2nd UTI in intact son - Page 2 - Mothering Forums
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The Case Against Circumcision > 2nd UTI in intact son
myfairbabies's Avatar myfairbabies 07:55 PM 10-30-2007
Quote:
Originally Posted by Mommiska View Post
I was just very prone to UTIs as a young child. This was something I eventually outgrew - probably by around 8-9 years old, I think.
Me too, and I never had any parts cut off me. Please, do not listen to this doctor, he has no clue what he's talking about. I've heard of people circing their sons after many infections, to find that they don't go away at all, or even get worse. I hope you son gets better soon!

momto3boys's Avatar momto3boys 03:40 PM 10-31-2007
I dont even let the boys sit in the bath after I've washed their hair. They play in clear water to soak then I wash them with a wash cloth on their hair and face and then they exit immediately. I ABSOLUTELY can't even sit in a bubble bath without getting an irritated urethra.

if its any consolation my circ'd son would get UTI's. You know why? Soap and chlorine from the pool would irritate the tip of his penis at the meatus. He would cry when he peed because it stung so bad. He's 12 and still has to put diaper ointment on the tip before swim practice.

Just try a good soak, wash the bum with mild soap and rinse really well but always leave his penis alone. Just a rinse is all thats needed.
mrsfrazier's Avatar mrsfrazier 04:01 PM 11-05-2007
Any recommendations for me?

My son is in the same boat as the OP, on his second UTI by 4 mos, only he has never been even slightly retracted!
Golden's Avatar Golden 04:46 PM 11-05-2007
Have you (both the OP and MrsF) done any testing for kidney reflux? My son was born with mod/severe hydronephrosis (detected from way too many ultrasounds prenatally for something else). He did the voiding test- that's the one where they cath him to fill his bladder, take it out and take imaging of the void, right?

Have they done any other kidney tests? If he is refluxing, that is your answer. My son was on prophylatic abx for the first couple of months til all the testing was done. Although he has hydronephrosis, thankfully it was not refluxing back to the kidneys. And he's never had a UTI.

And even with his history, or should I say especially because of his history, I have never restracted his penis (even for the caths for testing, he wasn't retracted - I can give you more info on how they did this) nor used soap. He bathes on average 1-2x a week. When he was wearing cloth diapers, and then eventually disposable diapers, I always just used water with a tiny squirt of Dr Bronners soap as wipe solution and cloth wipes to wipe to clean off the poop.

Forgot to add: he's also been on probiotics since birth too...
carriebft's Avatar carriebft 05:13 PM 11-05-2007
Quote:
Originally Posted by mrsfrazier View Post
Any recommendations for me?

My son is in the same boat as the OP, on his second UTI by 4 mos, only he has never been even slightly retracted!
These pop into my head:

1) Make sure you are really dealing with UTI (too many people have come here and told us that the UTI wasn't confirmed)

2) Eliminate soaps on the genitals

3) Probiotics (so many have had good results with these, hopefully someone will post about the right way to administer to a 4 month old)

4) testing for reflux, find the underlying cause

5) Possibly also diapers causing irritation or pesky bacteria still in them-- maybe strip diapers if you are using cloth
2crazykids's Avatar 2crazykids 05:38 PM 11-05-2007
For both posters with UTI problems:

1. My son is intact and I never, ever washed the inside of his foreskin and he has never had an UTI. I have always used natural, organic soap and just washed around the penis never, ever going inside.

2. I would make sure he always ate lots of yogurt during the day so that he had lots of good bacteria going on in his body.

3. Cranberry(the all-natural kind with no added sugar or artificail sweeteners) juice mixed with a little apple juice may help with the UTI's w/out need for anti-biotics.

4. Look at your children's diet and see if they are getting too much sugar, which could lead to yeast and bad bacterial growth.

5. To the OP, I wonder if what you are smelling in the dipe is a yeast infection...those tend to smell pretty bad and if there's discharge that may indeed be the culprit.

6. If they are getting antibiotics for these "infections" it may only be exacerbating the underlying issues.

7. If yeast is suspected wash everything that touches babes in hot water with vinegar...it is so hard to kill. and start a flora regimen asap!

8. Finally: NO NEED TO CIRC!!! Your ped is using old, bad, outdated info if that is the scenario he/she is proposing! DO NOT LET YOUR CHILD BE CIRCED!
MCatLvrMom2A&X's Avatar MCatLvrMom2A&X 07:45 PM 11-05-2007
In a child under a year who has 1 or more UTI the first thing that should be checked for is urinary reflux. It is a test called a VCUG were dye is put in via a cathiter and looked at to make sure that when the dye runes back out it dosnt "reflux" back into the kidneys. It is important to find this condition as early as possible to prevent kidney damage.

Most of the time kids with this will have to be on long term abx and they may or may not need surgery to correct it depending on how bad it is. The only caution here is make 100% sure that they do not retract at all to insert any caths.
MCatLvrMom2A&X's Avatar MCatLvrMom2A&X 07:45 PM 11-05-2007
Quote:
Originally Posted by mrsfrazier View Post
Any recommendations for me?

My son is in the same boat as the OP, on his second UTI by 4 mos, only he has never been even slightly retracted!
How were the UTI's diagnosed?
Golden's Avatar Golden 08:25 PM 11-05-2007
[QUOTE=MCatLvrMom2A&X;9640775]
It is a test called a VCUG were dye is put in via a cathiter and looked at to make QUOTE]

Oh yes, the VCUG! That's what I meant. Then there is the MAG3 that checks for kidney function - they inject something to watch the rate of filatration through the kidneys.
mamaverdi's Avatar mamaverdi 12:23 AM 11-06-2007
Actually an u/s (ultrasound) should be done before a VCUG. If an obstruction is suspected (one must ask), then urology needs to be called for special catheters etc in order to do the VCUG.

My question for the OP is, why were the tests inconclusive? That sounds like you need a second opinion. Copies of the tests can be obtained from medical records on CD so that they can be taken to another ped urologist.

While many ped urologists still recommend circ for UTIs, many of the same lot are willing to work with you and NOT circ. Depending upon your area of the world, you may not have the option to see someone else (there may only be one ped uro), so knowing that if you adopt the surgeon attitude with them they are usually compliant with your wishes is helpful.

Also, it sounds like you consulted perhaps a regular uro instead of a ped uro. Ped uro is needed for cases of infant UTIs.
jenP's Avatar jenP 02:50 AM 11-06-2007
Quote:
Originally Posted by carriebft View Post

3) Probiotics (so many have had good results with these, hopefully someone will post about the right way to administer to a 4 month old)
I used Udo's Children's probiotics in capsules. Opened the capsule and put some of the powder on my nipple before baby nursed. Also sprinkled some on his penis once or twice a day.

Don't stess too much about aggressive cleansing having caused it. While, as you've learned here, ANY amount of retraction is bad and soap ain't so great, the fact that you did retract a little to clean doesn't therefore mean you caused a UTI. I never retracted my son and he got a UTI, and I've seen several other posters say the same. So who knows, maybe your son would have gotten one anyway. Don't beat yourself up on that count. Any baby can get a UTI, after all, they do poop their pants. (except those that use exclusive EC.)

Sounds like a good idea to confirm that it IS a UTI and if so, exactly which bacteria it is and which antibiotic to use.

Good luck!

Jen
mrsfrazier's Avatar mrsfrazier 06:27 PM 11-06-2007
Quote:
Originally Posted by carriebft View Post
These pop into my head:

1) Make sure you are really dealing with UTI (too many people have come here and told us that the UTI wasn't confirmed)


Yep def confirmed. He's had to extended hospital stays, and one infection turned into sepsis!!

2) Eliminate soaps on the genitals

Never used soap--DH is not circ'd so we know all about proper care...

3) Probiotics (so many have had good results with these, hopefully someone will post about the right way to administer to a 4 month old)

We do that...

4) testing for reflux, find the underlying cause
Found out he has grade 1 reflux, but still they are recommending circumcision...and this is at a major teaching hospital! Mainly we are concerned about the longterm effects of keeping him on antibiotics for the first year of his life, and the disrespect we are getting from everyone about him being intact. Every Doc we see acts like he's "dirty".

5) Possibly also diapers causing irritation or pesky bacteria still in them-- maybe strip diapers if you are using cloth
I will look into stripping his diapers....
Thanks for the advice!
Papai's Avatar Papai 06:54 PM 11-06-2007
mrsfrazier,

If your son has been diagnosed with reflux what on earth will circ do for him? :

These doctors are sick in the head.
MCatLvrMom2A&X's Avatar MCatLvrMom2A&X 07:22 PM 11-06-2007
: reflux is on the inside and has nothing to do with the foreskin. Actually the foreskin is there to keep things out so removing it will let things in that would not normally get in there. That is why it is so important to not retract because it allows bacteria in.

Personally I would tell the Dr. in no uncertain terms that you will not consider circ and it is no longer up for discussion.

If you can you need to find a new dr as well one who actually knows what the foreskin is for and how useful it is.

I have heard on this board many times that childrens hospitals are the worst when it comes to foreskin care they seem to want to circ first and ask questions later.

As for others giving you a hard time about your son having all his parts tell them to stuff it :
Quirky's Avatar Quirky 07:34 PM 11-06-2007
It doesn't sound like these "experts" are up on the latest scientific information.

First, there is no conclusive evidence linking foreskins with greater incidence of UTIs. See here:

http://www.cirp.org/library/disease/UTI/

and here:

http://www.nocirc.org/statements/breastfeeding.php (sidebar)

Second, there was a study that made the news recently that there's no need for long-term abx for reflux.

http://www.nytimes.com/2007/07/17/health/17regi.html

Quote:
Urinary tract infections are fairly common in children, especially girls, and when doctors worry about recurrence, they often prescribe antibiotics preventively.

But the practice not only fails to reduce the risk of reinfection, a new study says, but it also may make it more likely that a new infection will be resistant to drugs.

The findings do not mean that the infections should not be treated with antibiotics, said the senior author of the study, Dr. Ron Keren of The Children’s Hospital of Philadelphia. Untreated infections can lead to serious kidney problems.

“The question is, after you have that first infection, does putting a patient on a daily low dose of antibiotic prevent recurrent urinary tract infections?” Dr. Keren said.

Since the drugs can be given for several years, the researchers said doctors should discuss the pros and cons with families before beginning them. The study appears in the current Journal of the American Medical Association. The lead author is Dr. Patrick H. Conway.

The researchers based their findings on a review of the medical records of more than 70,000 children under age 6 over a period of almost five years. Many of the children had a urine reflux condition that often leads to infection.

The study suggests that a better approach may be to carefully monitor children believed to have a reflux problem for signs of reinfection, and treat as necessary. The reflux problem usually resolves itself after several years.
Here's the study: http://jama.ama-assn.org/cgi/content/abstract/298/2/179

Finally, the doctors obviously have no clue about the structure and function of the foreskin. Would they suggest cutting any part of a girl who had reflux and UTIs? No. Because it's understood that that would be genital mutilation. Why, then, do they assume that removing the foreskin on a boy is harmless and has no long-term effects on sexual feeling and function? Because they're totally ignorant, that's why.

Stay strong. Your son's penis is normal -- it's your doctors who need to get a clue. Challenge them to do the research for themselves.
mamaverdi's Avatar mamaverdi 11:16 PM 11-06-2007
Major teaching hospital does not automatically equal good care.

Did you see a ped urologist? While yes, they can be the worst about the circ issue, they are also the best eyes to look at uro-genital anomalies in babies and children.

It's not as simple as I'm about to say it for some people, but we simply make it clear to our surgeon what we will and won't do.

He respects our decisions.

My son has reflux, though it cannot be captured on testing, it is assumed. He has several urinary tract anomalies, and has had many many infections. He is three.

Because he has had so much exposure to infection and antibiotics, he cannot have antibiotics prophylactically. We treat infections as they come. We have bags and urine dipsticks, and we can test the urine if he starts to become symptomatic. Then we call and get a urine micro and macro, culture, sensitivities, and a call back from our ped. They pick an antibiotic, and usually these things resolve easily.

I am happy to PM with you about different doctors around the US, as I'm assuming that is where you are located. It sounds like you need one who better suits your needs.

I'll say one more thing which hopefully won't be taken the wrong way. It is not necessary to convince the doctor that it is better to be intact. It is necessary to make sure that your doctor will respect your wishes for your child. It is not necessary for the doctor to agree with you. It is necessary for the doctor to follow your advance directives.
shaylahc's Avatar shaylahc 06:49 AM 11-07-2007
This happened to my intact son. He got his first UTI at 5 weeks of age (had to be hospitalized: ) and again about 2 months later. He was tested for reflux (we have another child who had it) and the tests were negative. We saw a wonderful pediatric urologist and he basically said that the increased risk of UTIs for intact males is only greater in the first year of life. After that the rates of UTIs are pretty similar between intact and circ males. HE DID NOT RECOMMEND CIRCUMCISION. He said if my son continued having UTIs that he would put him on prophylactic antibiotics until he turned 1.

My son never had another UTI after that and is 3 now and still intact
mrsfrazier's Avatar mrsfrazier 08:26 PM 11-08-2007
Quote:
Originally Posted by mamaverdi View Post
Major teaching hospital does not automatically equal good care.

There is no other hospital or care within a two hour drive beside PCP's

Did you see a ped urologist? While yes, they can be the worst about the circ issue, they are also the best eyes to look at uro-genital anomalies in babies and children.

We saw a ped nephrologist (kidney dr) we will be travelling to another children's hospital several hours away at the end of the month to visit their pediatric urology dep't

It's not as simple as I'm about to say it for some people, but we simply make it clear to our surgeon what we will and won't do.

Dh and I are 20 years old. I wish this worked for us, but usually our youth means that the dr treats us as though we are irresponsible teen parents who know nothing

He respects our decisions.

My son has reflux, though it cannot be captured on testing, it is assumed. He has several urinary tract anomalies, and has had many many infections. He is three.

Because he has had so much exposure to infection and antibiotics, he cannot have antibiotics prophylactically. We treat infections as they come. We have bags and urine dipsticks, and we can test the urine if he starts to become symptomatic. Then we call and get a urine micro and macro, culture, sensitivities, and a call back from our ped. They pick an antibiotic, and usually these things resolve easily.

This is a good idea. How often do you end up testing? Do they do anything besides a bag test (eg cath/suprapubic) if the bag test comes back positive?

I am happy to PM with you about different doctors around the US, as I'm assuming that is where you are located. It sounds like you need one who better suits your needs.

I'll say one more thing which hopefully won't be taken the wrong way. It is not necessary to convince the doctor that it is better to be intact. It is necessary to make sure that your doctor will respect your wishes for your child. It is not necessary for the doctor to agree with you. It is necessary for the doctor to follow your advance directives.
I am in northern VT, if you know of any good dr's in that area please PM them to me
mrsfrazier's Avatar mrsfrazier 08:28 PM 11-08-2007
Quote:
Originally Posted by shaylahc View Post
This happened to my intact son. He got his first UTI at 5 weeks of age (had to be hospitalized: ) and again about 2 months later. He was tested for reflux (we have another child who had it) and the tests were negative. We saw a wonderful pediatric urologist and he basically said that the increased risk of UTIs for intact males is only greater in the first year of life. After that the rates of UTIs are pretty similar between intact and circ males. HE DID NOT RECOMMEND CIRCUMCISION. He said if my son continued having UTIs that he would put him on prophylactic antibiotics until he turned 1.

My son never had another UTI after that and is 3 now and still intact
That's awesome!!
mamaverdi's Avatar mamaverdi 03:20 AM 11-11-2007
So if you are in VT, you should go to Boston or the NYC. Your best bet is likely Boston. There are some women here in that area.

As for age, I understand what you mean. I look very young. At least I did when this all started. I don't wear a wedding ring because mine is damaged. So I get "the looks."

BUT a good doctor will treat you and your child DESPITE these biases. If they aren't, it is best, if possible to seek other care.

Our uro is the one who told us that basically we need to adopt the surgeon's attitude with the surgeon and other doctors. He stressed to us that we didn't convince others to adopt our opinions. We just needed doctors to understand that we as the parents were the ones who held the red and green lights.

All infections need to be dipped and microscoped and cultured with sensitivities. You can't know anything unless that is being done. All of it. At the same time.

For my son, he's had well over 10 infections. And we've only dealt w/ped uros. This is all what they want done.

Have you had suprapubic aspiration? Really they can use a bag or barring that a cath sample. Suprapubic aspiration should be avoided unless there is an obstruction.

Ped nephs are great. But you need both specialities if you are dealing with true multiple infections.
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