[tellmemore]

I just discovered this problem with my DS first thing this morning, and it looks terrible. I have read some things on other threads about this, but there's so much that it's confusing and overwhelming! I am not having him circ'd, so that's not gonna come in to play if we do end up at the Dr. Forget it. My first thought was this: he's a stomach sleeper, and his PF diaper was in a bikini twist. I wonder if there's a chance this will dissappear today. But seriously, it does look like more than that. Just in case, I'll do another fold instead. He does not want me to touch it.

I searched for a intact-friendly ped. in Vancouver, WA, but did not find a thing. We are on state insurance with Molina Healthcare, so if anyone can be of help there, it'd be appreciated. I am SO glad that I have MDC to help!

 

[tutucrazy]

This is very normal. He is going through a separation process. Ballooning is a normal phase that indicated the foreskin is separating but the opening is still narrow. This will happen throughout his childhood until hormones allow the opening to widen. You should not be alarmed. Swelling and redness is just a little trauma due to the recent developments of his separation (foreskin is very vascular so it reacts easily to separation). That will go away in a few days. Please read these thread thoroughly. Feel free to ask us any followup questions.

http://www.mothering.com/discussions...893&highlight=

Quote:

SPECIAL INFORMATION ABOUT THE DEVELOPMENT OF THE INTACT BOY: During childhood/adolescence your son will go through a normal separation process as the foreskin separates from the glans. As I said before, the foreskin is fused during childhood to protect the developing penis from feces and other pathogens. Separation is different for each boy and happens at a different age for each boy. During this time he might experience some irritation, itching, stinging, minor redness, minor swelling, ballooning, spraying, smegma pearls, uneven retraction, etc. These are all totally NORMAL and resolve by themselves. I get get many concerned parents come here asking about their son's irritated, red, or slightly inflamed penis. 97% of the time it is just normal separation occurring. Some boys don't experience any of this but most boys have 1 of these symptoms at some point especially around ages 2-5 when boys really begin to explore their genitals with their hands. During self-discovery is a prime time for separation trauma to appear. UNLESS it gets increasingly worse, extremely inflamed, he has fever, or you suspect yeast infection there is nothing to worry about. (Bacterial infections are VERY RARE and usually only occur only after forcible retraction or a wound to the penis.) Usually the symptoms of normal separation resolve themselves within 48 hours. Due to the fact that US doctors know very little about the development of the intact boy, it is wise to wait it out and let this resolve on its own. Since boys tend to be more "hands on" with their genitals and their genitals are not as internal these symptoms appear more frequently than with girls. You may want to remind your son to be gentle with his privates as he begins to self-explore.

Normal Separation:
http://www.mothering.com/discussions....php?t=764732?

 

[MCatLvrMom2A&X]

I agree with PP sounds like normal seperation 3 and around that age is a very common time.

Ballooning is just part of the process nothing to cause concern.

Read the thread linked above it is very helpful and reassuring.

 

[tellmemore]

Okay, so went to the ER this AM since DS had horrid swelling still, and a smelly discharge that's brownish. The Phys. Assistant did pull back a bit, which made me mad, then suggested that we "needed" to retract it fully. I said, "I am not at all comfortable with that. There's too much evidence that it's harmful. " And proceeded to tell her what I was comfortable with. She mostly agreed, and I'm mostly following it. All but "while in the bath, pull back just until it stops and then give it a extra TUG." I told her no on that, too. I told her we'd cover all bases for yeast and bacteria orally and topically, 10 min baths in clean water 4 or so X per day. Swishing, no tugging. We're seeing a regular Dr. in the morning, a male, and will see what he says.

I'd have hesitated to bring him in at all, unitl the smelly discharge. I don't think I mentioned that he's been diaper-free due to rash for 3 days until the problem showed up. Something could have irritated him, but I really expect it's mostly just the normal stuff. Does it ever include the smelly stuff, though? Anyway, swelling is down and there's less discharge, even before taking any measures at all. We just finished the initial bath/meds thing.

Any suggestions for probiotics or anything to help the oral antibiotics not give the runs? Just got my first wool wrap (Loveybums), and I don't wanna wash it over and over for 10 days due to dihereah. LOL!

 

[l_olive]

Oh, if you haven't given any antibiotics yet, please consider waiting a day.

Have your read the separation thread yet? I would bet a whole lot of money that the smelly discharge was just smegma buildup releasing and the swelling will go away in less than 24 hours all by itself.

 

[l_olive]

Oh shoot, I tried to post too quickly, and just re-read that you already started the antibiotics.

Yes, my son experienced exactly what you're describing. He was about 3 1/2 and his penis swelled alarmingly, and he cried that it hurt. It scared me half to death, but I knew I'd read something about this here before.

A few hours later, after a warm bath and a snuggle on my lap, I smelled something funny. I checked his underwear, and there were several fairly sizeable smears of some pinkish, brownish thick discharge. And the smell wasn't too pleasant.

After that point, the swelling completely went away within a day, and there was no more pain. But, ever since that time, his foreskin now balloons away from his penis when he urinates. So, basically, it happened exactly like what's described in the separation thread (WHICH NEEDS TO BE A STICKY!!) -- the separation was happening, and the dead skin cells were accumulating in pockets. Eventually, the built-up smegma washed out, and now that his foreskin is loose (but not yet retractable) it doesn't build up anymore, and he hasn't experienced the swelling or the discharge again.

On top of my son's story, if you do a short search on this board, you will find dozens and dozens of exactly the same thing -- all of which resolved within a couple of days all on their own.

True infections usually get worse, the discharge doesn't just go away on its own in a couple of hours, and normal, natural separation is quite often associated with discomfort, swelling and discharge.

I hope your little guy is better tomorrow!

 

[l_olive]

Sorry to serial post. But geez, this makes me so angry at the health care providers out there. How can we ever make a difference if the all the HCPs out there are so uninformed? It's like you take your kid to the dentist because he has a wiggly baby tooth, and instead of being told that it's normal and natural that kids lose their teeth, you're told he needs an emergency root canal or something.

It's so freaking frustrating!

 

[ChaoticMum]

My little guy ended up with an infection when he was about 3.5 also. He started with redness and within 24hrs it had moved right up the entire length of the penis with EXTREME swelling and pus coming out the tip and he was running a fever. The doctor put him on a course of AB's and we put him in the bath regularly. Within 24hrs the swelling had gone down and the pus had slowed. The redness was gone and it 'healed' wonderfully.

Amazingly it was immediately after that that his foreskin was able to be retracted (he retracted it himself in the bath) completely and with ease and absolutely no discomfort.

We don't know if he forcibly had retracted it causing trauma, or if it was just that buildup of smegma that just got a bit out of hand. Now we've taught him to slightly retract his foreskin as he pees as he has a LARGE balloon when he urinates! But, his retracts extremely easily and he does it completely on his own so we know its safe for him to do so.

 

[tellmemore]

I did start the antibiotics, but just gave 1 dose, a tsp, so far. Should I stop and wait do you think? I'll at least not give again tonight and research, since the dose I gave was around 5 pm anyway. As for the cream, Clotrimazole, I'm dabbing a bit on the tip, but glad I have it to try on his rash, which the Dr. thought was prickly heat, but as for the diaper region and nearby, looks like possible eczema to me. I'm trying it in case of yeast, and hoping it can't hurt? I'm so glad to hear of more stories like mine, and the smegma build-up sounds logical. The discharge is gone, and it's been about 12 hrs. Which it disappeared as far as I could see within about 8 hours.

Yay! I am SO taking this info with me to educate the Dr. we see in the morning, and have full faith that it'll be even better then. And I'll tell him of all the improvement before even a bath!

One thing I notice now, besides swelling and redness are gone, is that there is almost a purple tinge below the skin in a small section around the middle. It's faint, and it's gotta be separation related. What else would go all around in that area under the skin but... Uh... His penis?!?! God created amazing bodies, and I am so glad that things resolve themselves!

I will read the separation thread for sure tonight, and if anyone has more info, please send it my way. Especially on the ABs or rash. Anything!

 

[l_olive]

Quote:

Originally Posted by ChaoticMum My little guy ended up with an infection when he was about 3.5 also. He started with redness and within 24hrs it had moved right up the entire length of the penis with EXTREME swelling and pus coming out the tip and he was running a fever. The doctor put him on a course of AB's and we put him in the bath regularly. Within 24hrs the swelling had gone down and the pus had slowed. The redness was gone and it 'healed' wonderfully. Amazingly it was immediately after that that his foreskin was able to be retracted (he retracted it himself in the bath) completely and with ease and absolutely no discomfort. We don't know if he forcibly had retracted it causing trauma, or if it was just that buildup of smegma that just got a bit out of hand. Now we've taught him to slightly retract his foreskin as he pees as he has a LARGE balloon when he urinates! But, his retracts extremely easily and he does it completely on his own so we know its safe for him to do so.

Again, I would strongly suspect that this was normal separation / smegma build-up since it coincided completely with the ability to retract. It's just the way that it's supposed to work. Like when kids lose their teeth -- it's uncomfortable for them, they often bleed, and if you didnt' know it was normal and natural, it might be pretty alarming!!

But there have been what... maybe 10 threads exactly like this over the past week? All with boys from about 2 to 4? Hmmm......

 

[tellmemore]

Quote:

Originally Posted by l_olive Sorry to serial post. But geez, this makes me so angry at the health care providers out there. How can we ever make a difference if the all the HCPs out there are so uninformed? It's like you take your kid to the dentist because he has a wiggly baby tooth, and instead of being told that it's normal and natural that kids lose their teeth, you're told he needs an emergency root canal or something. It's so freaking frustrating!

:

 

[Lula's Mom]

Yeah, I agree that it sounds like normal separation for the OP and ChaoticMum's ds. My son experienced the swelling (*wow* it got big! I was so glad I had this forum to read, or I would have thought it was something abnormal), the redness, the pain, and the smegma discharge. His smegma was greenish. Then it went away in a day or so without treatment. Shortly thereafter he showed me that he was retractable. He was 3 when that happened.

I would not be giving those antibiotics. That's just asking for a yeast infection, and good thing you made a preemptive strike on that with the clotrimazole.

 

[tutucrazy]

Quote:

Originally Posted by ChaoticMum My little guy ended up with an infection when he was about 3.5 also. He started with redness and within 24hrs it had moved right up the entire length of the penis with EXTREME swelling and pus coming out the tip and he was running a fever. The doctor put him on a course of AB's and we put him in the bath regularly. Within 24hrs the swelling had gone down and the pus had slowed. The redness was gone and it 'healed' wonderfully. Amazingly it was immediately after that that his foreskin was able to be retracted (he retracted it himself in the bath) completely and with ease and absolutely no discomfort. We don't know if he forcibly had retracted it causing trauma, or if it was just that buildup of smegma that just got a bit out of hand. Now we've taught him to slightly retract his foreskin as he pees as he has a LARGE balloon when he urinates! But, his retracts extremely easily and he does it completely on his own so we know its safe for him to do so.

With any infection it will get progressively worse and the swelling will be extreme with fever and discharge, as what happened to this poster's son.

To the OP: Keep in mind when we say extreme swelling we mean swelling up the entire length of the penis. Moderate swelling is not an indication of an infection. If you doctor suspects infection he/she should first culture the very tip (NO RETRACTION). I highly doubt this is an infection unless the symptoms become as described by the previous poster's experience.

 

[tutucrazy]

Quote:

Originally Posted by tellmemore I'd have hesitated to bring him in at all, unitl the smelly discharge. I don't think I mentioned that he's been diaper-free due to rash for 3 days until the problem showed up. Something could have irritated him, but I really expect it's mostly just the normal stuff. Does it ever include the smelly stuff, though? Anyway, swelling is down and there's less discharge, even before taking any measures at all. We just finished the initial bath/meds thing. Any suggestions for probiotics or anything to help the oral antibiotics not give the runs? Just got my first wool wrap (Loveybums), and I don't wanna wash it over and over for 10 days due to dihereah. LOL!

The smegma that is coming out will be very smelly b/c it has been in there for a long time. This does NOT indicated infection. Your son is just begining to separate so the skin that has been keeping the foreskin attached is just now evacuating the area. Skin cells that have been in there for a long time WILL smell. The brown is coming from some blood that has mixed with the smegma. Where there was some detachment sometimes if it can bleed a bit.

I strongly advise you to STOP the antibiotics and get a culture if the swelling is down. If you decide to continue the antibiotics you put your son at risk for a yeast infection. If there were an infection (which I doubt by your description) you would need to have him on a probiotic supplement like Intestinex DURING and for one week AFTER the antibiotics.

 

[tellmemore]

I am stopping the antibiotics and will continue to try the yeast meds just in case and especially for his rash unless I find info against it. I want to cancel my appt in the morning, yet at the same time I wanna see what he has to say and then show him my contradicting info and beg him to see the other side if he's like the lady we saw today. Hello medicine! Hello America! Like we are lemons and our bodies are incapable of going through processes naturally. Even normal ones. Who woulda thought?

 

[Fellow Traveler]

If you do go to the ped just get him to do a culture, no harm in that. They should be able to tell you what you're dealing with.

ETA: The separation thread is stickied, it's in the resources section:

http://www.mothering.com/discussions....php?t=1050900

 

[tutucrazy]

Quote:

Originally Posted by tellmemore I am stopping the antibiotics and will continue to try the yeast meds just in case and especially for his rash unless I find info against it. I want to cancel my appt in the morning, yet at the same time I wanna see what he has to say and then show him my contradicting info and beg him to see the other side if he's like the lady we saw today. Hello medicine! Hello America! Like we are lemons and our bodies are incapable of going through processes naturally. Even normal ones. Who woulda thought?

Sounds good momma!

Don't you find it amazing that doctors don't learn about normal development of the foreskin and only learn how to cut one off.

:

Btw, you can read my son's separation experience in the thread I just posted "Separation Stories Thread".

The yeast cream shouldn't hurt. My son has had terrible yeast around his anus b/c he had internal yeast. I found that my own Citricidal grapefruit seed extract diluted in water worked better on my son's butt yeast than the nystatin cream that the doctor gave us. I never tried the yeast cream you mentioned so I am not sure how well that works. We have also used oral diflucan for my son which works the best for his internal/topical yeast. He had terrible eczema all over his body from the yeast.

 

[tellmemore]

The ER dr today did a culture, after TOTALLY trying to retract and acting like she wasn't. My son fussed and she quit (good thing). But when I asked why we couldn't see what the culture came back with, she claimed it could take 3 days. We'll see, and whatever.

 

[ChaoticMum]

Quote:

Originally Posted by tutucrazy With any infection it will get progressively worse and the swelling will be extreme with fever and discharge, as what happened to this poster's son. To the OP: Keep in mind when we say extreme swelling we mean swelling up the entire length of the penis. Moderate swelling is not an indication of an infection. If you doctor suspects infection he/she should first culture the very tip (NO RETRACTION). I highly doubt this is an infection unless the symptoms become as described by the previous poster's experience.

And that is true - the swelling my son had was up the entire length, with redness in the groin area. The fever was also pushing 40*. There was no doubt there was infection that was more than just typical seperation symptoms.

 

[l_olive]

I'm sorry ChaoticMum, I missed the fever part of your original post.

But just for the record for people who might read this in the future - my son's swelling which was quite obviously NOT an infection since it completely went away on its own within a day without any medical intervention of any kind -- was WAY more than "moderate." His whole penis was very swollen along the entire shaft. The foreskin is made up of highly vascular tissue, from what I've been told, and any trauma to it can result in alarming looking swelling -- just like a really fat lip that puffs up huge in just a minute or two, and then, almost as quickly, subsides.