4 year old´s foreskin not retracting - been advised circumsition!!

[peterpie]

I realise things are done differently here in Spain but I am aghast that the paediatrican gave me a referral for DS1 to be circumsized!

His foreskin is very firmly atttached, the Doc took one look this morning at his check-up and said he will need the op. I have been googling this and it certainly doesn´t seem to be common practice in the UK.

I am really upset about it all, surely 4 years old is far too early to tell and there is plenty of time for things to change, no?

Can anybody advise me?

Does it "balloon" when he has a wee? If all is normal, I'd wait, as it the foreskin can be attached to the glans up to the age of 9 and sometimes beyond.

Still plenty of time if it isn't causing problems. :) My DS is five and his is still attached. I found a brilliant paper on it somewhere that completely reassured me about waiting. I will see if I can find it!

DS1 had the same and consultant gave him betnovate ( yeah betnovate)and advised me to gently ease it each day after a bath and it was fine after 4 months.

DS was in a similar situation and we waited, I'm glad we did as he is 6 now and it seems to be fine - tbh I haven't checked but he hasn't complained lately so I assume all is ok!

Are they supposed to at this age? I hadn't thought to check. How do you check?

Our DS (5) had an op in December to basically loosen the 'threads' at the top, the idea being it would then start to retract. It didn't work at all, is still firmly attached and he's still getting infections, so now he has to go through the whole operation (general anesthetic) again for a circumcision. Wish I'd just pushed for that in the first place tbh :(

Having said that, if it's not causing him problems then you can wait, but if it needs to be fixed in later life then the arguement is it can be more traumatic.

Nikki I hadn't been checking at all, it was only repeated urinary infections that alerted me. Try and get him to pull it back very gently in the bath for 'cleaning' and you'll see if it can retract.

Def no need if it's not causing any problems..i would refuse...i've heard some doctors do the op too readily and that it's only ever needed as a last resort

Peterpie according to my research, circumcision is even less common in Spain than it is in the UK. If the paediatrician was so sure, you have to remember he/she is used to seeing and checking out foreskins every day of the week and experience has taught them what needs a fix and what doesn't.

There is such a thing as resolvable tight and unresolvable tight, ie, some foreskins - the majority, become retractable in time either naturally or with a little gentle manipulation anywhere up to the onset or through puberty. Others are damaged (usually through persistent infections) or malformed to the extent they will never function properly to allow proper cleaning or fulfilling sexual activity. It would seem that your pediatrician has decided your son's foreskin is one of the latter and is best removed.

That being so, it is least upsetting to have your son circumcised as soon as possible. It is a simpler and quicker healing procedure right now. The older he is the more traumatic, painful and embarrassing it will be for him. This is the dilemma if you decide to 'wait and see.' So you have to either trust or disregard your pediatrician's advice.

Being circumcised isn't the misfortune for a boy that many seem to strangely imagine. There are many benefits over a lifetime (PM me if you want info.) Since the dawn of time and everywhere today, millions of males worldwide have had this procedure for religious, medical or just personal reasons and they and their partners are quite happy with it. My DH is one and I hope my two circumcised sons, done as babies, will be in due course.

I would be so gutted if my DS had to have it done..so i would bend over backwards to try and find a way around it...there's another op that they can have that's not as drastic..but i can't remember the name...will see if i can find it

My ds had this and frequent bouts of balanitis leading to scarring meaning his foreskin was tighter than ever and looked to me that it would never fit over the glans. At the age of 4, 6 and 9 we visited a consultant for the infections who assured us a circumscision was not necessary and that at puberty things would sort themselves out naturally.

The consultant was absolutely right. At 12 ds finally announced that his foreskin now did what it should and he is very grateful (as a now older teen) that he has still got all the bits he was born with!

Get a second opinion.

Thank You to everybody for replying and for all the advice.

The thing is he is absolutely fine, no infections or problems at all. And it certainly isn´t damaged as somebody mentioned. Therefore I can´t help thinking that the Paediatrician is being somewhat hasty. She talked about it being more hygenic but surely this isn´t reason enough for an operation

I really feel I should wait. He only turned 4 in December FGS. I will certainly seek a second opinion but I am worried I will get the same response as it does seem to be the route they take here. For example a Paediatrician forced DS1´s foreskin back at his 9 month check-up and I was horrified, I didnñt even realise what he was doing until it was too late. I later learnt that this is NOT done any more in the UK and should indeed be left well alone.

Thanks again to all. I often feel out on a limb when it comes to health issues in Spain.

Ow! No it's not recommended to pull the foreskin back at all. I'm still trying to find that article but I have come across others that say similar things- circumcision is performed too readily and is often unnecessary and the foreskin will naturally retract eventually usually before the age of 17. Will try to post later from the computer.

paddy the not so drastic op was the one we had - and it didn't work. (You'd think I'd be able to remember the name in that case though - pleuriplasty??). I would much rather he'd been circumcised the first time than now to be looking at a second operation, with all the risks that entails. IMO my surgeon was too conservative and tried too hard to preserve what is, really, a bit of skin.

Yes that's the one!

This link has a lot of good info on foreskins...

www.norm-uk.org/circumcision_alternative_treatments.html

I am really sorry OrdinaryJo that the op didn´t work, and that your DS has to go through it all again

Thanks for the link paddy

It's far more than a bit of skin! There are more nerve endings than in the feet, it's the equivalent of removing a postcard of skin from an adult, it has a similar function to the eyelids that it cleans, protects, lubricates. Don't get me wrong, like anything if it's not working properly the benefits of removing outweigh the benefits and risks of keeping it but it's not what the OP is describing. It shouldn't be retracted by anyone else but the owner and it shouldn't be expected in a prepubescent child. A lot of problems come from them not being looked after properly in the first place (not saying that's the case for anyone here) either because people have cleaned them or attempted to retract. If there are no problems with it then leave it alone like you would anything.

No medical authority in the world recommends RIC or accepts any health benefits.

peterpie - my sister was in Spain and her elder son had the same issue as your DS at about the same age, with the same recommendation to circumcise.

My sister took her DS to a doctor in the UK when she was on a visit to my parents who recommended gentle massage of the foreskin in the bath. Her DS was delighted to get free rein to play with his penis and it all sorted itself out in due course.

OrdinaryJo wrote:
IMO my surgeon was too conservative and tried too hard to preserve what is, really, a bit of skin

I agree it is only a bit of skin and for some boys it can be a painful and troublesome bit. Why some people, including doctors, think it is precious and worth preserving is beyond me!