DS (15) has had some urinary issues for a long while but I think has been hiding the extent of it from us due to the fear/embarrassment of being examined or whatever. He's had a few UTIs over the past 18 months-2 years but unfortunately due to the lockdowns he wasn't physically examined down there by anyone (and wouldn't let me look either, or just see how his urine flow was) - we had brief telephone consultations with the GP then told to drop urine samples in and prescribed antibiotics which seems to clear up any actual infection (he finished 3 days of antibiotics last weekend) but it's gradually taken him longer and longer to have a wee, and I think he's been hiding how bad it's got, or maybe just got used to it being "normal" for him. I guess we knew something must be up when he took longer and longer int he bathroom than normal but assumed it was to do with his UTIs, or even just on his phone!
However, earlier this week, he couldn't pass urine at all and was very upset, so we had an emergency dash to A&E which was horribly traumatic for him as his foreskin was so tight and the urethra so narrowed that they could not insert a catheter at all (despite trying various sizes, having the main urology consultant called out, and gas and air etc). It was horrific really, I wouldn't wish that on anybody. He was in lots of pain both from the urinary retention in his bladder, plus the end where they were trying to widen things to get a catheter in (bleeding at the opening etc 
). After him screaming out with pain and crying they decided it was too traumatic for him to continue and he would have to have an emergency procedure to widen his urethra etc, under general anaesthetic so that they could get a catheter in and get his bladder emptied. It was the middle of the night by this time and I think they had to call the surgical team out, it wasn't ideal all round. Horribly stressful and worrying.
Anyway.....they finally managed to empty his bladder and ultrasound and blood tests don't show any damage to his kidneys (which is a major relief). He stayed in hospital another night as they said he has something called BXO, a chronic skin condition/disease which causes scarring of the foreskin and can go up the urethral tube, which is what has happened with him. He needs an operation to fix it, and has been released home with a catheter until Monday when he returns for his op.
We have 2 choices: a full circumcision or a preputioplasty (which basically retains the foreskin but cuts are made to widen/loosen it). There are pluses and minuses with both. There is a 20% chance that if he opts for the preputioplasty that it might not fix the issue and he might need to have a circumcision later anyway. But obviously circumcision takes longer to recover from and there may be sensitive issues, possibly long term.
He is a very young 15, emotionally, and started developing later than his friends. He is just not at the point at even thinking about a sex life and how this choice might impact on it. Since the emergency procedure we've had a frank discussion about erectile function etc, and it seems he doesn't even masturbate as "can't see the point." 
It's possibly because the tight foreskin issue means it's not pleasant for him to touch down there like that, I suppose.
Anyway, I guess I'm asking for advice from anyone who has had to help their son make the decision over which procedure to have. I feel like it's a big responsibility because if we opt for the circumcision, once it's gone, it's gone and what if he later regrets it? If we opt for the preputioplasty will he hate us if the BXO recurs and he has to go in for further surgery, and a circumcision anyway?
Its so hard to know what to do. Plus the terrible guilt I feel at not realising how bad things had got. He was very private before, about his privates, and just did not want to dicuss it at all, and as I said, the lockdowns and lack of face to face consultations have just made things develop so that it's got more difficult to sort out.
Apart from seeing if anyone else's son has had this problem, I'm also posting to urge anyone with sons who you have even a slight concern about, regarding foreskin or weeing issues, to get them checked out physically. If they're at an age where they are embarrassed and you think they are minimising the extent of the problem just tell them my son's story and hopefully that would have them ruuning to the GP to get looked at!