Redundant prepuce, phimosis and phimotic band - Mothering Forums

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#1 of 10 Old 05-23-2012, 05:08 PM - Thread Starter
 
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My little 4 ½  y.old nephew has been diagnosed with the above by child urologists,

My SIL  is very against circumcision (I am as well) and insisted on trying treating it with steroid cream first.  To me that diagnosis sound like a BS diagnosis since non-retractable and long foreskin is normal for children, at least all articles say to leave it alone unless there is a problem. I think that she needs to take him for second opinion to a doctor who is foreskin friendly, but I als do not want to rile her up aganst the advise of her doctor because there might actually be an issue.

In last two years, he had couple episodes with friequent urges, pain while peeing  and ballooning. Last one started a week ago. Regular ped ruled out UTI and agreed with SIl that friequent urges might be caused by bladder spasms, it was also suggested to her that pain might be caused by irritation by urine due to ballooning and that there might be skin infection on foreskin that causes pain. 

Now to tis morning. She wrote that  LO is having a hard time peeing, only drops come out at the one time , urologist gave them diagnosis of “Redundant Prepuce and Phimosis” and that he has a rock hard “phimotic band” that blocks urine flow. She did not give any update on his urges or pain.

How fast can scar tissue build up to cause such issues if he had normal flow of urine two weeks ago?

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#2 of 10 Old 05-24-2012, 07:52 AM - Thread Starter
 
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So, 27 views and no replies? Anybody? 

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#3 of 10 Old 05-24-2012, 11:35 AM
 
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At 4yo a diagnosis of phimosis is not possible since he should have it meaning that if he is not retractable he shouldnt be. Unless someone has been trying to retract him all his life he should not have have scar tissue The thing about the tip of the foreskin it is a sphincter just like the anus and if you try to force it open you will get major resistance unless it is in use while urinating it should clamp pretty tight. A Dr. trying to force it will cause it to react by clamping.

When the Dr. told me ds's forskin was to long I laughed at him because I have seen ds when he was erect and he has just the right amount to fit. TO me there is no such thing as to much foreskin unless he can tie it in a bow or around his neck lol.gif: The human body knows what it is going to need down the road and just because there is a lot of it there now dosnt mean it wont be needed after puberty

Ballooning is part of the separation process and is 100% normal. Also pain while urinating is normal during separation as well. If it comes and goes then you can almost be 100% sure that it is due to separation going on. Frequency of urination has nothing to do with the foreskin that would have to do with his bladder or kidney's

I would be concerned about him not being able to urinate at all or just dribbling out. But I have seen ds dribble at then a full stream forms so that can be normal. That dosnt sound like what you described though. It would take years for enough scar tissue to build up to cause the type of issue you are describing. It could be that he is burning some from separation and is holding his urine to the point it only dribbles. Has she put him in the bath or given him a cup to pee in so that if it is burning it will dilute the urine and stop the burn.

The steroid cream is meant for boys in puberty or adult mean not for young boys simply because once you stop it his body will tighten things back up like it was meant to be. I hope she can find another Dr. who is foreskin friendly maybe give her the following information so she can call and see if one is near her. Marilyn can also help her with questions.

NOCIRC(Maralyn Milos)
PO Box 2512
San Anselmo
CA 94979-2512
info@nocirc.org
Phone: 415-488-9883
Fax: 415-488-9660
http://www.nocirc.org

 
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#4 of 10 Old 05-25-2012, 07:48 PM
 
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I'm not sure that there is even such a thing as a "redundant prepuce".  What ever foreskin he has is what he should have.  The average age of retraction (in cultures where they do not mess with the foreskin) is 10 1/2. To diagnose phimosis in a child of 4 1/2 is irresponsible at best, in my view.  As the pp suggested, the odd episode of pain is quite likely nothing more than separation trauma - which is borne out by the fact that he baloons when peeing. In other words his foreskin has separated from the glans, but his preputial sphincter is still tight.  I also agree with the pp when she stated that his peeing slowly is likely him holding it to mitigate the stinging in a freshly separated area. My DS did this. I think your SIL should leave it alone and ignore that doctor, since he clearly has a poor knowlege of intact genitalia.

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#5 of 10 Old 05-31-2012, 01:43 PM
 
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Frequent urges are usually associated with urinary tract infections but there can be other causes.  I'd suggest she take him to another doctor if the symptoms persist. A culture should be done to positively identify any pathogen and prescribe a treatment.

 

The steroid treatment (Betamethesone) may work temporarily but as soon as it is discontinued, the normal condition will return if the child is not yet ready for retraction.  Another treatment should be tried as few boys are ready for retraction at 4 years old.

 

"it was also suggested to her that pain might be caused by irritation by urine"

 

Not likely.  The glans and inner foreskin is covered in a special kind of skin called "mucosal skin" that is designed to be wet without harm. Urine willl have no effect on it.  It is exactly the same kind of skin found in the vaginal cleft.

 

" it was also suggested to her that pain might be caused by irritation by urine due to ballooning"

 

This is possible.  Sometimes when the foreskin balloons, it will pull at remaining adhesions and cause tiny tears.  When urine gets into these, it can cause burning sensations.  These typically self resolve in a day or two with no treatment.

 

"diagnosis of “Redundant Prepuce and Phimosis” and that he has a rock hard “phimotic band” that blocks urine flow.

 

Redundant prepuce simply means he has excessive foreskin.  But it is normal for young boys to have foreskin that extends beyond the tip of the penis.  Does it hang down to his knees?  This foreskin that extends beyond the tip of the penis is called the "acroposition" and is totally normal.  I suspect the doctor saw this normal condition and falsely diagnosed "redundant foreskin" to convince her it needed to be cut off.

 

Now, for the "rock hard" phimotic band . . . The phimotic band doesn't get hard, only tightly closed and resistant to opening.  This is another indicator that the doctor was doing a selling job on her.  The normal condition of a 4 YO's foreskin is phimotic.  It will be that way until his body decides it's time for retraction.

 

I suspect the reason for the difficulty in urinating is because the normal adhesions between the foreskin and glans is begining to break down and when the urine gets to it, it causes it to burn and he reflexively clamps off the urine stream.

 

"How fast can scar tissue build up to cause such issues if he had normal flow of urine two weeks ago?"

 

About as quickly as it can build up on your body, a significant time.  However, I suspect she/he is just guessing or about to advocate a circumcision.  It's a profitable procedure and generally accepted by trusting parents.

 

 

 

Frank

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#6 of 10 Old 05-31-2012, 03:59 PM
 
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There is no such thing as a "redundant" prepuce, foreskin or anything regarding male genitals. Redundant means not necessary and of course the foreskin is necessary for normal development. Ask anyone with a tight and painful erection if they think their foreskin was redundant and they will say NO! Don't be fooled by Dr. Cutter and the band of baby torturers. There is zero reason to cut off any foreskin for the problems you mentioned above. I was butchered and the reason on my medical paperwork said "residual redundant foreskin" so now I'm here to help prevent the lifetime of problems I've suffered from happening to new generations of helpless boys. FIND A NEW DOCTOR.
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#7 of 10 Old 06-05-2014, 12:22 PM
 
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Intact young men

I am mother to four intact sons. We were happy and confident in our decision but never expected the ongoing skepticism during annual pediatric exams when retraction was expected earlier. My pediatrician also has an intact son but is still opinionated on what is normal. Annual physicals caused me anxiety as I continued to hold my ground and not accept referrals to urology; I know I skipped some check-ups because I knew the questions would again arise.
Now here I am with older sons, 21, 19, 16, 13. All of my sons were seemingly slow to retract but I still don't feel like I really know the truth about what normal is. M (19) can retract just a little and G (13) does not retract. It's troubling hearing the concerns of doctors. They say intercourse will be very painful. Now sadly M thinks he is or will be unable to have sex. M & G have no "issues" to speak of, no pain or discomfort or difficulty with urination or erections. Not sure of the right actions to take at this late stage, if this is a late stage. Thank you for your insights.
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#8 of 10 Old 06-05-2014, 03:36 PM
 
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Especially for the older son he can be doing stretching exercises to make his foreskin retract all the way. Though there are men out there that never retract and have perfectly fine sex lives and children so retracting does not = a must do.

All the teen boys can work with their foreskins on retracting over time.

Gentle retraction to the point it will go then pull the foreskin forward to stretch it that way. Being careful not to go to far and get the foreskin stuck behind the glans.

I recommend doing a lot of reading on phimosis here seems to be a good place (other than the circ talk at the end) it talks about both phimosis and paraphimosis http://www.thestudentroom.co.uk/wiki/Tight_Foreskin and how to do the stretching.

Another link http://www.circumcisionquotes.com/stretching.html
One more http://www.healthboards.com/boards/m...-phimosis.html

I hope that is helpful

 
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#9 of 10 Old 06-07-2014, 04:50 AM
 
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Congratulations on keeping your boys whole, and especially in the face of so many doctors who clearly know little about normal, intact male genitalia. Here are a couple more sites for you:

www.cirp.org/library/treatment/phimosis/

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

Be encouraged by the fact that in Finland, a country that does not practice circumcision, only one man in over 16,000 will die without his foreskin! A tight foreskin can nearly always be treated by means other than amputation. If the use of Betamethasone cream and gentle stretching fails, then there are many methods of preputioplasty, which do involve surgery, but there is no loss of foreskin (with all the attendant 20,000 specialized nerves).

Why does your son feel that he may not be able to have sex? I think that explaining all the alternatives to him should ease his anxiety.

Please come back if you have other questions, and let us know how you (and he) make out.
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#10 of 10 Old 06-08-2014, 06:03 AM
 
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Balooning is normal and may or may not mean that he is started retraction process (my son ballooned for some time when he was very young yet he did not retract till many years later). Not being retractable at this age is very very normal. My son only became retractable close to 9 years of age. Only about 50% of boys are retractable by age of 10 and this is completely normal. Just need to make sure that doctors or nurses never try to pull him foreskin back, never try to retract him. As long as everybody keeps their hands off his penis, he should be fine.
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