Mothering Forum banner
1 - 20 of 41 Posts

·
Registered
Joined
·
10,944 Posts
Discussion Starter · #1 ·
Ds is 3 yrs old. Yesterday, ds's penis became swollen, red and painful to the touch. (the entire penis was red/swollen). Doc said (via phone call) that it was an infection. Suggested ointment.

This morning (saturday), the underside of ds's penis was black and blue! His pediatrician made a house call. He started to retract ds's intact penis and I said "Whoa! You're not supposed to retract it!"
His doc said "Yes, normally, you do NOT retract it but I NEED to see the glans so I can get an idea of what is going on."

I felt soooo bad. He did retract it...just enough to see the tip of the penis.
Ds definitely has an infection. It looks all oozing. (gross, I know).
Doc recommend Lotrimin but he said I have to retract the penis a little so that I can apply the the Lotrimin right on the tip/head of the penis. He said that the medicine MUST get in there in order to clear up the infection.

I'm so afraid that I'm going to cause MORE damage by retracting the penis 3 or 4 times a day.

What should I do???

FYI: Ds has sensory issues and PDD...Which means that he FREAKS out when his penis is touched even when he doesn't have an infection. Plus, he does not understand reasoning. Nor does he stay still for all this.
This is heartbreaking to watch him thrash about, cry, scream while we have to put the Lotrimin on.

Someone mentioned ds dipping/soaking his penis in Colloidal Silver but there is NO way ds would stay still for that.

PLEASE HELP!
I just don't know the best course of action for this.

Thank you!!!
Liz
 

·
Registered
Joined
·
8,415 Posts
hmmn. i have no 'official' advice, but i do wonder why a lubed sterile blunt-tipped syringe would not slip in the fraction of an inch necessary (if it HAD to be invasive at all, you understand i am not advocating this) to apply an ointment without any retraction or force whatsoever? (because it would take more time & finesse, i'm guessing?) i can only look at my sons and that is the logical thing that comes to my mind, anyway.

and now for a word from our experts, lol.
 

·
Registered
Joined
·
6,285 Posts
The first thing that occurred to me is that the black and blue would be bruising from the swelling. Ds gets horrendous swelling from mosquito bites and often bruises deeply as a result.

I also think there should be a way to get the medication in without retracting - or at least not retracting past a point where he could retract himself. (Ds is not retractile at all, but often pulls his foreskin back to where the opening can be seen.)

Sorry he (and you!) are suffering through this.
 

·
Registered
Joined
·
2,295 Posts
It doesn't sound like your doctor took a swab for culture-which means, he's just guessing as to what's causing the infection. He prescribed Lotrimin-which I believe is an anti-fungal, but what if he's wrong? Then a bacterial infection would be continuing on, untreated. And it already sounds like the inflammation is pretty severe.

I would demand a culture.

Also, if it is a yeast infection, I know their are oral medications for yeast that work systemically (Diflucan). I'd imagine it would be possible to it that way, in addition to applying Lotrimin topically...and avoid messing with the penis too much.

You could also look into giving him acidophilus supplements or feeding him yogurt, to help if it's yeast.

But if it's bacterial, he needs antibiotics.

The only way to know, is to take a culture.

Jen
 

·
Registered
Joined
·
11,048 Posts
Lotrimin is definitely an anti-fungal, not an antibiotic. You NEED to get a culture to determine what the issue is. If this is a bacterial infection, Lotrimin will do no good and you may even need oral abx. If this is a yeast infection, you need to know that it is a yeast infection.

Is your ds retractable? If he is, I don't see a huge issue with retracting as long as there aren't any adhesions being broken. After all, for a vaginal yeast infection you insert the cream into the vagina, so I do see the logic in getting the medication where it needs to go. As long as the retraction isn't causing any FURTHER trauma it should be OK - but first you need to know if there is something going on that necessitates this course of action!
 

·
Registered
Joined
·
4,673 Posts
Ok, first things first. Go to the main forum page for this forum and read my sticky titled "Red, Swollen or Inflamed Foreskin?" This may answer a lot of questions. Your son is about the right age for what that thread is describing. If that's the case, I can imagine your son is showing improvement as I am writing this. If it is the case, the lotrimin is does not get the credit. I do!


But, if that is not the case, what Jen wrote is absolutely correct. A culture is needed to accurately diagnose the infectious pathogen. A culture will determine if it is fungal or bacterial in nature and will identify the specific fungi or bacteria. Once it is identified, an antifungal or antibiotic can be prescribed that is known to attack that particular pathogen.

But, I'm going to concede another point to the doctor. It is highly unlikely that he would bring what is needed for a culture on a house call. If he knew that it was a suspected infection, he should have but we've got to look at realities here. I doubt you could get one of the local doctors here to make a house call with the promise of a new Mercedes Benz.

I don't know the mechanics but I know that you do not have to get the lotrimin or the antibiotic inside the foreskin for it to work. Just apply it to the outside and if you can, put a dab in the foreskin tip. Ladies, if you have a yeast infection, do you have to swab the antifungal inside your vagina? I'm thinking not and I suspect it has something to do with the lack of oxygen inside the vagina or inside the prepuce.

If you don't see substantial improvement in your son's condition by Monday morning, take him to the doctor's office and insist on a culture. If this condition appears to go away only to come back a couple of weeks later, take him to the doctor and insist on a culture.

This is not rocket science, it's just good practice and diagnostic procedures. It's the kind of thing a med school student should know.

Frank
 

·
Registered
Joined
·
1,355 Posts
No advice, just wanted to say I hope it clears up. Your poor son, and poor you. I agree that I would demand a culture - don't want to treat a yeast infection with anti-biotics - you'll have a real mess on your hands. My kids get horrible yeast reactions to antibiotics. I can't imagine how bad it would be if it was a yeast infection to begin with.

Best of luck, keep us updated.
 

·
Registered
Joined
·
1,918 Posts
Sorry Frank, the antifungal must go INTO the vagina to be effective on a vaginal yeast infection. If you only have a vulvar infection, you can apply it to just the vulva and labia. It's a topical cream, you have to apply it ON the infection site, not nearby.

I'm with the PP who suggested a blunt-tipped syringe to push a small amount of the cream into the foreskin. But only after the infection has been cultured and a pathogen-specific anti-microbial has been prescribed. Just sticking any old anti-fungal on it is shooting from the hip, as Frank likes to put it.
 

·
Registered
Joined
·
10,944 Posts
Discussion Starter · #11 ·
His pediatrician was coming from the hospital (to see a new baby) and stopped here on his way home.

I will DEFINITELY take him to get a culture on Monday. Why is it that kids seem to mostly get sick on weekends?


Ok, NOW for something that is REALLy going to get ya...
His doc just emailed me and said that I should retract ds's foreskin to the glans every time I bathe him.
:

Although this doc isn't completely mainstream, he's enough to make me want to change docs. This doc is completely ok with non vax, no circ, etc.
Plus, he used cloth diapers on his kids and they are vegetarian (like us).
And, he has made two housecalls to us so far. So, in some ways he's great...but in others...He just doesn't seem to have a clue.


So, Frank, what do you have to say about retracting the foreskin every time I bathe ds?

Oh, that post you suggested seemed just to be about red, swollen foreskins... My sons ENTIRE penis was red and swollen...not just the foreskin.
Don't know if that makes a difference.

Thank you all!
Liz
 

·
Registered
Joined
·
4,673 Posts
Quote:

Originally Posted by lizc
So, Frank, what do you have to say about retracting the foreskin every time I bathe ds?
Balderdash!

Quote:
Oh, that post you suggested seemed just to be about red, swollen foreskins... My sons ENTIRE penis was red and swollen...not just the foreskin.
Don't know if that makes a difference.
The swelling and redness does often involve the entire penis. The entire area is sensitive like the lips and even the slightest trauma results in over the top responses. But, just as quickly as it comes up, it goes back down. If it is separation trauma, tomorrow morning or afternoon, things will be mostly back to normal.

Let us know tomorrow how it looks.

Frank
 

·
Registered
Joined
·
2,295 Posts
Quote:

Originally Posted by Frankly Speaking
But, I'm going to concede another point to the doctor. It is highly unlikely that he would bring what is needed for a culture on a house call. If he knew that it was a suspected infection, he should have but we've got to look at realities here. I doubt you could get one of the local doctors here to make a house call with the promise of a new Mercedes Benz.

I don't know the mechanics but I know that you do not have to get the lotrimin or the antibiotic inside the foreskin for it to work. Just apply it to the outside and if you can, put a dab in the foreskin tip. Ladies, if you have a yeast infection, do you have to swab the antifungal inside your vagina? I'm thinking not and I suspect it has something to do with the lack of oxygen inside the vagina or inside the prepuce.
First, to take a culture all he needs is a sealed tube from the lab that comes in a sterile package. These come by the boxfull in tear apart packages, and any doctor that does well woman care probably has dozens of these swab kits in their gyn drawer. Inside the package is a sterile, capped tube with a swabstick inside. All he has to do is glove up and open the package, take out the swab, swab the discharge from the penis, stick the swab back in the tube, put the cap back on, label it, and have it sent to the lab. I don't see any reason why this wouldn't be quick and easy to do during a house call.

Secondly, yes, when women get a yeast infection the treatment IS internal. Either we take Diflucan (and/or acidophilus caps) orally, or we use vaginal tablets, suppositories, or suppository creams...or, for naturally-minded ladies, plain unsweetened yogurt is a popular natural remedy. Sometimes over the counter vaginal yeast treatments (Like monostat) come with a small tube of soothing cream to use externally as well. But, the creams and suppositories come with applicators and instructions to insert the medication as deeply as possible, usually at night.

Jen
 

·
Registered
Joined
·
10,944 Posts
Discussion Starter · #14 ·
Back to the original issue: Penile infections. I'll update in the morning. I have been using the Lotrimin so if it does start to look better, who knows if it's from the med or if it just got better on it's own.

I will continue to let ds to soak in a plain, warm tub every day til this clears up though. It seems soothing to him.

I wanted to put Tea Tree Oil in his bath but I discovered that mine had expired. Doh.
 

·
Registered
Joined
·
2,295 Posts
Quote:

Originally Posted by LeosMama
I'm with the PP who suggested a blunt-tipped syringe to push a small amount of the cream into the foreskin.
My only concern is that doing this, especially if the child doesn't have much space between the prepuce and the glans (and may have still have a narrow foreskin opening) could force some of the cream into the urethra. I'm not sure what affect that might have, but I'd be very careful and not use much cream at all if the OP tries this (with the approval of her son's doctor, of course).

Jen
 

·
Registered
Joined
·
2,295 Posts
lizc-

Has your son ever retracted his foreskin himself, or have you ever went to change his diaper and noticed his foreskin retracted? If so, retracting to apply the cream or teaching him to rinse underneath during bathing would probably be okay, IMO. But if you haven't seen any signs that he's retractible without you or a care provider manipulating it yourselves, it may not yet be retractible. The general rule I've heard is that he should be the first one to retract his own foreskin, because only he knows what's comfortable, and if it hurts will know precisely when to stop. KWIM?

HTHs,

Jen
 

·
Registered
Joined
·
11,048 Posts
Personally I wouldn't put TTO in the bath because I think it would be too irritating even if there weren't already pain and irritation present. I am not a huge fan of TTO - it is very strong and a lot of people get skin reactions from it (like me).
 

·
Registered
Joined
·
10,944 Posts
Discussion Starter · #19 ·
I had emailed ds's pediatrician this evening asking whether retracting ds's foreskin on a regular basis is such a good idea. He replied saying that he is aware of foreskin retraction controversy but in my son's case, it the benefits outweigh the risks. He says ds has Balanitis.

I replied asking if I should bring ds to the office on Monday for a culture just to be on the safe side and that I do know that he can take a culture without retracting the foreskin.

Now I just wait for the reply.
 

·
Premium Member
Joined
·
16,194 Posts
Quote:

Originally Posted by Pandora114
Acctually Frank, you do have to put the Monostat *up there*

.
Or you just take Diflucan orally.
 
1 - 20 of 41 Posts
Top