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#1 of 25 Old 07-14-2008, 10:07 AM - Thread Starter
 
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Ds was too small at birth to be circumcised. I found that to be a blessing b/c I wasn't really for the procedure anyway. Dh on the other hand is.
At 5 weeks old and a week hospitalized we found out ds has a grade 4 kidney reflux. The urologist says the circumcision is a must but not until after 6 months old. Also if he needs surgery to repair the valve they would circ at the same time. I was just wondering if anyone else has had a ds with kidney reflux and has not had them circd? They say it is best b/c of the bacteria and reflux, but they won't do it now b/c it may irritate the kidney's. I don't know what to beleive. Any help would be great.

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#2 of 25 Old 07-14-2008, 11:31 AM
 
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My DD had reflux and no one ever mentioned cutting her genitals....don;t see why this should be any different for a boy...except most docs in the US are looking for any reason to cut a baby boy.

Since the foreskin is fused to the glans, there is no bacteria to 'get in there' it's there for exactly that reason. Unless someone is or has been retracting his foreskin, it should not be a problem.

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#3 of 25 Old 07-14-2008, 05:56 PM
 
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Two of my friends have daughters with this and were not asked to have their labias removed. Sounds like complete BS to me. Be careful about the cathing him also. They can just as easily do a catch bag.

Perhaps you can find a urologist that isn't circ. happy.
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#4 of 25 Old 07-14-2008, 06:25 PM
 
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Ds was too small at birth to be circumcised. I found that to be a blessing b/c I wasn't really for the procedure anyway. Dh on the other hand is.
At 5 weeks old and a week hospitalized we found out ds has a grade 4 kidney reflux. The urologist says the circumcision is a must but not until after 6 months old. Also if he needs surgery to repair the valve they would circ at the same time. I was just wondering if anyone else has had a ds with kidney reflux and has not had them circd? They say it is best b/c of the bacteria and reflux, but they won't do it now b/c it may irritate the kidney's. I don't know what to beleive. Any help would be great.
Well, you would have to consent to such a surgery. They can't do anything without consent. Please a get a second opinion. I am no doctor, but I don't understand what kidneys have to do with the foreskin. If it does not make sense, I would do some research and get another medical opinion. Perhaps, contact NoCirc.
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#5 of 25 Old 07-14-2008, 06:47 PM
 
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I had reflux. I'm female. No circ here!
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#6 of 25 Old 07-14-2008, 07:16 PM
 
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Get a new urologist!!!
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#7 of 25 Old 07-14-2008, 07:30 PM
 
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Most definitely get a new urologist. PM me if you need some names.
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#8 of 25 Old 07-14-2008, 07:49 PM
 
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So circumcising him would fix the reflux? Amazing how a external procedure can fix an internal problem. That is what I told my friend to ask her son's doctor when he suggested the same thing.

My friend never circumcised his son despite being suggested to do so.
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#9 of 25 Old 07-14-2008, 09:10 PM
 
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My intact son, currently 6.5, had reflux and I did have to take him to a urologist. I do not recall the doctor mentioning circumcision or retraction, but I also think I pre-emptively just stated as the very first thing that I follow the AAP guidelines stating his foreskin might not retract until after puberty, and I asked all doctors working with my child to document that in his chart and to ensure that all individuals and staff from that office follow the AAP recommendations and not retract my son. If a urologist had mentioned the word “circumcision” I would have very firmly and clearly stated that circumcision was not an option and I never wanted the word mentioned to me again, period, and to please mark the chart accordingly.


My husband (and his sister) both had very severe reflux. Reflux can be very mild, and most children outgrow it. It can however be quite serious. My husband's sister lost a kidney from it. There are various degrees, 1 is mild, 5 is very severe.


My circumcised husband had NUMEROUS UTIs as a kid, and needed corrective surgery. It is very unfortunate that urologists seem to recommend an amputative surgery to reduce risk of UTIs for males, because if a child has reflux he is at risk for UTIs regardless of whether or not he is circumcised. One of the biggest issues I have with a recommendation for circumcision is that it doesn't change treatment one bit - whether a child is circumcised or not, he is at risk for UTIs, he needs to be carefully monitored for UTIs, and they recommend the daily prophylactic antibiotic whether or not the foreskin is present.

Fortunately, my intact son outgrew his reflux.

Ask your doctor if circumcision will cure his reflux… when he says no, then state that circumcision is not an option you are willing to consider and to not mention it again.
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#10 of 25 Old 07-14-2008, 10:33 PM
 
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Foreskin and reflux have NO bearing on each other AT ALL. any dr that is saying the boy needs to be circed is a Dr. I would never give my money to again. Find a new urologist who actually knows what he is talking about and make it clear that your son isnt to be circed and his foreskin is never to be retracted ie pushed back on ever.


These ignorent dr's are really getting on my : nerves.

 
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#11 of 25 Old 07-14-2008, 10:56 PM
 
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Circumcision does not "cure" reflux.
But this is a truth in U.S. medicine...doctors make money, lots of money, from every procedure they perform. Sad, but true.
While I've never experienced reflux personally or with my own children, my best advice as a mom and as a RN is to get a second opinion (or third, if needed).
Good luck to you and your son!

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#12 of 25 Old 07-15-2008, 12:28 AM
 
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Your urologist is working off outdated, poorly designed studies. The foreskin has nothing to do with UTIs and in fact PROTECTS the urethra from harmful bacteria.

Read up here:

http://www.nocirc.org/statements/breastfeeding.php (see the sidebar, and do whatever you have to do to ensure a successful nursing relationship)

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

I would get another urologist ASAP, one who is informed about the (non) issue of the foreskin and reflux.

Also, you and your dh need to educate yourself as to the structure and function of the foreskin. It's not just a useless flap of skin but a highly sensitive and functional part of the penis, and removing it makes the penis shorter, thinner, and less sensitive, as well as permanently altering sexual function and sensation.

If you're trying to live a natural lifestyle, then why even consider removing something that nature has perfected through countless generations?

Come visit the NEW QuirkyBaby website -- earn QB Bucks rewards points for purchases, reviews, referrals, and more! Free US shipping on great brands of baby slings and carriers and FREE BabyLegs or babywearing mirror on orders of $100+. Take the QB Quiz for personalized advice!

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#13 of 25 Old 07-15-2008, 01:44 AM
 
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This study found that circumcision at the time of surgery to repair reflux made no difference in the subsequent rates of UTIs. The upshot is fix the reflux and leave the foreskin alone. While some commentators have criticized this study, the results to tend to support the rationality of declining circumcision in conjunction with anti-reflux surgery.

http://www.ncbi.nlm.nih.gov/pubmed/15329127

BJU Int. 2004 Sep;94(4):627-9.

Comment in:
BJU Int. 2005 Feb;95(3):453-4.
J Urol. 2005 Apr;173(4):1192.

Effect of circumcision on urinary tract infection after successful antireflux surgery.
Kwak C, Oh SJ, Lee A, Choi H.

Department of Urology, Seoul National University College of Medicine and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

OBJECTIVE: To evaluate whether circumcision during antireflux surgery can reduce the incidence of urinary tract infection (UTI) after successful ureteric reimplantation in patients with primary vesico-ureteric reflux (VUR). PATIENTS AND METHODS: Children who had undergone antireflux surgery for primary VUR were divided into group 1 (27, circumcised at the time of antireflux surgery at the parents' request) and group 2 (50, those not circumcised). All antireflux operations were by the Cohen method. Regular urine samples were cultured to detect UTI, which was defined as a single species with >10(5) colony-forming units/mL in a midstream voided specimen. Numbers of UTI episodes before and after surgery were compared between the groups, with (99m)Tc-dimercaptosuccinic acid (DMSA) renal scans also taken in all patients. Each scan was blindly reviewed in terms of the size, number and zonal location of cortical defects, based on morphology. Interval changes were categorised as improved, no change, progressed, and new scar formation, and compared between the groups. Prophylactic antibiotics were maintained until the follow-up studies at 4-6 months after surgery. RESULTS: There was no significant difference between the groups in age at the time of operation (mean 42.4 vs 47.4 months), the age at the first documented UTI (mean 26.5 vs 29.3 months), reflux grade, or number of UTI episodes and renal parenchymal scarring on DMSA before surgery. There was no significant difference between the groups in the number of UTI episodes at a mean (range) follow-up of 151.3 (114-207) months after antireflux surgery. Also there was no significant morphological change on follow-up renal scans and no difference between the groups. CONCLUSION: These findings suggest that circumcision during antireflux surgery has no effect on the incidence of postoperative UTI.

Gillian
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#14 of 25 Old 07-15-2008, 10:15 AM - Thread Starter
 
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If you're trying to live a natural lifestyle, then why even consider removing something that nature has perfected through countless generations?
No one has ever said that to me, and it makes perfect sense. Thank you. I figure there is a reason it hasn't occured yet, there must be some power that is watching over him to protect his foreskin.

The first urologist we saw was very adiment about having it done and due to other unprofessional issues I
expierienced with him and his office we no longer see the Dr. The new urologist is a woman and doesn't see a need for it, she feels it is cosmetic not medically necessary. I just wanted to get your thoughts on it as my natural parenting peers that may have had children with reflux. Thank you so much for all the sites and advice.

 Yoga loving momma to DD, Eden Raine 8/04 , DS Brett Edwin 2/08, DS Brantley Albert 12/12 and wife for more than a decade to Jason 
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#15 of 25 Old 07-15-2008, 10:22 AM - Thread Starter
 
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question: I do NOT need to pull the foreskin back to clean it? A male nurse that did ds's kidney test and had to cath him said it was starting to attach and that I should be pulling it back regularly. By reading your posts I see HE was wrong. I feel so bad that I did this!

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#16 of 25 Old 07-15-2008, 12:03 PM
 
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He is wrong and is working on outdated information, or simply ingnorance which is very likely in the US...the only thing most US docs know about foreskin is how to cut it off.

You might want to read, print out and have the intact care agreement entered into your son's file.

http://www.mothersagainstcirc.org/care.htm

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#17 of 25 Old 07-15-2008, 01:33 PM
 
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No, dont retract him, its actually SUPPOSED to be attached until he's older. It'll seperate on its own as he gets older-my ds is 8 and still doesnt retract, its perfectly normal.

I'm glad the new doc isnt suggesting circ; however, if you do have any questions or concerns, you could always contact DOC. They are a group of doctors who are against RIC and would be happy to give you info and reassurance that you are doing the right thing

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#18 of 25 Old 07-15-2008, 06:29 PM
 
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Originally Posted by Fyrestorm View Post
He is wrong and is working on outdated information, or simply ingnorance which is very likely in the US...the only thing most US docs know about foreskin is how to cut it off.

You might want to read, print out and have the intact care agreement entered into your son's file.

http://www.mothersagainstcirc.org/care.htm
: Just like that. Firmly state that. They can't fault you for doing your homework on the issue and you correcting them on it.
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#19 of 25 Old 07-15-2008, 07:28 PM
 
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The only one who is allowed to push back on the foreskin is the owner of the penis. NO ONE else should even be allowed to touch it, aside from wiping it like a finger during diaper changes and swishing it in the bath.

 
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#20 of 25 Old 07-15-2008, 07:38 PM
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Originally Posted by edensmama View Post
question: I do NOT need to pull the foreskin back to clean it? A male nurse that did ds's kidney test and had to cath him said it was starting to attach and that I should be pulling it back regularly. By reading your posts I see HE was wrong. I feel so bad that I did this!
Please make sure you read this

A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378

The Definition of "Retraction" & Why it is BAD
http://www.mothering.com/discussions...d.php?t=575627
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#21 of 25 Old 07-15-2008, 08:24 PM
 
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You should report that nurse to some higher ups. He should not be giving advise on foreskin b/c he clearly knows nothing about it.
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#22 of 25 Old 07-15-2008, 11:17 PM
 
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Yes, speak with the charge nurse and if he or she is not receptive ask to speak with the "house manager" which is the boss of the charge nurses (and all the other nurses). If that is ineffective, consider writing to JCAHO http://www.jointcommission.org/ which is the organization that accredits hospitals. This is one thing that hospitals respect. Good luck and I applaud your advocacy efforts
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#23 of 25 Old 08-03-2008, 02:37 AM
 
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edensmama,

do you have any more insight to share? How is your little one?

I just wrote a big long message which got eaten by my computer, but I am desperate for info- you could pm me if you prefer- I have the same situation with my 3 week old nephew, and my sis and my BIL were already on the fence about not circumcising but did not due to my two and my other sis' two being intact with no problems whatsoever, and now my little nephew has a raging UTI and is hospitalized as of yesterday

I just know what is going to be suggested. And I am on the east coast right now and don't know how best to get this information to my sister.

I am just so worried about the UTI and about how it is going to be handled by the doctors.

I also read the package insert for Hepatitis B that the baby got at birth, and it says under the side effects UTI -well it uses the medical term which I promptly forgot, but I looked it up and it means a urinary tract infection.

I am sure the doctor hasn't mentioned the Hep B being the cause of this but I do think it's possible:. The other Hep B package insert (energixB I think it's called, he had the other kind) also says "abnormal liver tests" under one of the possible side effects... has anything like that been mentioned to you and what do you make of it?

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#24 of 25 Old 08-03-2008, 03:07 AM
 
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Originally Posted by Nandi View Post
Yes, speak with the charge nurse and if he or she is not receptive ask to speak with the "house manager" which is the boss of the charge nurses (and all the other nurses). If that is ineffective, consider writing to JCAHO http://www.jointcommission.org/ which is the organization that accredits hospitals. This is one thing that hospitals respect. Good luck and I applaud your advocacy efforts
I doubt Joint Commission would do anything. Hospitals are scared of them because they accredit hospitals but their focus is more on documentation, safety (as in, not having a bunch of crap blocking the hallway), infection control, Universal Protocol (taking a "time out" to ensure the correct procedure is done on the correct patient on the correct side), communication among staff, ect (for a complete list go here http://www.jointcommission.org/Patie..._hap_npsgs.htm ).

Complaints need to go to the nurse manager, house supervisor, department director, chief nursing officer, or CEO of the hospital.


And for the OP an article titled Pediatric Urinary Tract Infection and Reflux
http://www.aafp.org
/afp/990315ap/1472.html


" The Foreskin and Urinary Tract Infections

A resurgence of sentiment favoring routine neonatal circumcision has occurred in the last decade because of recently described associations between an intact foreskin and urinary tract infections in infants. This association was best illustrated in a series of systematic studies by Wiswell and associates25-28 at U.S. Army hospitals. In several large epidemiologic studies, the authors found that the incidence of significant urinary tract infections in uncircumcised males less than six months of age was 1 to 4 percent. The incidence in circumcised males was only 0.1 to 0.2 percent.

Because of the data demonstrating an increase in the rate of infection, routine circumcision has been advocated by some authors. They point out the significant mortality and renal scarring associated with urinary tract infections occurring in early infancy. However, circumcision is a permanent solution to a problem that affects males only during the first six months of life. There may be alternative, nonsurgical means of preventing these infections, and the question of whether all boys should be circumcised to prevent infection in 1 to 4 percent remains debatable. It is also unclear whether circumcision would augment the benefit of antibiotic prophylaxis in boys with reflux or other urologic anomalies. "
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#25 of 25 Old 08-03-2008, 10:03 AM - Thread Starter
 
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I am standing firm on not getting ds circed. Thank you for all of your help. I feel very comfortable with the decision. Dh is still wanting to get it done : but I tell it's not going to happen.

He is doing well with the UTI's none to report since he was in the hospital, so the antibiotic is working for him.

Ericswifey, Give your si and bil as much info as possible, refer them to the site and let them read the articles. It really helped me decide to take action and stand firm on my decision. When I found out I was having a boy, he was going to be circed no questions now with recent events and gained knowledge from my friends at MDC I am now a firm believer in NO CIRC!!!! :

 Yoga loving momma to DD, Eden Raine 8/04 , DS Brett Edwin 2/08, DS Brantley Albert 12/12 and wife for more than a decade to Jason 
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