WWYD? DS1(5) may need to be circumcised but is needle phobic

[RachelWatts]

I took DS1 to the drs this morning because his foreskin is very tight and he can't retract it at all. Although it doesn't cause him any problems at the moment, it might when he's an adult.

My brother had to have a circumcision as an adult due to a similar issue, and he was getting recurrent infections which sound very unpleasant and painful.

And thinking way, way ahead, I'm concerned at any possible impact on DS1's future sex life, when he's a responsible adult and in a stable relationship with a lovely partner, of course...

The GP is referring him to a paediatric surgeon. Although they could prescribe hydrocortisone cream, she says there's not much point as he would still need surgery anyway.

The GP said that this type of surgery is better done at this age than when he's older, as it tends to be less traumatic for younger boys.

DS1, though, has a needle phobia. He needed a lot of reassurance to even get him into the GP surgery in case they decided to give him an injection.

So WWYD? Would you put your 5/6 year old child through surgery which he will find traumatic and frightening, for something which is not an issue now but could potentially be a problem in the future, on the basis that the probable future surgery could be more traumatic?

You don't have to be awake when having an injection / needle for GA.
DS is needle phobic and both times he has had a GA they gave him gas to go to sleep and then inserted cannula into his hand.
If it is better for your DS to have the op done now rather than later, I would go for it

Hope this helps.

i would leave it longer and certainly get a second opinion. Its really common to not be able to retract at this age, and your doctor may be not up to date or be showing a personal preference.

It IS traumatic at age 5 to be circumcised and whilst i am open minded about circumcision, i think you should try and avoid it unless absolutely necessary, and that doesn't mean preventative issues that might never happen

Ooh I didn't know they could put you to sleep with gas and then do a GA. That would make things much better!

Would they take the cannula out while he was still under? Taking the damn things out is almost as traumatic as putting them in.

Yes, I think they did - can't remember it was a few years ago.
It was very stress free for him. Not so much for me as I had to hold the mask on his face for the gas & he fought against it. Felt like I was putting my child to sleep.
I cried loads when he was in theatre. But at least he wasn't traumatised.

If it is decided that the surgery should go ahead ask if their is a play specialist on the ward who could help with the phobia.

Thanks. I'm obviously going to discuss with DH, and see what the surgeon has to say before making any decisions.

I don't think it's uncommon not to be able to retract at this age, is it? And I thought they tried steroid cream before surgery anyway. I would get a second opinion.

We have to give ds gas first before the cannula, it is still traumatic for him, but easier, because he doesn't physically fight the person putting the cannula in.

Cannulas have always been removed after the gas has worn off though, I think because you have to make sure the child is recovered, in case the cannula is needed again.

Good luck with whatever you decide.

They don't recommend retracting it at that age - it used to be that parents were told to retract it an an early age to ensure it did and to ensure it was properly cleaned - and teach the child to do the same. This is not longer recommended - you are to leave it alone - unless it is caused pain or discomfort in which case you would then need to see a Dr.

NHS page on phimosis the recommendation is that no action is necessary unless there are problems- and that circumcision should be the last resort.

Some don't retract until puberty or after so it isn't unusual for it not to at age 5. If it isn't causing problems I would leave it alone

Thanks for the advice and the link.

Having read the link, I'm not sure it's phimosis as the foreskin does not appear to be adhered to the glans. It's more that the opening in his foreskin is much, much too small. I don't see how that can improve without some medical intervention.

Hi Rachel, at age 5 my ds was in a similar situation - his foreskin was very tight, and although very occasionally he could pull it back a little, a lot of the times he tried it split and bled
We visited the doctor here (Belgium) a few times about it, and the advice has always been to try alternative treatments before thinking about a possible operation. The thing that worked best for us was steroid cream - he had to pull the foreskin back as much as he could, and I rubbed a bit of cream all around. We did this each evening for the first week of the month for about three/four months iirc. I think it really helped, so much so that we relaxed slightly and stopped doing it... It's now tighter again, but the doctor has said that he must just move the foreskin around each night before bed, either in the bath or with a very gentle moisturiser.
I'm not sure whether that's much help to you, but it might be worth a try with the steroid cream for a while?
If we'd have been told to go for the operation though when he was that age then we probably would have done it. Ds had grommets put in when he was 2, and he was put to sleep using gas, and then they put in the drip for the GA. They try to keep it as stress free as possible for little ones.