Phimosis / Tight Foreskin / Circumcision

[ZacK]

Lili 22:

Hi Zack,


Tks for your reply!

Is not fully retractable also for the 3 yrs old. Elder boy got long foreskin, so I think there is enough room for the organ to grow. That is also why I dun agree with hubby's suggestion for a circumcision.

Not only family members who help to babysit the boys ever commented discreetly about the difference in size, even 6 yrs old commented that titi ones is bigger. Am worried that this might affect his ego in another few years time.

Hiya Lili,

From my understanding, male organs may be classified as grow-ers and show-ers... Perhaps your elder son is classified as the former, which means that in the normal un-erect state, he shd be small but will grow more in size when erect.

My only concern is there may be a host of other reasons why your elder son's penis is smaller than his titi and it's not the mere fact that his foreskin is not retractable which may be resolved by circumcision.

I guess I adopt the mentality that if it ain't broken, I'm not gonna fix it

In relation to his ego, you may wish to be more sensitive to him and constantly assure him that he is no lesser of a boy... If he is into cars, not sure if this analogy would work:

In this world there are many type of cars, there are small cars like your 1000cc cars to the big BMW 7series etc but if we take away all the gadgetry, technology etc... They basically only serve one purpose ie to provide a means of transport. So whether we are in a small car or a big car, ultimately, they serve the purpose of transporting us from Pt A to Pt B... So they are still good cars as they serve the purpose according to our needs.

It is the same of our little boy's \"wee wee\", it is a means to discharge body waste so that the body will not be filled with toxins. So regardless whether the \"wee wee\" is big or small, it is a healthy and good organ as long as it is able to discharge liquid waste.

Wonder if this analogy would be too chim for a 6 yr old? :idea: I would of cos choose to omit the other procreation purpose for now... unless you have already covered the birds and the bees with you boy

[Christine_T]

From what I understand, the penis grows in puberty. Infant size has little bearing on what the adult size will be.


Circumcision always reduces the size. In my life I have had a few partners of different circumcision status. On average the natural ones are always bigger -especially thicker. It makes sense, in circumcision you are losing about half the skin of the penis. I heard it also changes the structure of the penis and so it doesn’t grow in the natural manner it is supposed to.

But it is considered normal for 6 year olds not to retract. The important thing is that you should not try to pull the foreskin back as this can create inelastic scar tissue. As I said in my previous post and the links I provided, there is nothing to worry about with an intact boy. Naturertakes care of itself. If more people knew this then I guess there would be less circumcisions.

[Lili 22]

Thanks for all your comments, really appreciated!


Think I will not worry about the issue for now and of cos will not send boy for circumcision. Just hope that everything will turn out well for the boys as they grow.

[jenniferjoey]

Hi worried mummy,


I hope I am not too late to inform you about Phimosis

As what you have mentioned about the number of times that your boy will go to toilet in an hour. I would hope that you take the urologist advices to send your boy for circumcision.

Phimosis
In phimosis the opening at the tip of the foreskin has narrowed down to such a degree that the foreskin cannot be retracted. The external urethral meatus is not visible. Phimosis must be distinsguished from normal adherence of the foreskin to the glans.
In most boys, phimosis can be treated by application of steroid ointment (eg. betamethasone valerate ointment) to the tight, shiny part of the foreskin. This usually obviates the need for circumcision.
However, marked previous inflammation, infection, skin splitting and balanitis xerotica obliterans phimosis, and in many of these children the reasonable treatment is circumcision. Sometimes the severity of phimosis is such that there is ballooning of the foreskin on micturition, and on rare occasions it may even cause urinary retention with a distended bladder. (May be the reason for many times of passing urine.)

http://www.indiancontinencefoundation.org/phimosis.html
http://kidshealth.org/parent/general/body_basics/male_reproductive.html

It will be good that your child is ok after the treatment of steroid prescribed by the urologist if any. Go for follow up and must listen to the urologist if he thinks its best to go for sugery.

This may be a painful process for your boy and you parents to undergo, but for long run, these will prevent worse senario like infections to urethral, bladder and kidneys. No kidding.

All the best,
Jenniferjoey

worried mummy:

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?

[Christine_T]

jenniferjoey:

Hi worried mummy,


I hope I am not too late to inform you about Phimosis

As what you have mentioned about the number of times that your boy will go to toilet in an hour. I would hope that you take the urologist advices to send your boy for circumcision.

Phimosis
In phimosis the opening at the tip of the foreskin has narrowed down to such a degree that the foreskin cannot be retracted. The external urethral meatus is not visible. Phimosis must be distinsguished from normal adherence of the foreskin to the glans.
In most boys, phimosis can be treated by application of steroid ointment (eg. betamethasone valerate ointment) to the tight, shiny part of the foreskin. This usually obviates the need for circumcision.
However, marked previous inflammation, infection, skin splitting and balanitis xerotica obliterans phimosis, and in many of these children the reasonable treatment is circumcision. Sometimes the severity of phimosis is such that there is ballooning of the foreskin on micturition, and on rare occasions it may even cause urinary retention with a distended bladder. (May be the reason for many times of passing urine.)

http://www.indiancontinencefoundation.org/phimosis.html
http://kidshealth.org/parent/general/body_basics/male_reproductive.html

It will be good that your child is ok after the treatment of steroid prescribed by the urologist if any. Go for follow up and must listen to the urologist if he thinks its best to go for sugery.

This may be a painful process for your boy and you parents to undergo, but for long run, these will prevent worse senario like infections to urethral, bladder and kidneys. No kidding.

All the best,
Jenniferjoey

worried mummy:

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?

He hasn't got phimosis. Every boy's foreskin is attached to the glans at birth:http://www.cirp.org/library/normal/
If the urologist doesn't know this, then he is probably a pro-circ doctor with a pro-circ bias. A circumcision isn't needed. The only person who would benefit from a circumcision would be the urologist - he would get the money for performing the circumcision. The child in the meantime would be put at risk, and also lose an important part of his penis. Furthermore, the baby would gain no medical benefit. If you factor in the risk of the operation and the loss in function of the penis - there would be a net disadvantage t circumcision.

Circumcision carries a lot of risks:
http://www.circumstitions.com/Complic.html
http://www.catholicsagainstcircumcision.org/cac_complications.htm
There is also evidence that the pain and discomfort of circumcision disrupts the mother-son bond and also breast feeding. Some evidence suggests the trauma of circumcision has long-term psychological effects.
http://www.cirp.org/library/psych/goldman1/

The foreskin is a vital part of the penis. Men that are circumcised do not know what they are missing in general.

The foreskin contains many specialized nerves on it's underside. When the foreskin is moved up and down it is very pleasurable. Circumcised men have lost this ability to masturbate easily as there is no gliding effect. Circumcised men often have to resort to artificial lubrication in masturbation and sex. See here for the function of the foreskin:
http://geocities.com/painfulquestioning/naturalresources

Without the foreskin protecting the glans, circumcised men lose further sensitivity. The glans (head of the penis) dries out. It also brushes on underwear causing the skin to toughen. See here for the full damage done:
http://www.noharmm.org/IDcirc.htm

There are good reasons to believe that sex is better for the woman as well, if the man has his foreskin intact:
http://www.sexasnatureintendedit.com/10F/doctor_northrup.html

There are many flaws in the studies that show circumcision carries medical benefits. If men In Britain, France, Germany, Italy, all grow up fine then there is no reason to mutilate your son's genitals to prevent something so rare and that can be easily treated by anti-biotics:
http://www.cirp.org/library/disease/UTI/

[worried mummy]

Now, I am confused again. There seems to be 2 differing views on the effects of circumcision. I have consulted 2 doctors, one GP says it is very unlikely for a kid with tight foreskin to open up eventually without being circumcised. He claimed that there will be scarring if we don’t do it and it will cause more problem in future. Another doctor said that circumcision is an elective surgery unless the kid has frequent infections, else just leave the kid alone. So now the point is my kid has only one infection and there wasn’t any bacteria infection in his urine. He has since recovered. So is it still medically necessary to go through a irrevisible surgery such as circumcision? Btw, my boy is 6 years old this year and we are unable to pull back his foreskin to clean his gland during bathing, leading to the infection, according to the paediatric urologist.

[heutistmeintag]

I think the difficulty here is dealing with the risk of future infection. As in any risk management, we need to appreciate the probability factor. My questions are


1) it happened only once, do you need to fix it now when "it’s not broken"?

2) is the foreskin retraction problem permanent?

3) if the circumcision has adverse effect on sexual pleasure in the future, do you want to make a premature decision for him now? After all, it’s his private part, not yours. Could the decision be delayed?

Just some thoughts that came off my mind, I am not biased towards any approach.

[worried mummy]

heutistmeintag:

2) is the foreskin retraction problem permanent?

.

Precisely, I do not know whether the foreskin retraction problem is going to be permanent or not. As it is right now, he cannot pull back his foreskin to clean properly, thus resulting in the infection, according to the doctor.

[ZacK]

worried mummy:

heutistmeintag:

2) is the foreskin retraction problem permanent?

.

Precisely, I do not know whether the foreskin retraction problem is going to be permanent or not. As it is right now, he cannot pull back his foreskin to clean properly, thus resulting in the infection, according to the doctor.

Today DS1 complained of pain when he urinates.... Will observe and see how it developes... Probably got an infection.

Btw just to confirm if fever usually follows when there is an infection? Thanks.

[MLR]

ZacK:

Btw just to confirm if fever usually follows when there is an infection? Thanks.

Not necessarily. When theres fever, it would be serious enough for anti-biotics. Check to see if theres redness, if there is, most probably it is infected. If the pain and redness do not go away after a day, should consult doctor.