Treatment of Phimosis using steriod cream

[sarah81]

Hi,

Not sure if this is the right place to put this. I have a 3yr old boy who I have been told may have phimosis.

The Dr suggested trying treatment with steriod cream. I am wondering if anyone has any information or personal experience (good or bad) with phimosis and in particular the use of steriod cream as a treatment option.

Thank you.

[Yoshua]

phimosis is natural at 3 years old.....


You also shouldn't retract a foreskin, not all doctors know this because they have been trained the foreskin is naturally dirty.




There are 2 kinds of phimosis. Natrual and Bacterial. Natural phimosis is what keeps the foreskin TIGHT to the head of the penis until the foreskin naturally retracts. Your son will do this on his own some time usually between the ages of 3 and 7 but some people do not retract until after puberty.

The cream your doctor is talking about typically is used on teenagers and adults who are sexually active but can not retract. Your son is a bit young, it isn't recomended in america to use the Beth cream until teenage years.



I wouldn't worry about your sons foreskin at this stage of the game, it isn't likely it should retract yet and the phimosis is probably natural. However..... if it is bacterial the tip of the foreskin will appear BRIGHT red (typically) and your son will not want ANYONE near his penis because it will hurt. He will actually complain about it hurting even if his is limp. Not just erect.

It is similar to the feelings a woman gets with a yeast infection. And is actually often caused BY yeast infections on boys. However if it is bacterial, the doctor can swab the TIP of his foreskin and do a culture to see what bacteria it is and the right medication to cure it.



However, if your son is peeing normally, shows no signs of distress about his penis, he is probably fine.


Natural phimosis can cause irritation when the child becomes erect. It is because the ridged band is tight around the tip of the foreskin and it is stretching the shaft skin. This is also fairly normal and is 'usually' considered part of the growing process. If your son shows signs of great pain during an erection that is when doctors try to prescribe the steroid creme to help out, however it really isn't nessesary to put the extra steroids into your child so young. Before there was a creme they used to just wait it out until the natural phimosis was done again.



I hope this is making sense, but the moral to this diatribe is that unless you doctor has done a culture, found out the bacteria, and already attempted to treat it with the similar medications they would treat a daughter..... He is jumping to the last resort to 'fix' a problem that probably doesn't even exist.

[Yoshua]

one last thing i felt i want to add.


Remember that no one should be retracting your son. not even the doctor.


Retraction causes small tears between the head of the penis and the mucous of the foreskin. Until the child has retracted himself, no one else should. And your child will learn to retract himself sometime between 3 and 16. There is no set time a child SHOULD retract by.

If someone, including the doctor, retracts him it causes the foreskin to try to 'heal' itself which will make it feel warm to the touch, hurt to the touch, and cause a reddenning of the foreskin while it is healing.


Also, the small tears in the head of the penis now become open sources for bacteria that normally would be kept out by the foreskin to enter into the penis and cause an infection.




if you already knew all this, then hopefully someone else that comes by your thread will read it and become that much more protective of their intact sons. :0)

:wave:

[sarah81]

The reason his foreskin was looked at was because he has had two infections in the last 6 months. Both causing DS discomfort and requiring antibiotic treatment. A swab was taken.

I have seen two Gp's who were both concerned that the possible phimosis was going to cause recurrent infections. The first wanted me to get him circumcised and the second had a wait and see approach. I have gone with the second DR.

If the foreskin shoudn' t be retracted until they can themselves(which we haven't done), how long should it be left? My concern is that by waiting he is going to be subject to more infection and discomfort. But my personal view is that I want to leave the foreskin alone. I guess what I am trying to say is when is treatment warranted for phimosis?

Thank you Yoshua for a comprehensive and informative reply :thumbsup:

[Yoshua]

what kind of antibiotic treatment was prescribed? and yes, go with the second doctor.


Is it possible he has a yeast infection that is recurring? from what I understand Anti-biotics cause yeast infections in intact boys, same as they do in girls. Is there a possibility that the first infection was an infection and the second was a yeast infection?


I would treat each case independantly and get a swab/culture done for each case.

As for the leaving it alone question. The antibiotic creams do not work as well as the oral medications. This is because with a foreskin the cream would need to be applied to the inside of the foreskin, which requires retraction, which opens up more cuts for the infection to take hold. So it winds up going round and round with the infection if the anti-biotic isn't strong enough. And at the same time you would be damaging the ridged band because of the retraction.


The phimosis isn't causing the infection. That is backwards logic on medical thinking. The phimosis CAN be CAUSED by an infection, but not the other way around.


Is your boy out of diapers? 3 seems to be about the right age for that. Not that it will make a real difference but some people have said that when their moved to underwear UTI's reduced or went away after poddy training. Irritations can also be caused by the chemicals placed in disposable diapers.


An intact lil boy is alot like a lil girl. The foreskin 'usually' (as in 99% of the time) isn't the actual cause of the problem. It is typically something outside.


Was yeast infection ruled out? If not those are handled in the same manner a yeast infection is handled for a litle girl... but I would get a diagnosis first.




Your main question about treatment for phimosis? No.... Phimosis itself is naturally occuring, if you want I can go find you links. But, if there is an infection you can treat that, and if the infection was causing the phimosis the phimosis 'should' loosen up a bit when the infection is gone.


If you are concerned about retraction at all, around this age all little boys start vigorously playing with themselves. Don't stifle that. That is part of the retraction process. They test to see how far they can pull it back and stop when it is uncomfortable.

This can also cause a redness and irritation. That is why I suggested the culture. If there is no bacteria or yeast present he could just be going through the natural separation process. but honestly that would be for him to know and you to monitor.


Remembr I am not a doctor, and a proper diagnosis should be found each time there is an irritation or redness. You might want to 'ask' the doctor if this could be part of the natural separation process, he may not even think of that because Doctors are trained to find problems, not acknowledge the normal.


I hope any of this information helps, and if you have any questions don't hesitate to ask in this forum. I don't really check PM's but I will come back and check on the thread.




Side note-
Chemicals in laundry detergent can sometimes cause irritations too. Make sure the doctor specifies what kind of bacteria is present when they prescribe anti-biotics.