Circumcision a Necessity

[Bumblelion]

My son has suffered three times in the past from balanitis xerotica obliterans - an infection at the end of his willy - he is now 8. The first time was when he was about 3, then about 5 and then once more recently. I took him to the emergency doctor on a Saturday in November as I could see his willy looked a bit inflamed when he was in the bath. The doctor said it was a bacterial infection and gave us some medicine. After two weeks it hadn't cleared up (the doctor said it would take 2 weeks to clear) so took him to my own GP. She said the infection wasn't bacterial but fungal so gave us some different cream. Again, it didn't clear up. By now it was nearing Christmas so could not take son until between Christmas and New Year. My doctor said that she didn't want to keep on giving us cream for it but would take a swab and then get back to me. I phoned early in the new year and she said the swab came back clear but she would refer him to the hospital (I didn't really realise why).

Had the appointment on 12 February and the doctor said it was balanitic xerotica obliterans and the only way to clear it was a circumcision.

I AM DEVASTATED. Why, you might ask (and I ask myself the same question).

My Ex-DH was circumcised at age 9 because of the same reason but after reading about the circumcision operation and what it involved I really do not want to put him through this (although it has been medically suggested). I want his willy to be intact, don't want him going through the pain and then having a "different" looking willy.

I know his dad had it done but I can see how it affected him with our sex life (sorry to be so blunt). He was never very confident in bed and I always put it down to the fact that he was circumcised and didn't feel comfortable about it (he is now 39 by the way). Although this might only be my perception of why he was not confident - he has now got a new girlfriend and I am sure he is more confident in bed with her than he was with me.

How can I ask for a second opinion on my son having to have this operation or what other routes could we go?

Any advice gratefully received.

It sounds strange, but I cried in bed that night after we found out about the operation. It just seems to be one thing on top of the other - my mum is in a psychiatric ward, my youngest daughter has sotos syndrome and global developmental delay, am trying my hardest to work and look after 3 children.

This message may come across as being selfish as why am I so upset about my son having to have this done, after all, it is happening to him and not to me - but I don't want to put him through an unncessary operation unless that is the only option.

Does he really have to be fully circumcised Bumblelion? Just wondered if there was any chance they could just take away enough of the foreskin to clear the recurrent infections.
So sorry you have this to worry about on top of everything else.
If he does need the op, try if you can not to conclude that he will react in the same way to being circumcised that his dad did...remember it is the norm in some countries and religions...and presumably many of those men don't find it affects their sex lives adversely.
How does your ds feel about all this? Is the infection painful?
And VERY sorry to hear about your mum, I know she has caused you much heartache in the past.

I googled and found this on the net.
I have to say, I tend to agree with you that I wouldn't want my son to have surgery unless there was no sensible alternative, but I have had a circumcised boyfriend who had no 'issues' with his willy! I don't think that the two necessarily go together at all. I do know you have an awful lot to cope with and I'm really sorry. It isn't fair on you at all, but if you do get your ds circumcised, then I'm sure the outcome will be good. You are a great mother.
QUOTE:
"BXO is a relatively serious disease. It can cause urethral stricture and retention of urine.2 Malignant tumors have (rarely) been reported to develop from BXO.2,23 Meffert et al. provide a recent review of the literature.17 A person with BXO or suspected BXO should be under the care of a medical doctor.

Conventional vs. Conservative treatment. Conventional medical wisdom has stated that BXO is an absolute indication for circumcision.16 However, that treatment modality dates from a time when the prepuce was considered to have no value for the individual. Clearly this is no longer the case. The function and value of the prepuce is now recognized, and protection of the individual from unnecessarily radical surgery is always adoctor's prerogative. Fortunately, researchers have reported some success with conservative therapies for BXO that preserve the prepuce.

Medical treatment. Corticosteroids have been used with varying degrees of success.4,5. Pasieczny reports successful treatment with topical testosterone propionate ointment.7,26 Several authorities report success with clobetasol propionate.14,19,22,24 Shelley and colleagues report successful treatment with antibiotics.25 Depasquale and colleagues, however, recommend radical circumcision, but also suggest mometasone or clobetasol cream as a medical treatment.27 Dewan reports that BXO is successfully treated with topical steroid ointment during the early stages.30 31 Assmann et al. report that tacrolimus ointment is effective for treatment of LSA in women.32 Clinical experience has shown it to be effective against BXO in boys.

Surgical treatment. Carbon dioxide (CO2) laser surgery has been used with reported good results.9,10,11,13,20 A carbon dioxide laser is used to vaporize the lesions. Circumcision is the conventional radical surgical treatment but sacrifices the prepuce.8,23,24,26,27

Conclusion. There still seems to a wide range of opinion on the best treatment modalities for BXO. The cause is still unknown, although Shelley et al. hypothesize spirochete infection.24 More research is needed. Now, however, there is a good possibility of successful treatment without radical circumcision.29

bumblelion, haven't had a proper look but here's a link which has some of the best treatments for conditions like your ds's.
hth

no advice, just didnt want you to feel alone.
have you got a hv that you could talk to about it or ask to see another doctor?
maybe you could get an app to speak to someone who is a specalist in this area.
i hope you get the answers you want and it all works out for you.

Also, have they done a biopsy? It seems from your post that the diagnosis wasn't absolutely 100%

hi there, sorry to hear you are feeling so down,
FWIW, my ex dp, my dh, my dad, my 2 nephews and apparently my fil(say it quick and dont think aboutit!) have all been circumcised for various reasons... when my dh went to secondary school my mil told him that he might look a bit different from the other boys! he says he never really took much notice and it didnt really bother him! IMHO i dont think it matters as long as the recurrent infections are gone once and for all and that he is happy and healthy. It sounds like you have enough to think about without this to! (((((hugs)))))

Hi Bumblelion. My DS1 has this done at three (he's now 12) for the same reasons. It's no big deal honestly, at least I've never found it to be so. DS has grown up remembering the little op he had on his willy when he was 3.. but didn't notice it looked different until DS2 was born a few years ago and compared his willy to his, even though he already knew they'd taken some foreskin away and why.

I rarely see it nowadays obviously.. he is a big both of 12.. .. but it really is a very neat job.. they just take away a small portion of foreskin so that that end of the willy is exposed.

Maybe the problems your ex had was due to a lack of confidence about sex in general at that point in his life? No mature woman in her right mind would be put off by a circumscison I'm sure.. I have never heard of anyone being put off. If you help DS to realise that it's quite fine.. no big deal.. and his willy is just like every other boys minus a bit of skin, he should grow up quite mellow about it I would think.

And it it saves him suffering the extreme discomfort of any more incidences of balanitis than it's got to be worth it. My DS used to be in such discomfort when he had a wee and the infections were awful.

HTH a bit

SJ x

I hadn't thought about him not having a full circumcision - do they have a smaller(?) version?

My son seems to be fine about it - although he doesn't say much, although he is what I would call a sensitive child. I am not making a big issue of it and he doesn't know how upset I am about it.

How can I say or who do I say it to, that I don't want him circumcised unless it is an absolute medical necessity and I would rather try ALL the other options before we go that route.

BL - poor you - it really sounds like you have a lot on your plate at the moment. Don't beat yourself up about being upset about being told your son needs an operation - I think that is totally natural. I'm afraid I don't know anything about the condition so can't offer advise. However my DH had to be circumscised when he was about the same age (possibly for the same thing, I'm not sure). Anyway, without putting too fine a point on it I can assure you it has in no way affected how he feels about his masculinity, his manhood or inhibited his sex life or appetite

I am sure that having a mom who is sensitive enough to even be considering the possible implications means that he will have the right support so that it does not need to be a negative experience for him. Tbh DH and I have never even talked about it really and I just don't think it was ever a big deal for him. If your son does need the operation then I hope it will be the same for him.

Did you read my post Bumbelion? It suggest steroids or laser surgery might work, but that it is serious enough for circumcision to be a reasonable and effective treatment. I agree wtih all those who say this doesn't need to affect your son's future sex life or confidence at all.

Bumblelion, my ds1 (5) had recurring infections there last year as well, we had a swab done, and I have to confess haven't phoned back for the result . But I felt that the infection looked thrush like, and so have drastically reduced the yeast in his diet, it seems to have worked. Ds1 also has a hooded foreskin so I have always been scared that he will end up being done.

Thanks for all your comments. I am going to read up more on that NHS site which seems to be very helpful.

Sorry, am responding to messages and then find another 5 have added to the post so it may seem that I am ignoring some of your remarks - am not!

But just to say, that it really is no big deal.. the biggest issue really is slight soreness at the site of the op for a little while. And it's just day surgery. There are so many more drastic ops that children often have to have done. Not belittling any fears for a second.. please don't think I am.. I remember being sick with fear on the days of DS's op.. but I needn't have worried.. he was fine and it solved the discomfort completely as soon as it healed. Just trying to put some of the worries into context.

SJ x

Think I may make an appointment at my doctor's and see if we can get another opinion. If it is decided that this operation is the only option, then that is fair and fine and I will go along with it as I know it is for my son's best interest, but do want to try everything else first.

Good luck BL I think you are being a great and responsible mom for considering all the options and not rushing straight into the op. But please rest assured from those of us happily married to 'snipped' men that there is no reason why it should have any negative impacts on his future confidence at all.

My H was circumcised and, to be honest, I found it no different to someone who isn't (not that I have come across that many!) but my new boyfriend isn't and if I am really honest, I have to say I found my H's willy to be that little bit nicer looking and easier to handle (wrong words to use there!!!) but then it may have been that I was with my H from 16 years of age and I didn't really know any different. Now, at my age, I am grateful for any kind I can get!!! (Only joking!!!).

I can't afford to be fussy (again, not quite the right word to use) as if someone wants to get nasty, they could get quite critical about my body (boobs, bummy, bum, legs, face, etc. etc. etc.).