Phimosis / Tight Foreskin / Circumcision

[ksmama]

Hi, if the opening is pin-hole, it will remain like that.

I prep my kids well before op on what to expect.
Have to fast overnite cos to prevent aspiration of food during anaesthesia.
It is a day surgery
During registration, a nurse would apply lots of anaesthetic cream to back of both hands to give it ample time to numb the skin.
Boy boy change into OT baju and wait.
Once in theatre the anaesthetist and nurses would talk to the kid and give him stickers and stuff. The mummy or daddy can follow the boy into the theatre till he goes to sleep. ( parents: good to prep the kid by telling him he would see big ceiling lights and both big and small machines used to monitor his heart beat and oxygen level etc. This makes him curious at home and it can become an eye opener)
During all the distraction, the doctor would set a venular and give injection to one of the hands and off he goes to sleep.( I explained all these to my kids)
While under anaesthesia, local anaesthetic would be injected at the base of the penis to provide post op pain relief which would last for a few hours.
Nowadays, circumcision are done under laser- clean cut, less bleeding.
Post op off he goes to recovery room till he wakes up. I would get ready some Macdonalds for him ( told him pre-op as well I would do that)
Once home, out comes my reward for bravery…
Postop- yes there would be stinging when the kid pass urine and that is because the urine touches the raw area. What I do is I leave dry cotton gauze in the toilet and saline in a bowl. The caretaker or the kid can place the cotton just under the urethral opening to minimize contact with the raw areas and after pee pee immediately dab the opening with saline.
After a bath, apply antibiotic cream and anaesthetic cream to the area.
The raw area would turn weepy but would form crusts and then falls off. On healing, a nice pinky head!!

[buds]

You're THE MOMMA, ksmama!

:udawoman:

Clear.
Concise.
:salute:

[ZacK]

buds:

ZacK,


I'm the eldest! Being a chieh-chieh does not mean i'm outta the
picture even when it comes to innerworkings stuff like that...
More like bo-pien.. I was at their beck and call with a shake of
a tiny bell - yup - like a lady butler. And yes, i had to clean and
apply the cream too..

Haha so that's why you are errmm so familiar with the male's innerworkings

buds:

Oh-hell-NO! Let's not go deep in there, brader!
I wouldn't go down that road me-self! Nah-ah!
No way, hosei! :siam:

My sentiments exactly ... Phew. Anyway I wont be able to respond to your survey even if you decided to do one

[worried mummy]

Hi! My boy is 5+ year old.


Recently, he kept going to the toilet to urinate - sometimes up to 3 or 4 times in a hour. So I brought him to see a doctor who said that he had an infection on his penis due to tight foreskin or phimosis. He was given oral medicine to cure the infection and referred to a paediatric urologist for further check after the infection was cured. The urologist feels that I should send my son for a circumcision.

I am very worried as it will be painful and uncomfortable for my boy. Anyone knows of any alternative solution?

[schellen]

Hi, I don't know if there are alternatives but according to the parents here whose sons/bros went through circumcision, it apparently isn't that scary. here's the thread: http://www.kiasuparents.com/kiasu/forum/viewtopic.php?t=2022&highlight=circumcision

[worried mummy]

Thanks for referring me to the thread. Looks like there is no alternative for kids altho I think there are some homecure solutions for adult on the internet (not sure whether they really works…)

[ksmama]

Hi worried mummy, you can observe first if your kid and yourself are not mentally prepared for the op yet. Some kids get the first infection and is ok after that for a long time. My 2 kids took it very well. 1 had it at 6, 1 at 7. Younger child was manja the first day and after that ok. However, if he does get frequent infections, will be good to have it done because sometimes the pain from infection can cause a lot of stress for the kid and parent. After the op, let the kid run round half naked at home and they will be quite happy.

[worried mummy]

thanks! I hv already booked a date for the surgery, just hoping for a miracle…

[worried mummy]

Hi, does anyone know whether is it medically necessary to circumcise a boy before puberty if he has phimosis but never has any infection?

[ZacK]

worried mummy:

Hi, does anyone know whether is it medically necessary to circumcise a boy before puberty if he has phimosis but never has any infection?

Hi worried mummy... My personal opinion is even if there is infection, it may not be medically necessary to circumcise the boy... The risk of getting infection is much higher in a child with phimosis, however, it is not a life threatening situation probably more pain and discomfort than anything else.

Based on the extract below... It seems that the non-retractability of the foreskin is natures way of protecting the organ... And the non-retractability of the foreskin may be considered normal up to adolescence.

I'm not considering circumcision for DS1, will just wait and see the degree and frequency of his infection, if any, before making further decisions on this. So far, he is coming to 6 and has not experienced any infection.

Extracted from Wikipedia
Natural development of the foreskin

At birth, the inner layer of the foreskin is sealed to the glans of the penis. This attachment forms \"early in fetal development and provide[s] a protective cocoon for the delicate developing glans.\"[11] The foreskin is usually non-retractable in infancy and early childhood, when the developing glans needs complete protection from the mechanical trauma of the nappy and clothing, and the chemical trauma of ammoniacal urine.[11]
Until recently, knowledge of the development of the foreskin has been a neglected subject. Physicians often saw the natural unretractability of the foreskin in infancy as pathological and recommended circumcision. Often it was used as justification for routine infant circumcision.[11]
During the 20th century studies were released which furthered our understanding of the normal development of the foreskin.[12][13][14]
The American Academy of Pediatrics and the Canadian Pediatric Society state that no attempt should be made to retract the foreskin.[15][16] Age is reportedly a factor in non-retractability: according to Huntley et al. the foreskin is reportedly retractable in approximately 50% of cases at 1 year of age, 90% by 3 years of age, and 99% by age 17. These authors argue that, unless scarring or other abnormality is present, non-retractibility may \"be considered normal for males up to and including adolescence.\"[1] Hill states that full retractability of the foreskin may not be achieved until late childhood or early adulthood.[17] Cantu states that acquired phimosis may be caused by forceful retraction, due to the formation of scar tissue.[18]
Although the rate of surgical treatment of phimosis (usually circumcision) is falling, some pediatric urologists have argued that many physicians continue to have trouble distinguishing developmental non-retractility from pathological phimosis, and that phimosis is overdiagnosed.[2][19][20]
Phimosis is sometimes used as a justification for circumcision,[21][20] so that it will be covered by a national health system or insurance plan. The definition may be stretched by a physician for an older child; particularly where (as in North America), post-neonatal circumcision is usually outpatient surgery by a pediatric urologist, more expensive than the neonatal procedure.[20] Most pediatricians[who?] do not consider it a compelling argument for routine neonatal circumcision.[22] While circumcision prevents phimosis, at least 10 to 20 healthy infants must be circumcised for each prevented case of potential phimosis according to some incidence statistics[citation needed].