Tight foreskin=circumcision?

[mum_inlove]

Hey all..

I just want to ask some questions..I noticed in the past week, my ds' penis looks a bit bigger, well, swollen than usual. So anyway, I took him to the gp today just to get it check, coz I wasn't sure whether it's because it's growing or maybe something else.

The gp said it looks a bit inflame at the moment, but it's nothing to worry about, so that's good. Then he said that ds' foreskin is very tight. He said it's pretty normal at the moment, but we'll have to wait for a couple of years or until when ds is around 6-7 years old, if it's still tight, then we might have to consider a circumcision.

What I want to know is, does tight foreskin means a bigger chance he'll need a circumcision? I mean, circumcision will be my last option, but it is need to get done, I would want him to get it done when he's still a bit young. But hopefully we won't have to.

Anyway, Thanks for all your advices in advance:wave:

[pookiesossige]

I was under the impression that many boys' foreskins are unable to retract until they are 9 or even older? And that there is no issue with that at all...

If I were you- I'd put my mind at ease and get a second opinion (or two). You may find that there is nothing to worry about. Plus, for a tight foreskin that is actually causing problems, a range of topical steroidal creams are easily available and are often prescribed for this sort of thing.

Maybe you could ask your doctor (or another one) about creams such as Betamethasone or Clobetasol Proprionate, should the need for them ever arise.

[jasesmum]

DS also had a little penis infection where it was swollen a few months back. His foreskin does not retract yet either...we were given similar advice in that if it did not retract in next few months or so that it was possible that he would need be circumcised. They referred to a condition "phimosis". I also sought a second opinion during this period of time as he needed antibiotics, the second doc said that he was far too young at this age to be considering that I think he said I need not worry till he was at least 5.

P.S. for the swollen penis try warm salt water baths...worked wonders for DS.

[MotherNurture]

This 'sticky' thread may be helpful to you:

Phimosis? Foreskin Development & Normal Age for Retraction (http://www.bubhub.com.au/community/forums/showthread.php?t=70500)

The foreskin is designed to be tight during infancy and early childhood. The tip (preputial sphincter) is snug like a purse-string so that urine can flow out but foreign material stays out. The foreskin is also attached to the glans by natural, beneficial adhesions called synechia that disolve over time. The tip of the foreskin may not become stretchy until adolescence when puberty-hormones kick in.

The chances that he'll ever need a circumcision are very, very slim.

Jen

[BabyLs]

We went to a developmental paed for my son and as part of his assessment he was checked over physically aswell. The Paed said his foreskin was really tight and there was slight ballooning when urinating.

We were referred to a Paediatric Urologist and he said we have to wait and see aswell....he said keep and eye on it and we are going back in 12 months....He said these days a boys penis doesn't retract til they are around 8 years old. He said the same to us that if it is still tight then he would look at cirumsicision. We may need to we are not sure, time will tell.

[warriorPRINCESSdaughter]

My DS1 had a tight fitting foreskin and i used to be worried about it not coming back as he got older, he is now 19. anyway once he got old enough to bath himself, i would tell him thatto be gentle when it was ready it would pull back. so to wash it and rinse it well. i have always been big on the truth about our bodies so it came naturally one day to ask him if his foreskin was coming back to wash? his comment will ring in my ears for ever " Of course it is mum" he was about 9. Don't fret it's normal.

Jodie

[our3boys]

i was told this also and ended up getting ds done if i was you i would get a second opinion as i should of.

[mum_inlove]

Thanks for all your help ladies! It really does put my mind at ease. Will try the salt water bath and see how it goes. The swollen has gone down a little this morning, so that's good. He didn't show any sign of discomfort, so that's another good thing. Maybe I'm just over reacting..Lol..But yeah, I'll just need to keep an eye on it for longer and get a second or even third opinion when it necesarry..:)

Thanks again!

[MotherNurture]

The Paed said his foreskin was really tight and there was slight ballooning when urinating.

I just wanted to say ballooning happens when the synechia (natural, normal adhesions) release before the preputial sphincter (foreskin tip) becomes stretchy...it's a totally normal developmental stage that lots of boys go through. :)

Jen

[perthmum2007]

I was wondering this with ds so i just asked the doctor when i seen him one day he asked to have a look and agreed it was a bit tight (ds was 3) so he prescribed some steriod cream which will loosen it, I didnt want to put it on ds so i took him back to another doc he told me to forget about the cream as there suppose to be like that it will get looser as he gets older but for now not to worry to much.

[jasesmum]

This 'sticky' thread may be helpful to you:

Phimosis? Foreskin Development & Normal Age for Retraction (http://www.bubhub.com.au/community/forums/showthread.php?t=70500)

The foreskin is designed to be tight during infancy and early childhood. The tip (preputial sphincter) is snug like a purse-string so that urine can flow out but foreign material stays out. The foreskin is also attached to the glans by natural, beneficial adhesions called synechia that disolve over time. The tip of the foreskin may not become stretchy until adolescence when puberty-hormones kick in.

The chances that he'll ever need a circumcision are very, very slim.

Jen
Just wanted to say thanks for this information and to all the other ladies. Circumcision would be a last resort. During the time my son had his infection we were told that it may recur often because of his tight foreskin and the pain that he was in was the only thing that would have made me consider circumcision. However, touch wood, it has only happpened once so far and knowing it is normal for it to not retract at this age is comforting. Reading the material provided by MotherNature makes me wonder if his swollen penis was made worse by the doctors inspecting him! Makes me question the trust we put in so called experts!:confused:

[MotherNurture]

During the time my son had his infection we were told that it may recur often because of his tight foreskin...

I'm not questioning what you were told, but this is completely illogical. Infections are caused by viruses, fungus, an bacteria---not intact skin. Pre-puberty, a tight foreskin is normal, normal, normal. Messing with it, tugging, causing microtears and abrasion, overzealous cleaning with soap that disrupts the natural pH/flora balance, etc. is what causes irritation and makes the penis more prone to infection. :(

It's really sad and upsetting that care providers can be so ignorant.

Jen

[OscarTheGrouch]

It's really sad and upsetting that care providers can be so ignorant.

Jen
That's a bit of a generalised statement isn't it.:rolleyes: I'm not sure if you've even been to Australia before, but we're quite fortunate that 'most' (definately not all) health professionals are ethical and certainly not 'ignorant'.

[stellarella]

That's a bit of a generalised statement isn't it.:rolleyes: I'm not sure if you've even been to Australia before, but we're quite fortunate that 'most' (definately not all) health professionals are ethical and certainly not 'ignorant'.

Sorry to jump in here but I've been to Australia. Lived here all my life and unfortunately I beleive that many of our care providers are ignorant and do give out incorrect and outdated information. The ones who dont are few and far between so if you have one then stick with them. :)

[MotherNurture]

That's a bit of a generalised statement isn't it.:rolleyes: I'm not sure if you've even been to Australia before, but we're quite fortunate that 'most' (definately not all) health professionals are ethical and certainly not 'ignorant'.

I just reread what I wrote and I'm not sure how I generalized? I said they *can* be, not that they *are*...and, not just relating to Australia. We have very similar problems in the states with forced retraction and misdiagnosis of phimosis. :(

Jen

[Ys_Woman]

Sorry..long post..

When my ds was born 7 years ago our gp was dead against circumcision even though both dh's family and mine had always practiced it. So we let it go and thought maybe it is better to let him be natural.
Ds complained of a sore penis on Xmas Eve last year so I took him to a gp who couldn't find any infection. It settled quickly so we thought nothing more of it.
In July of this year ds started finding urination painful so I took him to my gp who couldn't find any infection but found that the foreskin was tight at the end. A few days later we presented to the emergency section of our hospital as our ds found it almost impossible and incredibly painful to urinate. They told us he needed to be circumcised asap and referred us to a pediatric surgeon.
The pediatric surgeon saw him in August and suggested we trial a steroidal cream for 3 months before reviewing the situation but after only a few weeks of using it the problem began to flare again. Hearing my son screaming the house down when he had to wee was the most awful thing ever.
I made an emergency appt with the surgeon on the 10th of September and felt sure he would take my son in immediately for surgery. Instead he agreed that the cream wasn't working as there was too much scar tissue at the end of the foreskin but said surgery would be three months away as it wasn't considered urgent.
I was furious as my lovely son was in sheer agony and could only dribble a drop of urine out at a time. His penis was four times its normal size and was blue and red.
The next evening ds was staying overnight with my eldest dd when the screaming began in earnest. She got frightened and rang an ambulance. The head of the penis was completely closed off and see through. You could see the urine trapped behind it but unable to escape.
The surgeons came down after a few hours and recognised it as a severe form of Balanitis Xerotica Obliterans and operated immediately. What should have been a simple circumcision ended up being an operation to open the penis to relieve the infection and swelling with the promise it would be closed and completed within 4-6wks.
We had our review appt yesterday and the surgeon now wants to wait for another 5 months to close the penis and complete the circumcision as he says the damage is too severe currently.
So when I asked the pediatric surgeon where I could get a baby boy circumcised in our town, should my current pregnancy turn out to be a boy..he replied by looking at me aghast and telling me, "That is ********!"
Go figure. I personally think that what my boy has had to endure is ********..and now he has another five months to look at the trainwreck his penis is now.

[circangel]

If you are against circumcision and a tight foreskin is all that presents then it should be ok as long as it is not phimosis and then it can be treated but if there is infection the circumcision might be the best.

[MotherNurture]

Amy,

It is usually absolutely unnecessary. I've worked in healthcare for years and have worked with many diabetic patients who have been missing toes, feet, or legs. I'm sure that the ulcerations and infections that lead to amputation being required caused a lot of distress and trauma. Does that mean we should remove those healthy, normal, functional body parts from infants? No. The chance of a boy ever requiring circumcision for medical reasons as it seems your son did is just 1%.

Some information on BXO: http://www.cirp.org/library/treatment/BXO/

It's apparently a skin disease of unknown etiology, meaning they don't know what causes it. And *females* can develop the disease too, so this isn't just a boy/foreskin thing. In fact, it 6x more common in females. About 15% of cases are in children, and most of the time it's vulvular; it's typically a disease of the vulva (external female genitalia).

http://www.emedicine.com/derm/topic234.htm

Not surprisingly, the "cut it off" method of treatment isn't applied nearly as readily to females as it is to males.

Jen

[MotherNurture]

If you are against circumcision and a tight foreskin is all that presents then it should be ok as long as it is not phimosis and then it can be treated but if there is infection the circumcision might be the best.

A tight foreskin post-puberty is called phimosis, and phimosis is almost always curable without circumcision. Phimosis does not mean "infection". Prior to puberty, as long as a boy can urinate okay an attached, snug foreskin is physiologically normal.

Phimosis? Foreskin Development & Normal Age for Retraction (http://www.bubhub.com.au/community/forums/showthread.php?t=70500)

Fungal infections (like candida/yeast) can be treated with an antifungal, and bacterial infections are treated with antibiotics. If you suspect your intact son has an infection it's important to demand a culture be taken from the tip of the foreskin (without manipulation/retraction) to ensure whatever they prescribe to treat it is appropriate. For instance, if you inadvertantly treat a yeast infection with antibiotics you're going to make the situation much worse.

Jen

[Ys_Woman]

Amy,

It is usually absolutely unnecessary. The chance of a boy ever requiring circumcision for medical reasons as it seems your son did is just 1%.
Jen
Thank you for your response Jen. Sorry I didn't see it earlier but just thought to pop in today.
I will be pushing for the new baby (should it be a boy) to be circumcised at 9mths. It will be done under anesthesia.
If you read the literature on BXO you will find that it actually occurs in 15% of boys, not 1%. The surgeon even quoted those figures.
As to it being rare and unlikely to happen again..well there is evidence (however slim) from the UK showing it can have a genetic link. Monozygotic twin nine year old boys both presented with BXO requiring surgery.
I will not subject another boy to the agony my 7yr old has had to endure.
Thankfully babies do not store memory in the first three years of life..and it would simply grow up looking like the rest of the males in the family.
Each to his/her own I guess.
Amy:)

[AM]

Thankfully babies do not store memory in the first three years of life..

Actually, every experience we have from the moment we are born, and probably some of in the womb is committed to unconscious memory, something we usually cannot access terribly readily, but it is still definitely there, and yes it is part of our makeup.

I am not writing this to make you feel bad, it is just a very common misconception which people still have.

www.birthpsychology.com/healing/emerson.html

[AquaDevil78]

Thankfully babies do not store memory in the first three years of life..

Actually, every experience we have from the moment we are born, and probably some of in the womb is committed to unconscious memory, something we usually cannot access terribly readily, but it is still definitely there, and yes it is part of our makeup.

I am not writing this to make you feel bad, it is just a very common misconception which people still have.

:yelclap:

[Ys_Woman]

Perhaps what you say is true too ApprenticeMomma..but, when asked, my husband and my father could not remember their circumcisions...children adopted in the first few years grow up with no memory of the previous family, and thankfully, babies born premmie and given all sorts of heinous surgeries without anesthesia present with no memory of it later in life either.
I wonder if you are actually saying that memory can be laid at a cellular level and therefore exist but is not understood by the conscious mind, nor ever brought to there, but due to its existence can somehow influence one's life unconsciously in a knee-jerk fashion?

Whichever way, I will be having this new one (if it indeed is a boy) circumcised in the first year of life so it doesn't end up with the memories my 7yr old is carrying.

Amy:)

[the_queen]

Amy, instead of a "pre-emptive strike", would you consider adopting a 'wait-and-see' attitude towards your new son? From your older son's story (which sounds awful, you and he have my full sympathy) it sounds like if effective treatment had begun when the problem first started, the following pain and suffering may have been avoided. There is a good chance that this new baby boy will not be affected by the problem, and although the risk factor may be 'higher' for him than for the average newborn baby boy, the chances of everything being fine and normal are still higher than the alternative.

As Jen mentioned before, BXO is usually vulvular - did you get Selia circumcised? That would have prevented her getting it too.

[MumOf4Monsters]

That's like your son having problems with his tonsils and then declaring that you will have the tonsils of any subsequent baby removed at birth.
No parent would follow this line of reasoning in regards to tonsils.
What makes you eager to apply that logic to someone's penis?

jjj199 If you think about what amy and her son have gone through, it's no wonder that she wants to make sure that this does not happen to her new baby.
I have three boys and none of them have been circumsised. When my 1st ds was 2 he had an infection under his foreskin and i can totally sympathise with amy! It is the most horific thing to have to stand by and listen to your child scream in sheer agony.
While i don't agree with circumcision, i can fully understand where amy is coming from, she is obviously thinking ahead and has her childs best interests at heart.

[MumOf4Monsters]

If you considered my entire post you would see the error in her logic. I have carefully analyzed her comment; hers is fairly generic. The lady on 60-minutes who had her 3rd son cut did so because of an infection in the 1st son.

Such parents build their approach to this on the idea that foreskins are troublesome and out of place to begin with. How many people demand their baby's appendics be removed at birth due to problems with appendics encountered in previous children?

The cultural forces of this issue can be illuminated with "cross-body-part analysis".

jjj199 I totally agree with you and please don't think that i was having a go at you, i just felt that amy was being judged a little because of her choice to circumcies her next child.

Regardless of weather there is error to her judgement or not, i was just trying to say that given the situation that she has been in with her son, it's no wonder that she wants to makes sure that it does'nt happen again. Weather this is right or wrong, she is trying to protect her new child.:yes:

I do understand where you are coming from with the apendix analogy. I think that alot of people DO think that foreskins are troublesome. My father and brother are circumcised, my husband is circumsised. I refused to circumcise my boys because i don't think that it is nesescary and the thought of it sends shivers up my spine.:(
I do still worry though weather they will fit in socially....I know that sounds silly, but when you grow up around circumcised people, i guess it just sounds like the normal thing to do. KWIM?
I still get family telling me that i've made a big mistake by not circumcising. I guess my boys are lucky that i was well informed by other people such as yourself. I can tell that you are passionate about this subject and just want to inform people:thumbsup:

[MotherNurture]

So, what happens if you circumcise a brand new, perfectly normal and healthy baby boy because your previous son developed a problem---a problem which is unlikely to happen again, and is even significantly more common in female children---and this new baby is one of the 10% of circumcised boys that acquire meatal stenosis (http://www.emedicine.com/ped/topic2356.htm) because the delicate opening has had it's built-in physiological protection permanently stripped away? Or what if he's one of the 71% of circumcised boys that develop penile adhesions (http://www.cirp.org/library/complications/ponsky2/)? Or what if he develops a more rare but serious problem like MRSA in his circumcision wound, or necrotizing fasciitis? If you think your child might not be lucky with regard to health issues, why roll the dice with unnecessary surgery?

A foreskin is normal, healthy, standard tissue. It's part of the penis. It's laden with nerves and blood vessels. The head of the penis is designed by nature/god to be an *internal organ* when not in use. No foreskin means that delicate skin dries out and thickens. The same thing would happen to your clitoris if your foreskin (female prepuce, clitoral hood) was amputated.

Genitals are personal. Intimate. Sexual. Perfectly healthy, standard, normal genital tissue needs to be given the benefit of the doubt. The chance of a boy ever requiring circumcision for medical reasons is just 1%. Prophylactic surgery that removes 1/3-1/2 of the skin on his penis---the only independently mobile part, in fact---denies him an optimally functioning penis and sex as nature intended it.

Jen