My son was circumcised yesterday. He's 4 in August. His foreskin couldn't be retracted at all and he had permanent infection inside which the specialist said would lead to long term damage and all sorts of problems. He said it wasn't urgent but should be done within the year. As it was inevitable in our case anyway, and as we're expecting another baby in a few months, we decided to have it done straight away.
Nobby & happycat, from what you've described, I'd be inclined not to rush into it. If the foreskin can be pulled back at all there is surely the possiblity of it loosening - my son's forskin couldn't be retracted at all. My other son also has a tight foreskin, but it can at least be pulled back a bit. Incidently, from what I've learned, unless you're specifically instructed to do so (eg putting cream on), you should not be pulling back little boys foreskins.
I was recently in contact, via mumsnet thread, with a journalist writing an article on this topic - maybe it's come out already ? - I think it was in Juniour magazine. Anyway, she mailed me this info she's received from a specialist in St Georges hospital, London.
consultant paediatric urologist in London who gave me tons of information.
She's very eminent. Her advice was categorical on this. I don't want to make
you any more anxious - I know it's already awful contemplating any procedure
on your son - however, I think if the roles were reversed I would want you
to give me this information, so I'll go ahead. The paed urologist (Miss Sue
Ann Boddy from St George's Hospital, London - contact given to me by the
British Medical Association as an expert on child circumcision) say this:
"There is never any reason to circumcise a boy under 5 years old" (any
medical reason).
She also said that "misdiagnosis is rife" and that GPs, paediatricians,
general surgeons may not be as up to date as a paediatric urologist. Her
advice to anyone in your situation was to make sure they see a paediatric
urologist before agreeing to any circumcision. If your specialist is one
then i'm sure it's fine (although Miss Boddy did say very clearly 'never
under 5' She also said that infections are common and 'normal' (ie.
redness, swelling) and treatable without an op.
There was a recent report in the British Medical Journal that also said that
misdiagnosis is common and they estimate thousands are having unnecessary
circs done each year.
Most of us are woefully ill-informed about penises. The notion that a
circumcised penis is easier to clean or more hygienic is, says Boddy
"nonsense". Your son's foreskin may not be fully-retractable (ie. you may
not be able to pull it right back) for up to ten years after his birth
(Boddy has seen perfectly healthy men as old as 20 with non-retractable
foreskins). What's more, you do not, she says, ever need to pull your son's
foreskin back and clean under it. In fact, she says, we should "just leave
it alone". She points out that boys (even young boys) touch and manipulate
their penises constantly and that although this may embarrass their mothers
it actually helps keep them clean by 'keeping things moving'.
Many pre-pubescent boys, says Boddy, are misdiagnosed with phimosis (a
condition in which the foreskin cannot be retracted , which is
physiological, i.e. normal, so not meant to be retracted) or balanitis
(infections under foreskin but can usually be cured with a bath or possibly
some antibiotics) If the balanitis causes scar tissue and the foreskin
becomes pathologically phimotic then circumcision may be required.
Boddy explains: "It is entirely normal for a boy's penis to balloon when
he pees. Tightness below the tip is also normal, or occasional redness."
Neither of these requires circumcision. What's more, a natural substance
known as "smegma" can cluster and swell in 'pearls' under the foreskin.
These can look a bit like pus when they emerge. "This is often confused with
balanitis" she says . Your GP may not be aware of this and may refer you to
a general surgeon who may not be aware of this either.
Boddy advises that if your doctor has diagnosed your son with balanitis or phimosis and says he should have a circumcision, you should "ask to see a
paediatric surgeon/paediatric urologist" before you agree. There is, she
adds, "virtually never any medical reason to circumcise a boy under five".
Hope this helps you.
If you want to know about the actual op, ds was in theatre for about 30 - 50 minutes. He had a light general, but mostly local anaesthetic. When he came round he was crying for a while, which is normal (but I still found it heartbreaking!) he cried for maybe half an hour, but then just gradually perked up. It was amazing really - he was brought from ot to his room at about 9.30. By 10.30 he was strating to sit up, and asking for a drink. By 11 he wanted to eat and by 12 he was allowed home as long as he'd done a wee. By the time he did this & he was checked again by the surgeon & the anaethetist & we'd got painkillers for him, we were ready to leave by 1. He was just like normal - running around, playing, you wouldn't have known he'd just had an op with ga. He only complained a bit a few minutes ago about a bit of pain, but didn't want any medecine. Kids are prety amazing aren't they - at what point do they develop this male habit of being totally unable to cope with any ache or pain??