Unretracted foreskin

[Toffeewhirl]

DS2 is nine and has been having problems weeing: he goes to the loo once, but then says he feels as if he hasn't finished and has to go again and again, but only gets drops coming out. He gets really upset about it and sometimes puts off going to the loo because he knows he'll be sitting there for ages.

The GP referred him to a paediatrician, who spotted that DS2's foreskin hasn't retracted yet and thinks this - plus a couple of cases of balinitis - is causing the problem. It is true that DS2's foreskin 'balloons' when he wees. The consultant is now referring him on to a surgeon.

However, I don't want DS2 to be circumcised. Does anyone have any experience with avoiding circumcision in this situation? I've read that steroid creams sometimes do the trick by thinning the skin and allowing the foreskin to roll back.

Why don't you want him to be circumcised? My son had this and was circumcised - he was about 5 or 6, I think. I would take professional advice and act on it.

It's not abnormal for his foreskin to not be retractable atm but if it's causing him problems, it does need looking at. As you have seen, it can cause infections such as balanitis and in some cases, phimosis (a tight foreskin) doesn't retract as it should for a couple of reasons.

An appointment with a surgeon doesn't necessarily mean circumcision. There are quite a few reasons why he might be experiencing problems, ranging from bacterial infections to fungal infections, eczema and so on.

There are a range of treatment options depending on what's causing the problem.

I completely understand why you wouldn't want him to be circumcised btw. It would be a last resort for me too.

You could ask for a dorsal slit circumcision en.m.wikipedia.org/wiki/Dorsal_slit

DS might need doing when he is older and I'm going to push for this.

I just don't see why he should have a part of his body removed unless absolutely necessary, Imperial. I remember my grandmother telling me she had her son circumcised "for hygiene reasons" and I thought it bizarre.

Also, I don't want him to have surgery unless it's essential.

Good to know that there will be other treatment options on offer, "Show*.

I tried steroid creams on DS, they worked in the short term but after a while the skin tightened back up again.

Oh bugger, Sanchar. Did you go for circumcision?

No, I'm going to wait a while, he is 7 and has no ballooning, if he starts having trouble at puberty I will go back to go and ask about the dorsal slit. At the moment I treat him with canestan if he gets sore.

Sorry, missed your last post, Sanchar. I see you are considering dorsal-slit circumcision instead. Useful to know about that option, thanks.

I think you need to encourage a degree of 'exploration' in the bath for a few nights (by him, on his own). This should help to loosen things up.
Has he tried rocking back and forth on the toilet to empty his bladder? I found this helped after pregnancy. Sometimes a low grade uti makes it feel like you need to pee even when you don't, it is very frustrating.

Yes, I'll do that, Ding. And will suggest the rocking back and forth thing to see if it helps, but I think the cause is different: he doesn't have a UTI (or at least, repeated urine samples come up negative), but probably gets some wee caught at the tip of his penis, under the foreskin. At least, that's what the consultant thinks.

If he will do it himself then regular stretching may work. I can't DS to do it and he won't let me do it either.

Some techniques here. www.healthboards.com/boards/mens-health/178155-stretching-fix-tight-foreskin-phimosis.html

Thanks, Sanchar. Will encourage fiddling in the bath .

We're currently trying steroid creams but you have to apply it everyday for at least six months. The next option is circumcision if it doesn't work.

A tiny minority of boys get BXO Ballanitis Xerotica Obliterans. They need a circumcision. The rest do not. A mentor of mine (long retired paediatric surgeon at Alder Hey) worked out that if you collected all the foreskins removed unnecessarily in the UK in one year and stitched them together they would cover the pitch at Anfield. Most GPs and many paediatricians got their last training years ago when there were still in medical school and have had no update since. I used to speak at annual training updates for local GPs each year and this was one of the top topics they asked to be put on the program.

Physiologically, the foreskin does not need to go back until you mums feel old enough to be grans! As suggested above, and if it is not BXO, then a little gentle exploration, after he has secondary signs of puberty, by him/girlfriend is fine. Any forced stretching, especially done by parents or doctors may cause scarring and problems later on, potentially ruining his social life. In previous years boys were very reluctant to discuss their anatomy with a doctor. Despite what may be said about "lad's mags" they have made a huge difference in the ability of teenagers to seek advice and to discuss their willy with a surgeon. But a word of warning: if you are caught by a fellow WI member in WH Smiths looking through a copy of Nuts for an article for your son don't blame me!

Two tips to identify BXO:

1. If you gently retract the foreskin and find it forms a tight barrier at right angles to the axis of the shaft of penis, suggests BXO. If the spare skin above the tight spot blossoms like a flower it is definitely not BXO.

1. If you gently lift the foreskin and pull away from body in line of shaft and look down the hole and the "narrow" bit opens out then it is not BXO.

Finally to answer Toffee: His foreskin has nothing to do with going again and again for only drips. This is very common at his age. To be honest it used to puzzle me but I think it is a normal part of growing up for boys. Simplistically he has a three way valve at the base of the prostate. The human race would die out if boys cannot shut off the bladder and give a clear run to the ejaculate to gush down the shaft of the penis! Actually the valve can be damaged, the ejaculate goes the wrong way and this is called retrograde ejaculation It happens to old boys (like me) after a prostatectomy. And if the valve fails the other way and each time we wee we blow up our testicles with urine then 50% of the human race would wander round like John Wayne without a horse.

Op my ds1 had this. In fact I thought it was normal til I had ds2 and his was so different. So I git referred to a specialist and he had what I think has been suggested up thread. They cut his foreskin and sewed it round.

So not a circumcision, more of a loosening

Took about a week to heal, so if you can get it done before a half term it's better for him.

I got it done when he was about 7 as my dr said they don't do anything on my he NHS til a child is older. I think the earlier the better. My ds is 13 now and doesn't remember much about it

dratsea - thank you for all that information - that's very useful and gives me good background knowledge for when I see the surgeon. Interesting that you don't feel the drips have anything to do with the foreskin issue. If that's the case and DS doesn't have BXO, then there should be no need for circumcision.

Jeffery and Dolly - thanks also.

I suggested to DS yesterday that he try gently rolling his foreskin back in the bath. He refused. Said he doesn't want to touch it because he doesn't like the feeling. Not sure what to make of this. (I have to say he used to have his hands down his trousers all the time when he was younger, so maybe he's moved into a latent phase).

I feel less worried about his issue with the foreskin after reading all the responses above and certainly won't be adding it to the Anfield pitch anytime soon .