Is separation with pain and swelling really this dramatic? Or is it infection?

LCBMAX · Nov 15, 2010

I was busy hijacking an old thread on this subject - here it is as a new one -
 
Hey all you experienced ladies, do you think my son's symptoms tonight shout separation or infection to you (he's been out of diapers for over a year now):
3 weeks ago had a single pee that hurt - no other symptoms at that time.
10 days ago had a full on niagara-like runny nose, no fever, no complaints.
3 days ago said his penis hurt, but no other complaints and nothing to see.
First morning pee today with unprecedented spray all over.
This morning in the car seat said his penis hurt again, belt adjustment helped.
Normal looking penis at 12:30 pee before nap.
Somewhat red and swollen penis at 2:30 pee after nap but I hardly paid attention.
Cranky as hell this afternoon.
Then at 5:30 pee a very swollen foreskin, with redness, then the penis narrows, then there is a dusky red and swollen lower third, meeting the body with normal color.
Pee has been painless so far since that one time weeks ago. No fevers so far. 
Took warm bath before bed, and slathered with miconazole (anti fungal) at bedtime.
Dosed him with a little benedryl so I could check him more carefully after sleep, and I found a pus-like drainage, about 1- 2 cc volume, minimal odor but some slight smell, not sticky. When the flow stopped, I gooped him up with antibiotic ointment to counteract the sealing that the fluid was doing at the opening - that would otherwise really hurt in the am with first pee. I know this works against the miconazole, but that just didn't have the goop factor and I don't have any other ointments at hand. (I am 100% confident that I don't have to worry about stds so the fact that this would also ruin a culture didn't stop me.) Lymph nodes in the groin are palpable, not very large, but certainly present.
 
We haven't given any fever/ pain reducer since I want to follow that overnight, and I'll also be checking through the night for worsening redness or swelling. So far it's really limited to the penis.
We'll be seeing our trusted pro-intactivist md in the am.
 
Could this really just be separation? It's sooo dramatic, and it sure looks wrong, not like a healthy process... Wish we'd taken pics. Will try in the am if it's still notable.
 
AM update - cheerful, no fever, playing comfortably, possibly less angry red this am, and the tissue of the foreskin seems less fluid-filled - I had husband take a picture in the bath this am which I would share with established mdc members by request. His pee this am caused crying and complaints of pain "at the bottom" by which he meant the opening, not the penis itself. I tried to get him to pee in the water, so of course, toddler style, he stood up in the water to pee. No spray today. 
 
Will lie in wait for the doc when the office opens.
 
Thanks for any thoughts you have time to share!

eepster · Nov 15, 2010

What kind of antibiotic cream is it? Neosporin (polysporin) can cause irritation to genitals, thus making current symptoms appear to last longer and start new symptoms.
 
Did you check to make sure there was nothing wrapped around the penis? Maybe a hair or loose thread from clothing. The "dusky color" makes me think this, so check really well. 
 
If it is an infection, the penis itself could be a bit warmer than usual. 
 
Avoid the Dr unless you know for a fact that he is unusually foreskin knowledgeable. If you do end up seeing the Dr, do not let him/her retract!!

GoBecGo · Nov 15, 2010

sounds like an infection. my friends little boy had something similar happen, bit of pus and inflammation, then cleared up by itself (she did even less than you did, just wiped the pus off once basically, took him to the dr who gave her a cream but he refused to let her touch it and she didn't want to force him). it looked dramatic, but the dr pointed out that the tissues of the penis are designed to swell easily and stretch well so it tends to look more dramatic than say a comparatively infected cuticle or something. nak

LCBMAX · Nov 15, 2010

Thanks eepster - we're good on all those issues - we used bacitracin, checked for a hair, and our doc is not only supportive of keeping boys intact, he's by nature a non-interventionist. He made sure that we knew not to ever retract when we told him we were not going to circ. Lucky to have such support. 
 
The penis is warmer, but it couldn't help being otherwise since it's engorged, even if no infection.
 
 
Any other decision-tree points?
 
(it still stings to pee even in water... I'll recheck that sticky on other pain relievers.)

LCBMAX · Nov 15, 2010

Update - 
Doc feels strongly that it's a severe yeast infection, and rx'd a liquid diflucan. My son says "yuck", or more accurately screams and drools for 30 + minutes every time I try to get it in him. I've tried honey, applesauce, gelled in his beloved aspic... no soap. So we've trashed 3 doses so far. Pharmacist says try chocolate pudding, so ok, I'll make some, though I do get pretty frustrated about treating a yeast infection with loads of sugar! Doc says a topical is unlikely to penentrate the tissues well enough but if that's all we can do, we should wrap the little penis in saran wrap after applying it. Can't wait for the messy fest of silliness that will be at bedtime.
 
Symptom-wise, much less tender, and no discharge, and no more pain with peeing so all is on the upswing. The redness though is still very dusky and perfuse and worrisome. Well, I'm good at the worrying.
 
Meanwhile, any other suggestions about how to get the med in? Should I move to a new forum now? Never been over here before so I don't know how loose the interests are here...

eepster · Nov 15, 2010

Old fashioned neighborhood pharmacists will add a special flavoring to medications that is much better at killing the icky taste than anything you have at home.
 
That said, I would give a topical cream like monistat a chance to work before resorting to diflucan. I would be very careful about wrapping it in plastic wrap. If you do it too tightly it could cut off the circulation. Personally, I would be more worried about the potential of wrapping it too tightly than the possibility that the cream didn't penetrate far enough. Even a really bad yeast infection doesn't pose much danger (it's really just uncomfortable,) so I would tend to stay conservative with the treatment.

MCatLvrMom2A&X · Nov 16, 2010

When we tell mama's here to use OTC monistat it is always just apply a liberal amount on the whole penis then diaper. I never heard of anyone needing to wrap it with anything before. 
My pharmacy here will add flavor to any medication like that.

NYMOM07 · Nov 16, 2010

i am dealing with something worse than this, and it definitely sounds like an infection. get it checked out, my son is in excrusiating pain and his whole penis is now swollen and he is scared to pee because it hurts.

MCatLvrMom2A&X · Nov 16, 2010

Have you read this thread <a href="http://www.mothering.com/discussions/showthread.php?t=764732">http://www.mothering.com/discussions/showthread.php?t=764732</a> there are some tips in there for helping with the pain and figuring out what might be going on ie separation, bacterial infection or yeast. <img alt="hug.gif" class="bbcode_smiley" src="http://files.mothering.com/images/smilies/hug.gif">

LCBMAX · Nov 18, 2010

Wow - still not sure how the multi quote thing worked, but it did...
 

<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by MCatLvrMom2A&X <a href="/community/forum/thread/1279459/is-separation-with-pain-and-swelling-really-this-dramatic-or-is-it-infection#post_16048357"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a> 
When we tell mama's here to use OTC monistat it is always just apply a liberal amount on the whole penis then diaper. I never heard of anyone needing to wrap it with anything before. 
My pharmacy here will add flavor to any medication like that.</div>
</div>
 
I think because disposable diapers really act just like an occlusive dressing, and because most infections just aren't this severe... it's a regular practice to increase the potency of many creams, especially steroids. 

 
 

<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by MCatLvrMom2A&X <a href="/community/forum/thread/1279459/is-separation-with-pain-and-swelling-really-this-dramatic-or-is-it-infection#post_16048820"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a> 
Have you read this thread <a href="http://www.mothering.com/discussions/showthread.php?t=764732">http://www.mothering.com/discussions/showthread.php?t=764732</a> there are some tips in there for helping with the pain and figuring out what might be going on ie separation, bacterial infection or yeast. <img alt="hug.gif" class="bbcode_smiley" src="http://files.mothering.com//images/smilies/hug.gif"></div>
</div>
 
That was so helpful - luckily the pain was gone after 2 pees!
 
 

<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by eepster <a href="/community/forum/thread/1279459/is-separation-with-pain-and-swelling-really-this-dramatic-or-is-it-infection#post_16048123"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a> Old fashioned neighborhood pharmacists will add a special flavoring to medications that is much better at killing the icky taste than anything you have at home.
 
That said, I would give a topical cream like monistat a chance to work before resorting to diflucan. I would be very careful about wrapping it in plastic wrap. If you do it too tightly it could cut off the circulation. Personally, I would be more worried about the potential of wrapping it too tightly than the possibility that the cream didn't penetrate far enough. Even a really bad yeast infection doesn't pose much danger (it's really just uncomfortable,) so I would tend to stay conservative with the treatment. 
</div>
</div>
 

oooh I wish I'd tried that... I think there's one in town that might be able to do that. I hear you on the precautions about tightly - I am unskilled with saran wrap in the best of circumstances, so I'm pretty sure I would make it loose enough to be ineffective!
 
Today - so much better! This was a shock to me - thanks for your support.

Is separation with pain and swelling really this dramatic? Or is it infection?

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