2nd UTI in intact son - Mothering Forums

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Old 10-30-2007, 12:26 PM - Thread Starter
 
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Hi all.

My 4 month old son Alex was diagnosed with his 2nd UTI. I asked the doc to get a urine sample due to a very foul smelling diaper. There was also a pea-sized yellowish discharge on his diaper where is penis is. He did not have a fever and was not acting sick. But, I've dealt with a lot of UTI's in my past and know the smell. Plus, he had his first UTI in August 2007.

Doc got the lab back and there was 'moderate' white blood cells so she prescribed bactrim. She's sending the sample off for a culture - we'll get that back in a few days.

I'd like to know what might be causing this. He's had the voiding-cystogram and an ultrasound, both came back inconclusive. Doc says that when other risk factors have been ruled out that it could be the fact that my son is intact and that a circ may be necessary if he has a 3rd infection.

When I bathe him I wash his penis really good...I wipe his penis when changing his diaper...is this right, or not? Of course he is breastfed, which I thought was suppose to ward off infections, like UTI. I'm confused and sad b/c I don't want my son to be sick and I don't want to have to get him cut.

Is there a good resource for keeping baby boys clean enough be clean but not to harm him or to do something that would allow bacteria inside? Is there something I'm doing wrong or could be doing better? This is a stretch, but could it be something in my breastmilk???

Anyone else have experience?
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Old 10-30-2007, 12:33 PM
 
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When I bathe him I wash his penis really good...I wipe his penis when changing his diaper...is this right, or not? Of course he is breastfed, which I thought was suppose to ward off infections, like UTI. I'm confused and sad b/c I don't want my son to be sick and I don't want to have to get him cut.

When you say you wash his penis...does this include any retraction? Do you pull back his foreskin at all?

If so this could be contributing. It is meant to stay closed to protect from bacteria.

IMHO circ is never called for in preventing UTIs. Would this same doctor be suggesting circumcising a DD if she had had a few UTIs? I don't think so. Why should a boy be any different.

Hope he continues to feel well.

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Old 10-30-2007, 12:35 PM
 
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Are you retracting his foreskin? or just cleaning the outside? are you using soaps?


If you are retracting, that is a no no and can cause infections and tears in the foreskin.

If you aren't but are using a lot of soap, that can also cause problems.

Also, diet is a big thing. I don't know if what you are eating can affect him, but its definitely possible. I know sugars are a big cause of UTI.

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Old 10-30-2007, 12:38 PM
 
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Also, it is important to note that the studies that do claim a Uti protective effect with circumcision only demonstrate this protection for the first year of life. Thus, cutting your son, if you are going by these studies, would not give him the protection this doctor seems to think it will.

Also, cathing can cause UTIs and bad bacteria growth. Use clean catch baggie.

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Old 10-30-2007, 12:41 PM
 
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Sorry for the serial posting, but I would also add that I would personally follow these steps:

1) not allow cathing for urine testing- only clean catch baggie at first. If that is positive, then go on from there for a cath.

2) Possibly think about starting over with a new doctor

3) Ask any doctor that wants to circumcise what their plan of action would be for a girl with your son's problems.

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Old 10-30-2007, 12:44 PM
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Sorry, i don't have the time to read responses now.
are you/doctor/nanny retracting his foreskin by any chance?
This can cause infection as it's like ripping your nail off again and again and again, and at some point it sure will get infected...

have you read this A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378
and this
The Definition of "Retraction" & Why it is BAD
http://www.mothering.com/discussions...d.php?t=575627
yulia.
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Old 10-30-2007, 12:47 PM
 
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"washing his penis really good" might really be hurting him. Many women get irritation and infections from using soap at all on their genitals. Even gentle ones.

While your son is an infant and up until he becomes naturally retractable, his penis is really self cleaning. Scrubbing it kills good bacteria, creating a niche for bad bacteria to take over.

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Old 10-30-2007, 12:55 PM
 
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I'd find a new Dr.
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Old 10-30-2007, 12:57 PM
 
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Yep! Wash it like a finger. No retraction, no cathing.

Have you considered an allergy to your diapers?

Additionally, as a PP stated, girls get UTI's at much higher rates than boys. I will not be trimming my DD's labia majora in order to "prevent" them. I would view this issue with your son as much the same. Only dr's in the US suggest circ to prevent UTI's; it's pretty ridiculous.
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Old 10-30-2007, 12:58 PM
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Yep! Wash it like a finger. No retraction, no cathing.
:

wash/wipe it from outside and from outside ONLY! NEVER RETRACT! it's a HUGE NO-NO...
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Old 10-30-2007, 01:01 PM
 
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all I have ever done is splash my sons penises in the bath a bit and wipe after changing with a clean cloth. No "cleaning really good" needed. Neither of them have ever had a UTI. I think you're being a bit over zealous..
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Old 10-30-2007, 01:03 PM - Thread Starter
 
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Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.
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Old 10-30-2007, 01:06 PM
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Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.
Yes, just like a finger. NEVER EVER EVER EVER retract, NOT EVEN A LITTLE BIT. THAT IS EXACTLY WHAT CAUSES INFECTIONS, SCAR TISSUE GROWTH AND PERMANENT NERVE DAMAGE.

PLEASE READ THIS
have you read this A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378
and this
The Definition of "Retraction" & Why it is BAD
http://www.mothering.com/discussions...d.php?t=575627
yulia.
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Old 10-30-2007, 01:08 PM
 
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Yes, retraction, even just a little, is bad bad bad. The American Academy of Pediatrics clearly states that retraction is not necessary to clean and that is it damaging. Many RNs and docs in the USA are just stuck in old ways and cycles of bad information.

I would definitely cease retracting him. In addition, the soap is probably hurting him. I know that some women and men can handle soap on their genitals, but many cannot. Just like some little kids can handle bubble baths and others get genital irritation from them.

I would follow your son's lead. Right now he is suffering from some kind of bacteria growth. While the RN's child might have not had any problems, it is definitely a big possibility that your son's skin and body are just different....so I would try switching it up a bit. (and def NO on the retraction)

Try some probiotics as well.

Also, use a bag for urine catch-- I can send you a study if you would like that demonstrates that the risk of infection through cathing is too much and that for intact boys, the false readings on bags and caths are nearly equal and should be read the same, and that bags are prefered beucase they are less traumatic and risky.

ill post it here when i find it in my archives real wuick.

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Old 10-30-2007, 01:14 PM - Thread Starter
 
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BTW, he's only been cathed once, when he had the cystogram @ radiology.

We've used the bags for all the urine collections.
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Old 10-30-2007, 01:17 PM
 
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BTW, he's only been cathed once, when he had the cystogram @ radiology.

We've used the bags for all the urine collections.
Excellent! in case you need it anyway, heres the study on bagged caths for intact boys:

http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

Quote:
CONCLUSION: In uncircumcized boys, both CVU and CathU were prone to contamination. Though the contaminating bacterial counts were lower in CathU culture, the false-positive rates were high with the lower cut-off CFUs. Contrary to previous recommendations, CathU should be interpreted similar to CVU to avoid false positive diagnosis of UTI.

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Old 10-30-2007, 01:22 PM
 
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Sorry but your son's urological issues cannot be attributed to the foreskin alone. There is something else at work.

I would suggest switching urologists if his only advice is to circumcise your son.
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Old 10-30-2007, 01:27 PM
 
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Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?
Yep!
FWIW, I didn't know that either when I first came here.
I'm so sorry your having trouble, but there is a lot of good info here. And I, too, would be looking into the possibility of a new dr if he suggested circ for UTI's. THe fact is that there are far better options. Little boys who are circ'd and little girls have UTI trouble, too, and they manage to treat it without cutting off body parts. They can do the same for your son.
Good Luck!

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Old 10-30-2007, 01:35 PM
 
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Yes, I have pulled back his foreskin. But, it doesn't go further than a certain point, and his penis or the head has never been exposed. I have never used force or anything. I always watch his face to see if he looks bothered by it. The RN that cathed my son for the cystogram was a mother of an intact boy and she told me washing with baby soap every day is how she kept her kid clean and he was never sick.


Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.


JUST like a finger.
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Old 10-30-2007, 02:44 PM
 
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Read up on this page:

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

It's entirely possible that his second UTI is really an extension of his first; those tricky little buggers hole up inside the body and it's VERY hard to get rid of them with abx. I would definitely work on getting lots of good probiotics into him.

But your doc is completely out to lunch on the circ thing. Stop retracting, stop using soap every day, make sure the flora get back into balance, and treat any UTIs just as you would with a girl.

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Old 10-30-2007, 03:08 PM
 
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My kids are very sensitive to soap. So all I ever do to my son is rinse him off in the shower and wipe it with a wet washcloth after a blowout. I've never retracted either, just wiped it off. The only time we've ever had a problem was the time my DH used soap in the bath.
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Old 10-30-2007, 03:39 PM
 
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I'm going to ditto what everyone else is saying here - DO NOT retract his foreskin!!! My son is 4 1/2 and I have never retracted his foreskin. The only "problem" he ever had was a year or so ago he had some pain when urinating. It ended up being the separation process and it was causing some stinging when he went. He has also had redness on his foreskin a few times, but I have found that A&D ointment clears it up in about a day or so. Please consider finding a foreskin-friendly urologist if his doctor mentions circumcision again.

Here is a quote out of What Your Doctor May NOT Tell You About Circumcision (great book - I highly recommend you purchasing it):
"Regardless of circumcision status, infants who present with their first UTI at 6 months or less are likely to have an underlying GU (genitourinary) abnormality. In the remaining patients with normal underlying anatomy and UTI we found as many circumcised infants as those who retained their foreskins." In other words, medical research has proven that UTIs are usually caused by internal congenital deformities of the urinary tract. Cutting off his foreskin is not going to correct this problem. Please buy this book!!! It will answer ALL of your questions!

I would ask the doctor about the possibility of a GU abnormality if this happens again. But...start with leaving his foreskin ALONE. No soap necessary. If he gets poop on it, wipe it with a warm wet washcloth. The harsh wipes and soaps are not good for him.
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Old 10-30-2007, 03:40 PM
 
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By the way....use the ORIGINAL A&D ointment for any diaper rash, not the zinc kind. The Original works much better.
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Old 10-30-2007, 03:48 PM
 
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As all the PPs have mentioned it sounds like you are washing too aggressively.

I'd like to add that it sounds like you have problemes with recurrent UTIs yourself. I would suspect the problem is genetic. How are you treating your UTIs? If it is working for you then that would be the most logical course of treatment for your DS.

Also what you describe sounds more like a yeast infection than a UTI. Has either UTI be confirmed? Have you tried an over the counter yeast treatment? Treating for bacteria can make yeast worse.

I also wanted to ask if he takes bubble baths? Bubble baths can also cause infection.

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Old 10-30-2007, 05:22 PM
 
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What type of diapers/detergents/etc do you use? My dd had several UTI's w/in a few month period. Couldn't figure out WHAT was causing them...VCUG showed up clear, etc... We switched to cloth and NO problems since. If you're using cloth, perhaps it's the detergent?! {HUGS} to you and to him!
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Old 10-30-2007, 05:40 PM
 
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#1 any dr that recommends circ for a UTI is not up to date on their research. There are no links between being intact and UTI. Only flawed studies.

#2 By pushing the foreskin back even a tiny bit you are making it possible for bacteria to get under there and cause problems. NO MORE PUSHING IT BACK EVEN A TINY BIT.

#3 Soap can cause UTI in woman and men because it kills off good bacteria. If you must use soap do so sparingly and make 100% sure you rinse him off with pure water.

 
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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Old 10-30-2007, 05:43 PM
 
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#1 any dr that recommends circ for a UTI is not up to date on their research. There are no links between being intact and UTI. Only flawed studies.

#2 By pushing the foreskin back even a tiny bit you are making it possible for bacteria to get under there and cause problems. NO MORE PUSHING IT BACK EVEN A TINY BIT.

#3 Soap can cause UTI in woman and men because it kills off good bacteria. If you must use soap do so sparingly and make 100% sure you rinse him off with pure water.
Yes to all above!!! And point #3...rinse under running water. Don't just wipe with a wet washcloth if you have used soap. Actually let running water flow over the foreskin to really rinse the soap off. You can use a large cup of water and pour it over your son while he is in his bathtub.
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Old 10-30-2007, 05:46 PM
 
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Please read the stickies at the top of the main CAC page. A Warning To Parents of Intact Sons and The Definition of Retraction & Why it is BAD!!!

 
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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Old 10-30-2007, 06:02 PM
 
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Originally Posted by Elisesmommy View Post

Are you all saying I should just wash his penis like I would his finger and just wipe it with a washcloth and do not push, even slightly, his skin back?

There are no intact boys/men in my family and social network, so this is all so new! I'll read up on the links that were posted.
yes, that's the way to go.

The studies on UTI and circ are really awful - I've read them and they do things like compare forcibly retracted intact preemies to circumcised full-term babies. They also mostly ignore breasfeeding status. There is no strong evidence either way.
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Old 10-30-2007, 07:43 PM
 
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Hey - you'll always get lots of advice from everyone here at CAC! I hope you aren't feeling too overwhelmed...lots of very good advice from the previous posters.

When I was younger, I had TONS of UTIs - so many, in fact, that I was admitted to hospital for 'exploratory surgery' to see if I had some kind of structural abnormality.

I didn't - 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.

I do remember, though, that I was never allowed to use bubble bath, as that would always trigger another UTI. I know with my intact son, All I ever get him to do is swish his penis around in the bath (he's 4 years old now) - he's never had any problems. When he was an infant, I just wiped it down like a finger after big blow-out diapers, and that was it.

I would second (or third) the recommendation to get a new doctor. Or at the very least, tell your current doctor that (as someone else posted), he/she needs to treat your son in the same way he would treat a girl who presented with a second (or third) UTI.

Good luck...I hope you can get this cleared up sooner rather than later.
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