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Foreskin troubles possible medical circumcision - anyone been through it?


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#1 Guest_Day-dream_*

Posted 11 April 2012 - 11:58 AM

My DS who is 18 months old has been holding his penis occasionally and saying "ow". Went to the Dr's and had him checked out, was a bit red at the end and seemed to cause him some pain. Doc says he has only a "pin" hole at the end of his penis and that we need to try and retract the foreskin in the bath each night for a month. If this is unsuccessful he may need a circumcision.
I am feeling worried, hopefully the manipulation will work. I've googled the issue and apparently topical steroids can sometimes help to though I'm confused as wikipedia says that the foreskin is not meant to be retracted at his age. I don't want to go ahead with the circumcision unless absolutely medically necessary.

So, have you been in this position? Would you seek a second opinion? unsure.gif

#2 Guest_Day-dream_*

Posted 11 April 2012 - 08:31 PM

Okay, not feeling happy about all of the above, I've booked an appt with a paed for a second opinion. Would still love to hear from anyone who has had a similar issue or been through this before.


#3 Mummy2twoBOYS

Posted 11 April 2012 - 08:37 PM

My older boy age 6 had a very tight foreskin. We have just finished 25 days of the steriod cream and his foreskin is completely retractable.  Worked wonderfully. Goodluck

#4 *Mumma-to-A*

Posted 11 April 2012 - 08:45 PM

I had my 4 years old checked when he had his needles 2 months ago. The Gp prescribed the steriod cream for 1 month and then if still tight she would refer to a urologist for further treatment or possible circumcision. I haven't gotten around to using the cream yet. I'd be concerned that a GP recommended this for a 18 month old as he should have referred you to a specialist if it seems that bad.

I was advised to gently retract the foreskin but never force more than it goes (which isn't much)



#5 soontobegran

Posted 11 April 2012 - 08:57 PM

I would definitely seek another opinion and in the mean time please do not try and retract the foreskin on your 18 month old's penis.
That is terrible advice! mad.gif
The foreskin is adhered to the glans of the penis usually for at least 3 years and often many years more. Retracting it can cause tearing and scarring that may mean it will not retract when it should.
The penis is self cleaning, it is normal for the tip to be a bit red sometimes, it is also common for the foreskin to balloon a little bit when they wee.
If you are concerned please see a paediatric urologist.

#6 B.3

Posted 11 April 2012 - 09:00 PM

QUOTE (soontobegran @ 11/04/2012, 08:57 PM) <{POST_SNAPBACK}>
I would definitely seek another opinion and in the mean time please do not try and retract the foreskin on your 18 month old's penis.
That is terrible advice! mad.gif
The foreskin is adhered to the glans of the penis usually for at least 3 years and often many years more. Retracting it can cause tearing and scarring that may mean it will not retract when it should.
The penis is self cleaning, it is normal for the tip to be a bit red sometimes, it is also common for the foreskin to balloon a little bit when they wee.
If you are concerned please see a paediatric urologist.


Yes, exactly. Don't retract... your GP is an absolute goose!!

#7 charleybear11

Posted 11 April 2012 - 09:01 PM

We are having the same problem with our 3 year old and have been referred to a paediatric surgeon who will investigate further. We were given steroid cream which was to be used for no more than 5 days and we were told not to force the skin back. Hope your LO feels better soon

#8 Mrs SW

Posted 11 April 2012 - 09:02 PM

DH was the same as a child, his parents were told to do the same in the bath etc. It did not work because when we got together sex was very painfull for him and ended up having a circumcision in his early 20's. I would look into circumcision if it were my DS. Good luck and i hope your little guy is feeling better very soon.

#9 soontobegran

Posted 11 April 2012 - 09:07 PM

QUOTE (Mrs SW @ 11/04/2012, 09:02 PM) <{POST_SNAPBACK}>
DH was the same as a child, his parents were told to do the same in the bath etc. It did not work because when we got together sex was very painfull for him and ended up having a circumcision in his early 20's. I would look into circumcision if it were my DS. Good luck and i hope your little guy is feeling better very soon.


The cause of many circumcisions having to be done later in life is because of the advice the OP was given.
Parents should NEVER be the first person to retract the foreskin, that is what the child will do when it is ready.
The parent retracts it, causes a tear, the tear turns into scarring and scarring is inflexible and will often stop retraction occuring when it should!

#10 ubermum

Posted 11 April 2012 - 09:21 PM

HE'S INTACT---DON'T RETRACT!

"As a consequence of misdiagnosis and confusion of normal developmental narrowessness and non-retractablity with pathological phimosis, many unnecessary circumcisions are performed."

What Is Foreskin Retraction?

Sometime during the first several years of your son's life, his foreskin, which covers the head of the penis, will separate from the glans. Some foreskins separate soon after birth or even before birth, but this is rare. When it happens is different for every child. It may take a few weeks, months or years.

After the foreskin separates from the glans, it can be pulled back away from the glans toward the abdomen. This is called foreskin retraction.

Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teenage years. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until separation occurs, do not try to pull the foreskin back — especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin.

American Academy of Pediatrics

Retraction of the Foreskin

At birth, the foreskin is usually attached to the glans, very much as a fingernail is attached to a finger. By puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans.8 This separation occurs in its own time; there is no set age by which the foreskin and glans must be separated. One wise doctor described the process thus, "The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom."9

Even if the glans and foreskin separate naturally in infancy, the foreskin Ups can normally dilate only enough to allow the passage of urine. This ideal feature protects the glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, when he has discovered that his foreskin is ready to retract.

Mothering Magazine:

The tightness of the foreskin is a safety mechanism that protects the glans and urethra from direct exposure to contaminants and germs. The tight foreskin also keeps the boy's glans warm, clean, and moist, and when he is an adult, it will give him pleasure. As long as your son can urinate, he is perfectly normal. There is no age by which a child's foreskin must be retractable. Do not let your doctor or anyone try to retract your child's foreskin. Optimal hygiene of the penis demands that the foreskin of infants and children be left alone.

Mothering Magazine:

Avoidance of premature retraction. Care-givers and healthcare providers must be careful to avoid premature retraction of the foreskin, which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause infection, is likely to generate medico-legal problems, and may cause paraphimosis, with the tight foreskin acting like a tourniquet. The first person to retract the boy’s foreskin should be the boy himself.3

The Development of Retractile Foreskin in the Child and Adolescent
A guidance for healthcare providers from Doctors Opposing Circumcision

Almost all boys are born with narrow non-retractile foreskin which are fused with the glans beneath. This is a normal developmental physiological condition and is not a cause for concern. Some parents needlessly worry that the opening is not large enough.

Retraction of the foreskin should never be forced. It will retract when it is ready. There is no "right" age for retraction to occur.

A narrow non-retractable prepuce in boys is within the normal range of development and usually causes no problems. The prepuce usually will spontaneously widen until complete retractability is obtained. About 50-60 percent of boys at age ten do not have fully retractable foreskins.16 This is normal.16 After puberty, the percentage of boys with full retractability rapidly increases spontaneously.16

If a narrow or non-retractile prepuce becomes a problem, a wide variety of conservative alternative treatments to circumcision are are now available. Circumcision is an outmoded, radical, traumatic, disproportionate, unnecessary surgery for a minor problem.

Normal development of the prepuce: Birth through age 18


More great info, from the Canadian Paediatric Society:

In general, there is inadequate recognition of the long period before the natural separation of the prepuce and glans is complete.96 Some authors still refer to the presence of "adhesions," when, in fact, separation has not yet taken place; similarly, a nonretractible foreskin is still sometimes incorrectly diagnosed as phimosis.97

In a study by Rickwood and Walker98 involving 420 boys referred to their unit for possible circumcision, only 116 (28%) required the procedure. They found no true phimosis in boys younger than 5 years of age. Most of the patients had developmental nonretractability of the prepuce, and their preputial orifice, although somewhat narrow, was supple and unscarred. The authors compared this finding with data from the Mersey region of England, where phimosis was the most common indication for circumcision, accounting for 87% of the procedures, and where 390 of the 950 patients circumcised were younger than 5 years of age. They estimated that approximately two thirds of these circumcisions performed in the Mersey area were probably unnecessary.

Can foreskin problems be treated without circumcision?
Patient friendly alternatives to circumcision.

The #1 rule for intact care is to leave it alone.

The first person to retract a boy's foreskin should be the boy himself.

Until then, just wipe it off like you would a finger or give it a swish of plain water in the bath.

Once he can retract it himself, all he needs to do is "RETRACT, RINSE, REPLACE" in the shower or bath.



I will PM you where I got my information so you can read some more yourself OP.

#11 Guest_Day-dream_*

Posted 11 April 2012 - 09:31 PM

Thank you all for your replies, I knew it didn't sit right with me. Hubby and I have discussed, we now don't even believe it is a real problem, we will keep an eye on it to make sure no further problems present  but I'm going to cancel the paed appt and just leave things alone.
Certainly won't be retracting anything!




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