been outside playing and I brought him in to change a poopy diaper and he had just started to stick his finger in there rather than just pulling on it and I hadnt washed his hands. : within 12 hours he was swelling up and in pain and by the next day his poor penis and foreskin was swollen to 3 times the normal size

 
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#15 of 21 Old 06-21-2007, 08:39 PM
 
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Pulling out is fine since that is what they generally do anyway. It actually helps the seperation process along the pulling and tugging. As they get older they will push it back on their own but in that case it is fine since they know when to stop. And even then they do sometimes cause a bit of damage but usually once that happens they know not to do that again.

 
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#16 of 21 Old 06-22-2007, 12:41 AM
 
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The opening size is fine as long as urine can come out of it :

The opening of the foreskin is a sphincter like the anus is when it is not in use it closes down to prevent stuff from getting in there and when urine comes out it relaxes.
In observing my son when I see him pee, it it so obvious that this shincter thing is happening. Do doctors really not know that this happens? HOw could they not know this??? It is actually cool to see how it functions. and such a well designed system, I cant see why anyone wants to mess with it. I hope your ds feels better, op.
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#17 of 21 Old 06-22-2007, 12:50 AM - Thread Starter
 
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Yeah, the more I think about it, the more it seems obvious (to me). I've been reading about Phimosis this evening since that was the word he threw out there and from what I'm reading, and the images I've seen (I feel kind of weird looking at baby penises - it's research!), my son does NOT have this. I'm wavering between relief that I know circ won't be an issue, and fury over how this guy was spouting incorrect info. And I have to PAY him. (well, insurance will. hopefully)

Thanks, all for your help and encouragement. It's nice to go somewhere I don't have to give explanations for why I didn't choose circ. Or why I cd. Or..Or...etc.
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#18 of 21 Old 06-22-2007, 01:10 AM
 
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I forgot to you earlier It is great to have new members especially ones that are proactive on the care of their children.

There are 2 different types of phimosis the first is 100% normal boys are born with it and grow out of it as they age. The second type is caused from trauma of one sort or the other like repeat forced retraction or repeat untreated infections. The tip of the tip of the foreskin becomes so scared that it cannot stretch out at all.

http://www.cirp.org/library/normal/ If you havnt found this yet it is a good one on the types of phimosis and what they mean. This one as well http://www.norm-uk.org/circumcision_...reatments.html

 
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#19 of 21 Old 06-22-2007, 12:09 PM - Thread Starter
 
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Thanks for the welcome! And thanks for the articles. I have the first one bookmarked, but the second one was new to me. I really doubt he has had any trauma to it, since there was only one other time that a doctor started to retract him and I practically yelled, "WHAT ARE YOU DOING?!" The man sounded incredulous as he replied, "I'm a doctor!" And I replied, "I don't CARE!" He backed off and started spouting some old-school crap and I was spouting as much current info as I knew at that time (not much). But the thing that really ticked me off was that he had a medical resident in there with him. He was TEACHING her false stuff. While he wasn't my son's regular doctor, I abandoned the practice after that. Now I have a v.nice "I don't have a reason to touch his penis" doctor.
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#20 of 21 Old 06-22-2007, 12:15 PM
 
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Hey Francesca I just wanted to throw out a welcome to you as well!

Good for you for standing up to that Doctor. Your son is lucky to have you.

If a Doctor ever tries to tell you that being circumcised would be easier, cleaner etc make sure you read the stories in my siggy to find out why that isn't true.
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#21 of 21 Old 06-22-2007, 12:41 PM - Thread Starter
 
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OMG your stories horrify me. Ugh. I am so sorry. Hugs to you. *shudder* Thank you for being so open and honest with your stories.
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