Ds is almost 4, and intact. He has kidney reflux and some kidney damage, and has been on antibiotics for a year to prevent UTIs and further damage. His urine tests are always negative for infection - but there is usually some unexplained blood in the urine. He had a VCUG (a test to check on the extent of the reflux) recently, and has only a Level 2 (relatively mild) reflux. Yay! The urologist is guessing that the blood in the urine is due to ds' very tight foreskin. He is recommending that we use steroid cream to loosen the foreskin. Once the foreskin retracts, we can take ds off the antibiotics (yay!) and just do regular urine tests to insure he doesn't have a UTI.
Any thoughts on this? Can a tight foreskin be responsible for minute quantities of blood in urine? Are there negative side effects of the cream? Any other wisdom to share?
It's tight because it's supposed to be tight. That's the way young boys are supposed to be and that natural and normal condition shouldn't be interfered with or you can cause problems more than what he already has. The foreskin opening is surrounded by a band of tissue that keeps it closed to protect the inner preputial space. In young boys, the band is comprised of non-elastic tissue and trying to stretch it open will cause the formation of scar tissue that will not be elastic and will prevent retraction later. This condition is called "acquired phimosis" or 'pathological phimosis" and may require circumcision to resolve it. When the time for your son's foreskin to retract comes, this band of tissue will be replaced with a band of elastic tissue and he will be normally retractile. You can not rush the process and only his body will know when its time for this to happen.
You should also forget that steroid cream. It's betamethesone .05% cream and it's for adults, not children. While there are no negative effects of the cream, there are definitely negative effects of trying to prematurely achieve retraction. If you could take your son off of antibiotics when he is retractile, you can take him off of them before he is retractile. It will make no difference. With the moderate case of reflux your son had, (has?) I suspect he has already out grown it any way. The foreskin has nothing to do with blood in the urine, absolutely nothing!
Originally Posted by Frankly Speaking
In young boys, the band is comprised of non-elastic tissue and trying to stretch it open will cause the formation of scar tissue that will not be elastic and will prevent retraction later. This condition is called "acquired phimosis" or 'pathological phimosis" and may require circumcision to resolve it.
|You should also forget that steroid cream. It's betamethesone .05% cream and it's for adults, not children. While there are no negative effects of the cream, there are definitely negative effects of trying to prematurely achieve retraction.|
|The foreskin has nothing to do with blood in the urine, absolutely nothing!|
however, even if you achieve retracting using the cream, you are STILL prematurely retracting your son, hence all the negative side effects that would come from retracting without the cream are STILL THERE.
the penis isnt designed to retract until it is ready to. period. The cream that they want to use is for adults who do not retract during an erection usually, or even can not retract when flacid.
It is used AFTER the separation has occured, but the forskin still refuses to retract.
You are essentially still ripping the forskin off of the glans before it is ready when you are using the cream, you are just making the skin itself more pliable to do so.
The issues of retraction before nature intends it with the cream is that it can cause him to develope pathalogica phamosis were the foreskin will not retract because of scare tissue. Like Yoshua said you are still essentially ripping the foreskin off the glans by making the skin more pliable so that it is more stretchy. Once you stop using the cream the foreskin will more than likely tighten back up to protected the glans and then u will be back were u started. The foreskin is there to protect the glans and it does that job best by not being messed with. Repeated forced retraction before it happens on its own can cause major damage and should never be done for any reason. Including cathiters. I am assuming that you had a knowledgable person do the cath on your son when it was needed and he was never retracted. As it is not needed even when doing a cath.
SAHMlovin' fan to DD 10/00 & DS 10/04 If your ds is intact, keep him safe, visit the Case Against Circ forumCirc, a personal choice, Your sons11/986/99anti-tobaccoThyroid cancer survivor. With & & (Boxer) wishing 4 &
Sister's son had reflux and was on antibiotics and still got a UTI
She took son off the antibiotics and started EC (no poopy diapers!)
No additional UTI's
The doc said that exposure to bacteria is what causes a UTI not the foreskin!
Boy was she P'd when she found out that there is no comprehensive study which indicates that antibiotics do any good in these situations.
Question. Seriously question.
Then know what you want so you know what you will allow them to do. You do not have to allow everything.
I dealt with a couple of really moronic urologists back when I was having issues with this. I'd recommend looking into a pediatric nephrologist instead, if you can. Nephrologists seem to be more up to speed about kidney issues than urologists. Plus maybe they won't be so inclined to worry about your son's foreskin. Good luck!
Originally Posted by napless
Once the foreskin retracts, we can take ds off the antibiotics (yay!) and just do regular urine tests to insure he doesn't have a UTI.
Any thoughts on this?
You can take him off the antibiotics whenever you want to. Now I am not saying to say phooey on proper treatment of your son. Just ask questions and do more research on long term antibiotic use to prevent UTIs and ask your doctor to look into it too.
My sister's son has reflux and was on antibiotics when he was one year old until yeast drove her insane and then she said that's it, no more antibiotics. She talked to the doctor about it and was surprised to find that the data supporting the use of antibiotics is not so solid.
Originally Posted by napless
Thank you for your quick reply!!!
I understand that trying to retract a foreskin manually will cause damage. Is there similar damage from the steroid cream?
|What are the negative effects?|
|Can you tell me more? How do you know? (I'm not meaning to sound confrontational - I have an appointment tomorrow with our GP to discuss these issues and I want to make sure I have my facts straight and my position strong.)
Originally Posted by napless
Thanks everyone! We've decided to pass on the steroid cream!!
You should ask the doctor to explain to you exactly HOW the tight foreskin causes blood in the urine.
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