Phismosis - Mothering Forums

Forum Jump: 
 
Thread Tools
#1 of 15 Old 05-25-2003, 11:20 PM - Thread Starter
 
CosmicMama's Avatar
 
Join Date: Mar 2002
Location: Queens, NY
Posts: 243
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My DS is one - we just came back from the emergency room because his penis was swollen (to more than twice its size) and very red- it was so scary. They said it was phismosis - the foreskin was infected and inflammed. They gave us an antibiotic - and I'm supposed to call the urologist tomorrow - but they kind of freaked me out - they said he might need to be circumsized or this could keep happening. Um, is that right? I mean, his penis does look really bad - I would NOT this to happen again - what does anyone know about this???

Also- since he was not circumsized, I basically just washed the outside of his penis with water - I wasn't pulling it back- the dr. mentioned I should've been retracting it slightly- should I have been? I just feel horrible now and hope my babe feels better soon (he's in pretty good spirits right now at least).
CosmicMama is offline  
Sponsored Links
Advertisement
 
#2 of 15 Old 05-26-2003, 05:02 AM
 
gilnikche's Avatar
 
Join Date: Nov 2001
Location: C.H.A.O.S.
Posts: 2,801
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
First of all....most Urologists will recommend circumcision. Second, the doctor was wrong about retraction. There is no need for this & it can cause damage. I have a 5 y.o. little boy(uncirced) that we never did anything except wash his genitals the same way as the rest of his body. We have always stayed away from bubble baths & other scented bath products. Could he be having a reaction to a bath product?

I did a search for phimosis & came up with these results:

http://216.92.20.151/discussions/sea...der=descending

I hope this helps.

**BTW, was he running a fever? Was there any drainage?
gilnikche is offline  
#3 of 15 Old 05-26-2003, 10:14 AM
 
SagMom's Avatar
 
Join Date: Jan 2002
Posts: 4,939
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
How is your little guy today? Here's our experience: http://216.92.20.151/discussions/sho...highlight=Joan

our doc gave us a topical antibiotic in case we needed it (we didn't.) and ds has had no problems since. I'll second the "don't retract" advice--hope he's feeling better.

Single Mom to 3 (12, 17 & 21)  luxlove.gif and dog2.gif.

SagMom is offline  
#4 of 15 Old 05-28-2003, 10:41 AM - Thread Starter
 
CosmicMama's Avatar
 
Join Date: Mar 2002
Location: Queens, NY
Posts: 243
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Thanks guys. I'd say ds is pretty much back to normal now- or about 95% there- maybe still a tiny bit red and swollen- but very little. I saw my regular pediatrician yesterday and she said I should still go see a urologist. He said his foreskine was tight - and that he probably wouldn't need a circumsision- but that he should be evaluated. She said she had a patient with something similar and the urologist gave the parents a cream to put on so that the foreskin could losen up a little and gently slightly retract.

He wasn't running a high fever. I think there may have been slight drainage- I saw a small spot of brownish on his diaper when I changed him twice- but it was tiny- I may not have even noticed it if I didn't look for it.

He also has a slight cold/and double ear infection going on now - which I didn't even realize until we took him to the ped. yesterday- but she said the antiobiotics he was on for the penis should help with that also.

We hadn't switched bath products lately, so I'm not sure about that.

Thanks for your responses. Any more thoughts on the matter? I see your point about urologists being surgeons and all - but I don't think I want to leave this to chance- I think it should be looked at - it was just so horrible and don't want it to happen again.
CosmicMama is offline  
#5 of 15 Old 05-28-2003, 11:42 AM
 
Sarah's Avatar
 
Join Date: Nov 2001
Location: Indiana
Posts: 2,093
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Cosmic- Someone on the understanding circumcision board mentioned this thread.

I don't get the diagnosis that you were given. An infection is called "balanitis" (infection located on the penis head) or (and don't count on my spelling) "Balanoposthitis" meaning infection on the penis also involving the foreskin.

Neither of those situations are cured with surgery- but are treated with the right medication. Studies on balanitis say that most boys who DO get it- only have ONE event. So it's not like you should even expect that it would ever happen again- why circumcise for that?... not to mention that circumcised boys have MORE balanatis than intact ones do (and it's impossible for circumcised boys to have balanoposthitis so that's beside the point)

now- Phimosis is a very tricky thing because there is the phimosis that all babys are born with which is NORMAL and then there is an abnormal phimosis that may develop later. Either way it means that the tip of the foreskin is tightened and non retractable. On a child one year old- how could they say he had phimosis when he is SUPPOSED to have phimosis at one? Duh! You can't even begin to sort out the abnormal phimosis until kids are about 5!

Here is a good article with pictures:
http://www.mja.com.au/public/issues/...w10610_fm.html

Now the last thing which I am wondering is PARAphimosis which is when a tight foreskin is forced behind the glans and acts like a rubberband and constricts on the penis- then the penis swells and the difficulty to get the foreskin back to it's normal position get very tricky and this is a real emergency situation- because if left for too long the circulation could get cut off. Paraphimosis would also cause redness and swelling and would go away as soon as it was mechanicly fixed- it does not represent an ilness anymore than getting a bean shoved up a nostril does.

Once again- circumcision would not be the answer to that.

Anyway- I hope that helped some just so you know these words- search the CIRP library if you want to learn more about any of the conditions- you will see the actual journal articles that the urologist *should* have also read.

http://www.cirp.org

Love Sarah
Sarah is offline  
#6 of 15 Old 05-28-2003, 11:48 AM
 
Frankly Speaking's Avatar
 
Join Date: May 2002
Location: North Atlanta
Posts: 4,928
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
There are two types of phimosis. One is the normal phimosis that every boy has. It's designed to be that way. It's so that the developing glans and mucosal foreskin can develop and mature. It protects those parts and "tries" to prevent early retraction. Of course this protection can be over come with determination by an unknowing medical provider or parent.

Then there is pathological phimosis where there has been damage by repeated infections that have scarred the preputial sphincter. One infection could not possibly cause this and it would be almost impossible for this cumlative damage to occur before about the age of 3 years. Here is a good link on diagnosing normal and pathological phimosis.:

http://www.mja.com.au/public/issues/...w10610_fm.html

From what you have said, it sounds like you have done exactly the right things taking care of your son. That is, do nothing other than wash the outside and never retract or allow anyone else to retract your son. Just like girls occasionally have problems, boys also have occasional problems. Just as girls respond well to non-invasive treatment, boys also respond equally well. Medication is the first line of defense, not amputative surgery.

It is normal for boys to have a non-retractile foreskin and it shouldn't be rushed with steroid creams such as betamethesone such as the doctor suggested. Only about 1/4 of bous will be retractile at 3 years old, 2/3 by the age of 6 years and 10% are still not retractile by 10 years. Toss the steroid cream and don't worry about retraction until your son is a teen. If it is still not retractile, then get the cream. In a worst case scenario, it may take two months of gentile stretching exercises to have a completely and easily retractible foreskin. Maybe at most 1% of boys have this problem and the steroid cream medication is about 99% effective.

It sounds like the antibiotic cream is working well just as it is supposed to. Good luck! I visit the circumcision board on an almost daily basis if you need more information or clarification.



Frank
Frankly Speaking is offline  
#7 of 15 Old 05-28-2003, 11:51 AM
 
Frankly Speaking's Avatar
 
Join Date: May 2002
Location: North Atlanta
Posts: 4,928
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Sarah and I were posting at the same time. Sarah is very knowledgeable and I'm not surprised she posted the same link!


Frank
Frankly Speaking is offline  
#8 of 15 Old 05-28-2003, 11:58 AM
 
Sarah's Avatar
 
Join Date: Nov 2001
Location: Indiana
Posts: 2,093
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Do we need to get walkie talkies?

lol
Sarah is offline  
#9 of 15 Old 05-28-2003, 12:33 PM - Thread Starter
 
CosmicMama's Avatar
 
Join Date: Mar 2002
Location: Queens, NY
Posts: 243
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Thanks again for the responses. So, do you think I should not go see a urologist now? I'm so confused. I am not a typical MDC- as in I have a tendency to listen to dr.'s because I don't have the best instinct otherwise for things. Poor ds's penis looked so bad- I would hate to think I'm ignoring a potential problem- however, I must say the antibiotics seem to be working. Do you think there is harm in going to urologist to have it double checked?

Also- about the care issue again- so as I said, I basically just left it alone- I figured if he was sitting in a warm bath on a regular basis-great. I usually just quickly ran a washcloth over his penis - should I have been giving more attention to the tip? - Not retractng- but washing more carefully there? I kind of figured - a quick wipe plus the time in the water would be sufficient, but maybe it wasn't? Also, I don't cloth diaper- (not going to change now, sorry)- and rarely put a diaper cream or vaseline of anything in the diaper - unless it looked like ds needed it. Do you think it would be a good idea to use a barrier cream on the diaper area more regularly? Although - that would be mostly on his tushy so I'm not sure how that would help, but just throwing questions out there. Don't mean to be so in the dark about how to care for it - I kind of figured everything was good since for a whole year it looked that way- but now I want to make EXTRA sure that I am doing whatever I should.

Thanks again everyone!! I really appreciate all your valuable feedback.
CosmicMama is offline  
#10 of 15 Old 05-28-2003, 01:34 PM
 
Sarah's Avatar
 
Join Date: Nov 2001
Location: Indiana
Posts: 2,093
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Cosmic- I'm not going to say don't go to the urologist, it's your call. I wouldn't bother if the antibiotics are doing the trick. Save yourself the copay. If you have a good relationship with the ped who sees him regularly- in a few years if the ped still thinks the foreskin might be tight- maybe then think about treatments for that (conservative ones) but really I would not even begin to be concerned till a boy is about 5... and even then- it's not like surgery would be in order.

I am just confused about the diagnosis you got- because phimosis has nothing to do with an infection- I mean you can have phimosis and have an infection, just like you can have a cold and have a big nose. But "big nose" does not mean "has cold".

As for how you have been treating him- I don't think you need to change a thing- not the way you have been caring for him- not the diapers, not the ointments- nothing! You have been doing everything right! this was just a fluke! Diaper ointments are ok if he has a rash or if his skin seems irritated- if he get's sick- diahrea (sp?) can scald skin and a barrier ointment might be good. If you nurse and get thrush, if he gets diaper yeast- his foreskin can get yeast (watch for this now with the antibiotics) and OTC yeast meds can work for that.

Urine is sterile and every time he pees the inside of the prepuce opening is flushed OUT. If you try to scrub into there- you will push contamination IN. Let the urine flowing OUT do the job of rinsing out the lining. This part of the body is designed for contact with urine and you do not need to wash the urine off it any more than you would need to scrub out your uretrha after taking a pee. The urine is fine.

As for what you saw- I do not doubt that his foreskin looked AWFUL, but if it is any consolation- try to remember that the foreskin is a very loose fold of two layers of skin, so there is a lot of room for swelling. If you hit your wrist with a hammer- it might swell a little, but the skin itself is tight enough that it has it's own hugging potential, it's not going to just swell and swell. But imagine another place on the body that does not have a bone under it- your LIP- have you ever had a fat lip? You know how fast it can swell up? And also how soon the swelling goes back down? Or the eyelids of a beat up boxer? Or an allergic reaction that someone might have in their eyes? That's because there is room for the swelling to happen. Foreskin injury/infection tends to LOOK a lot worse than it actually is because of the double layer loose swelling. Try to not apply the same scale of "drama" (I can't think of what else to call it) to the scene you saw as if you saw this elsewhere on your son's body. I know it looked bad, but it was probably just "fat lip" type reaction.

Love Sarah
Sarah is offline  
#11 of 15 Old 05-28-2003, 02:03 PM - Thread Starter
 
CosmicMama's Avatar
 
Join Date: Mar 2002
Location: Queens, NY
Posts: 243
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Thanks Sarah, your anology and reassurance did actually make me feel much better.

Your not the only one confused by the diagnosis. The first ER dr. said phimosis - that is also what he wrote on the discharge sheet. But the urologist who quickly looked at it - (he was on his way out of the hospital- wasn't the dr. who attended to us - just stopped to look in) - said it was some kind of infection. But he obviously had no clue either - becaue he actually asked "did he get a bug bite or anything there" - I was like "um, not that I know of" - and he was like, well "it could be diaper rash or just about anything that got it infected".

He is taking oral antibiotics- not a cream (as Frank thought?) - but like I said it seems to be helping - pretty much back to normal.

My pediatrician yesterday didn't say the word "phimosis"- but she did look at him and did say his foreskin was tight. - and she was the one who mentioned loosening it up with a cream if necessary - although Frank doesn't seem to think it is at this age.

I don't want to over medicate- or of course anything more drastic - if not 100% necessary. But I don't want to ignore it either- although we didn't - we took him to the hospital to get looked at and know he is on medicine. Of course, when we told family we got a lot of "well, he should've been circumsized" comments. And even the ones who didn't say that - kind of hinted that if dr.'s thought we should now then we definitely should. Ugh. Even DH who ISN'T circ. and didn't want Max to be - is kind of "if the dr.'s think it is needed..." Ahh.
CosmicMama is offline  
#12 of 15 Old 05-28-2003, 06:55 PM
 
Frankly Speaking's Avatar
 
Join Date: May 2002
Location: North Atlanta
Posts: 4,928
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It sounds like you have done everything exactly right.

Just be sure to give him all of the antibiotic prescription to make sure there are no "buggs" left to become restistant to the antibiotic and watch for yeast infections. Antibiotics seem to promote them. If he does get a yeast infection, a little Vagisil or something similar will cure it up.

I think somewhere in the definition of "Baby" are the words "gets sick." It's just part of growing up.



Frank
Frankly Speaking is offline  
#13 of 15 Old 06-07-2003, 09:15 PM
Banned
 
nightowl1234's Avatar
 
Join Date: May 2003
Location: NE Ohio
Posts: 44
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Hi, I hope your little guy is all right now again.
If you every have any other questions, come to
The Case Against Circumcision board and you'll find the same people answering any other questions you might have.
They are truly knowledgeable.
Best of luck!
nightowl1234 is offline  
#14 of 15 Old 06-08-2003, 12:34 AM
 
gurumama's Avatar
 
Join Date: Oct 2002
Posts: 1,777
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I strongly recommend that you get some powdered acidophilus or bifidus--Solaray makes a product called Infant Bifidus. You can get it at a health food store for about $15 for a few months' supply.

It's probiotics that will restore the good bacteria in his intestinal tract. Otherwise, when he poops, it might cause a diaper rash and he might get a slight stomach ache. The probiotics will help fight any possible yeast infections that could result from the antibiotics.

It's one more thing to do to keep him healthy and to avoid pain.

Best of luck,

Mel
gurumama is offline  
#15 of 15 Old 01-31-2005, 12:51 PM
 
Kermit's Avatar
 
Join Date: May 2002
Location: The Muppet Show
Posts: 4,202
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Probably an old thread, but just for the sake of accuracy, I wanted to add that balanoposthitis actually is not necessarily an infection, either. It is technically an inflamation. Yes, it could be caused by infection, or it could be caused by other irritants. Treating it as an infection automatically without a culture or biopsy is a shot in the dark.
Kermit is offline  
Reply

User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off