Docs wanna do a circumcision is it necessary??help!

Jessica - posted on 10/05/2010 ( 36 moms have responded )

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Hi,

My son is 4 yrs old and has been told by 2 doctors that he has a very tight foreskin and the hole for urine etc is very tiny I must agree. His penis balloons during urination and sometimes it shoots out to the side which he thinks is hilarious.

He suffers no discomfort when passing urine and never complains about his penis.

The specialist wants to perform a circumcision in November and I have to say I really don't want this to happen, its under general anestetic and sounds very traumatic to an already sensitive boy.

Is this ballooning normal, if he is in no pain I don't see the problem with waiting to see if the foreskin seperates as the docs say its fused due to infection.

Please help, whats normal and whats not???

x

MOST HELPFUL POSTS

[deleted account]

The average age of retraction is 10.4 years. Until that time it is normal for boys' foreskins to be 'tight' and it is one of the most commonly misunderstood (and misdiagnosed) things in the U.S. (Such things are never heard of in other nations where they are well informed on the intact penis). You may want to read this article, "The Phony Phimosis Diagnosis" and some others linked from there: http://www.drmomma.org/2010/01/phony-phi...



Here is an article that also addresses the normalcy of ballooning for some boys during the beginning of prepuce separation: http://www.drmomma.org/2010/01/common-qu...



Additional Intact Care information:



The Functions of the Foreskin:

http://www.drmomma.org/2009/09/functions...



Protect Your Intact Son:

http://www.drmomma.org/2009/08/protect-y...



National Organization of Circumcision Information Resource Centers Publication on care of the intact penis:

http://www.nocirc.org/publish/4pam.pdf



Raising Intact Sons:

http://www.drmomma.org/2009/11/raising-i...



Basic Care of the Intact Child:

http://www.drmomma.org/2010/01/basic-car...



Painful Urination During Prepuce Separation

http://www.drmomma.org/2010/01/painful-u...



How the Foreskin Protects Against UTI:

http://www.drmomma.org/2009/12/how-fores...





Forced Retraction Information:



Forced Retraction? Now What?

http://www.drmomma.org/2009/12/forced-re...



Only Clean What is Seen: Reversing the Epidemic of Forced Retraction:

http://www.drmomma.org/2009/09/only-clea...



Medical Testing: Do Not Retract:

http://www.drmomma.org/2009/09/uti-testi...



Doctors Opposing Circumcision Statement for Physicians and Nurses on Forced Retraction: http://www.doctorsopposingcircumcision.o...



Forced Retraction: Ask the Experts

http://www.drmomma.org/2009/09/ask-exper...

Colleen - posted on 10/07/2010

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No mama! With all due respect, STOP!
I'm not sure why you were ever given the damaging advice to pull your son's foreskin back! Please visit the AAP's website for proper care of an intact penis!
I didn't know either until my son was hurt during an unrelated surgery by an ignorant doctor. I reearched A LOT, read studies of thousands of intact boys in which the MEAN (not even average!) age for full retraction was report as 10 year old! Please read AAP guidelines and studies by Oster & Kayaba! When your son goes through puberty, and when intact boys start masturbating, the synechia (balano-preputial lamina) will separate the prepuce from the glans naturally- The cream your son was prescribed should only be used for adults! It is ABSOLUTELY normal for a male to NOT be retractable well into puberty. My father, two brothers, FIL, 4 nephews and son are all intact and healthy. ONLY clean what is seen! Never force the foreskin back-only the owner should! Hope that is some help mama!

Kimberley - posted on 10/07/2010

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Normal Development of the Prepuce:
http://www.cirp.org/library/normal/

The doctors you have spoken with are not well informed. It's COMPLETELY NORMAL for a child that age to not be retractable yet. Some boys won't fully retract till puberty or later. The ballooning is also totally normal and just part of the natural separation process. Even if he DID have a foreskin that is "too tight" (which really cannot be diagnosed till he's an adult) there are non-surgical treatments for it.

CynDaVaz - posted on 10/07/2010

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"She also said that if the foreskin doesn't go fully back by the age of 4 it never will."

Oh my gosh - what a horribly ignorant and irresponsible thing for your doctor to say! Awful!

Too many American doctors don't know what the heck they're talking about when it comes to the foreskin and circumcision. And way too many of them are so eager to cut.

It is NOT necessary to cut a child unless there is an immediate medical issue that has developed. And it's NOT unnatural for the foreskin to appear 'tight' - after all, it's *fused* to the head of the penis and it usually retracts during puberty.

My son's foreskin didn't retract until he was 11 years old (at puberty). He never had any problems before retraction - or afterward.

Kathleen - posted on 10/08/2010

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Hi! I see that you've already had a ton of helpful links posted (I've seen many of them, and they've helped TREMENDOUSLY with my intact sons), so I'll just add a few personal notes that may help:

My older son is 5 years old. I haven't seen him peeing in a while, but as of not too long ago, he was experiencing the "ballooning" that you describe. It's COMPLETELY normal! When a boy is born, the foreskin is attached to the head of the penis, much like your fingernails are attached to your nails-that's why they have to rip it off when they circumcise (ouch!). That fused skin and the "tight" hole at the end of the foreskin keep bacteria from entering the penis. Ballooning is just what happens when the bonding layer starts breaking down. We might think it's weird, but as someone else stated, urine is actually sterile, and is cleaning out under there. The ballooning will stop when the foreskin naturally detaches, *on its own time*. Anesthesia and surgery would only be "fixing" a natural development, and I get the feeling you don't want that for your little guy. I don't blame you.

The detachment could take up to another 15 years- if anyone's doctors are saying that the foreskin should be retractable by age four, that doctor is misinformed about the form and function of the foreskin, and a more informed opinion needs to be sought. Even when the foreskin is separated from the head of the penis, it should never be retracted by anyone but its owner- it's also normal for the muscles at the tip to hold it closed for quite a while longer. Forced retraction could lead to phimosis- problems aren't cause by "tight foreskins", they're caused my misinformed doctors telling parents to mess with their kids' normal genitals. And yes, foreskins that "need" to be retracted every day or they'll stick should NEVER have been pulled back to begin with- the penis is trying to heal itself as well as it can at this point, and that's why it's "sticking". I don't know why doctors are still advising parents to retract, unless it's genuine ignorance or some kind of desire to have more "necessary" surgeries in the future. If he's intact, DON'T retract! PLEASE!

One more personal note: My mom received similar misinformation to what your doctor is giving you, many years ago. He told her to forcibly retract my brother's penis when he was a preschooler, because it was "tight". It caused him immense pain, and she only did it once, but the damage was done- he developed the condition where the foreskin can be retracted, but it gets stuck. If it had been left alone to develop normally, the muscles would almost definitely loosened up on their own- as it was, he didn't ever have a full circumcision, but had to have a slit cut into his foreskin when he was a teenager. Totally avoidable if doctors knew better to begin with.

Please seek a second, third, or fourth opinion if you need to- if a doctor is giving you some of the advice other moms on here have been given, they need more training on the natural penis. If your lovely, sensitive son isn't experiencing any pain, you can be sure he is developing perfectly normally. Leave his foreskin alone (retraction is HIS business, when he discovers that little trick all on his own!), and I have no doubt he will thank you for it some day. As for the mess around the toilet... we've taught our son to clean up after himself:)

PS- If you look at nations where infant circumcision is almost never practiced, you'll see that they don't tend to run into these problems; because circumcision was never the obsession it became in North America, they haven't lost their original knowledge about penis care. They don't forcibly retract, and the boys grow up into perfectly normal, intact men. All of this is a North American phenomenon, and it's sad that our kids are suffering for past mistakes.

*hugs*

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36 Comments

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Dixie - posted on 10/10/2010

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My son, too, had to have a circumcision at 4 years of age. My husband and I had done extensive research before the birth of our son on circumcision as we wanted to make the best choice for him. After all our research, we decided not to have him circumcised. When he was three-years old, he began to return to the bathroom 4-5 times after his initial urge to urinate. The specialist we eventually took him to said that there was a bit of foreskin blocking his urethra tube and that he'd have to be circumcised. After the procedure, he experienced a lot of pain for about a week, especially during urination. He didn't wear underwear or pants for about 2 weeks. (This meant we didn't go anywhere during those two weeks.) He is fine now, but I still look back on that time and shudder. Good luck with your decision!

Michelle - posted on 10/10/2010

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a circumsion is not horrific procedure to do for any child no more if he needed a tumor cut out of his body. it it is something that will and most likely make his life better why do it now while he is young. most children do not remember such things once they are older. a ballooned penis is not normal in any country. it may be a popular procedure or standard as it is here in the states but i feel medically it should be taken care of now. your son at age four does not know what is normal. children do not complain the way adults do. they have a better adaptation to such matters. it is ulitilmately your choice of course and i do wish the best for your and your son.

Jessica - posted on 10/10/2010

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I saw two general practionioners (standard in the Uk) before referal to a peadiatric urologist with 25 yrs experience.. He told me my sons penis shouldn't be ballooning and this could cause infection as urine get stuck behind the foreskin.. he then pointed out how the foreskin was fused saying it must have happened during an infection at some point!!?? My son had never reported pain, discharge, anything abnormal and this was why I began to question his diagnosis.
If I had searched online for "ballooning of a childs penis" I wouldn't have even gone to the docs as it seems like a normal issue for hundreds of boys accross my country. I thank god for the internet and this global world we live in where I can combine such resources as I have in this situation. Without circle of moms my son would probably have had a circ!! How horrific for him that would have been.
Lets stop tampering with nature and start a dialogue about whats "normal" or Ok when it comes to children. So many people are frightened in this day and age to talk about kiddies bits and bobs.. its important to share info and help us move out of the dark ages when it comes to Circ.
My husband, brother, and father had no idea what was normal when dealing with a boys foreskin!! i find this alarming, if they don't know how can us girls understand.
In Europe, Sweden, Denmark etc Circ is virtually none existent, I am glad it is becoming increasingly rare but my Urologist still performed 3 a week at just one hospital here.
Bless all our precious children x

Michelle - posted on 10/10/2010

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jessica this sounds like to me it may be a medical situation that may lead to surgery later in his life. first seek a pediatric urologist. they specialize in male sex ordgans. whatever he say meditate on it make sure you are at peace with the decision. much luck to you!

Samantha - posted on 10/10/2010

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I should have read page 2 for the update! So glad that you got the info u needed and avoided surgery for your son! :-)

Samantha - posted on 10/10/2010

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Holy sh...... The foreskin of a penis should NEVER be retracted by ANYONE other than the person it belongs to, the reason it becomes tight if "not done daily" is because the forced retraction is causing adhesions. In childhood, the area under the foreskin is akin to the area inside a girls vagina. It doesn't need washing or stretching!!

I am in the UK where virtually all boys are uncut. These problems rarely occur if the foreskin is left alone.

Samantha - posted on 10/10/2010

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Circ is not necessary. Many drs in the US are not familiar with an intact penis. They are not taught about them when they are training, except how to cut them off.

Circ removes the foreskin, frenulum and ridged band, as well as tens of thousands of nerve endings. It changes the way the penis functions and nearly always results in a loss of sensitivity. This will profoundly affect how he experience sex as an adult.

It is normal for the foreskin of the penis to be fused to the glans in infants and young boys. If it is prematurely retracted it causes pain, adhesions and infection, but is still treatable without amputation.

You are absolutely correct in your instinct that circ is invasive, drastic and only suitable as an absolute last resort.

Charlie - posted on 10/09/2010

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So happy Jessica that you decided to inform yourself before following his terrible , ill informed advice .
Where did this guy get his certificate ? a wheeties box ? doctors of all people should know the prepuce is naturally fused .
Will you be seeing him again ? i would make a list of the links and pass them on , perhaps he needs a refresher course in biology too.

Colleen - posted on 10/09/2010

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Pediatric Urologists would be put out of business if they couldn't circ & fix botched circs....
They are most often going to recommend surgery-cumulatively, they make LOTS of money off of poor boys having their foreskins taken.
I'm so glad you followed your intuition. It is there for a reason. Although, unfortunately, many people (especially women, ESPECIALLY when it comes to mothers consulting (male) doctors in the medical community) are slowly conditioned to ignore that inner voice...
Everyone gave A LOT of great advice here. I'm very happy to see that many mamas are educated on the proper care of the foreskin.. This information wasn't so prevalent on line even just a decade ago!
(and YES! - I do think you should go back in with tons of resources to present to that doctor! and tell him how you feel, that if you HAD trusted only him, went through with his recommendation for circ, THEN found out all of this info (this is where you hand him some of the resources presented), you would be utterly infuriated!)....
(s)he should really know better! You could potentially be helping MANY boys from the harms this doctor could inflict...
I might also suggest you take the time to go to some of those "rate so-and-so" doctor websites... write a review/a warning for other suspicious parents that might be contemplating his harmful ad vice!

Iridescent - posted on 10/09/2010

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Exactly correct, Heather. Our area, no anesthetic is used, they are strapped to a circumcision board (similar to a papoose board), and their pacifier is dipped in sugar water. They are given Tylenol if anything at all, and many go into shock although it is not recognized as such (noted by no crying, no eye contact, going to sleep from shock not comfort). In our area, the circumcision rates remain close to 100% of males, mostly due to lack of education. That is the only reason our children were circumcised at all; we didn't know. Plus the falsified risks of not circumcising vs performing it, and the lack of rates of complications such as scarring the urethral opening closed... Once the baby is 7 days old, no hospital will perform the surgery in the same way - it is then a full surgery requiring general anesthesia, usually at least 1 night in the hospital, and significant pain control.

Heather - posted on 10/09/2010

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You're very welcome, Jessica. And the circ rate in the US s 80% of males in general, but we're down to roughly 30% being cut in the hospital now. Unfortunately, that doesn't account for the religious and pediatric circumcisions, but it's pretty sure we're finally under the 50% mark.

Horribly, this is done most often to newborn infants, who are strapped to a board, given barely enough anesthetic (or not enough time for it to work, though 80% of hospitals reported that they weren't using any in most cases according to the last survey done) and then the procedure is performed, with in the vast majority of cases, the parents are not allowed to even be in the room to comfort their baby, who is sometimes given sugar water to suck on. Then just Tylenol for the follow up.

An adult male gets sufficient anesthetic and is able to say if it's not and then heavy drugs for recovery.

Land of free choice, my ass. Only once you're 18 :(

[deleted account]

WOW! This thread has been super informative.

Some days I'm extremely grateful I had a daughter! Thanks ladies!

Kathleen - posted on 10/09/2010

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Hooray! Jessica, I'm so glad you decided to research this instead of just following "doctor's orders". I didn't notice you were in the UK- it really surprises me that doctors don't know better, and that they'd point to the States as a model of... whatever. Ugh. Anyway, I'm so happy for you and your little guy!

Jessica - posted on 10/09/2010

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I am utterly speechless at how most of you ladies have helped me and I hope you read this post as I want to thank each and everyone one of you for this advice. To be honest the night I posted this question I googled "fused foreskin ballooning" and found a tonne of info much like you have all posted. There was nothing in the top 10 pages that even hinted that this issue was a real problem. I can only gasp at the thought that Google is more up to speed with something so sensitive as circ!!!! My Doctor was so matter of fact and I cannot believe this is even undertaken on so many poor boys who's mothers wouldn't even think to question a Urologist!
Safe to say I will not be allowing a circ EVER!!! and I will be leaving my poor boy and his bits well alone.
I am so horrified I feel like sending all these links and documentation to the hospital in question.
Here in the UK Circ is very uncommon these days and the Doctor normalised it for me when I looked horrified at the thought of what he wanted to do by assuring me that 75% of boys in the US have had a Circ.. if this is true I am appalled and sad for these poor boys who are being deprived of something so precious and private! Please keep posting if u ever see mums with this problem.. I feel I have to educate as many as I can when I think what might have happened.
I hope the lady forceably retracting from early on the thread has read this too..
THANKYOU!!!!!!!!!!!!!!! xx

Iridescent - posted on 10/08/2010

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Lol, Christa! Yes, I've been reading the posts as well. As you could read, I thought a full circumcision was likely more extreme than necessary. As I received my nursing training where circumcision is assumed and standard care, there were apparently a lot of gaps (the same can be said for many doctors!). I am glad to see so much information about what actually is normal and to be expected with a circumcision. All my boys were circ'd and this spring we had to have a meatotomy performed on one of them, at 9 years old, due to scarring of the urethra at the penis tip. It was so traumatic, and at that time we completely regretted ever having our kids circumcised, and this is why I had posted to get another opinion on this post.

Christa - posted on 10/08/2010

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And also, my surgeon told me that 90% of boys are fully retractable by age 3. See the difference already? Don't circumcise I beg of you! And I hope that the first 2 people who posted are reading all this as well :)

Lucy - posted on 10/08/2010

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This is the kind of thread that makes me thank the technology gods for COM's!

Your instinct that a circumcision is unnecessary is bang on- The medical fraternity expends considerable energy convincing us Mums that we are silly little women who have to ask a professional what colour knickers to put on in the morning and certainly shouldn't be trusted with decisions regarding our children's health- But your gut feeling, common sense (and the sensible ladies of COM's) tell you different!

The foreskin is not fused due to infection, it is fused because it SHOULD be for a good few years yet!

Charlie - posted on 10/08/2010

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Great advice on this thread .

I hope you take the time to read the links and research a little bit on what these lovely ladies have offered , some doctors are far too hasty especially when it comes to lining their pockets !

It can never be said enough though = when intact don't retract , the foreskin is naturally fused and any retracting before it naturally does so on its own can rip the precious tissue that is the prepuce (foreskin).

Christa - posted on 10/08/2010

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It is entirely normal, my son has the same thing. He's 3. And my surgeon also wants to circ. I say NO WAY am I mutilating my little boy. He's perfectly normal! And my GP also said he's fine, there are no problems whatsoever. It's unfortunate that there are so many pro circ doctors out there forcing their opinions on mothers. As your son doesn't complain, obviously there is no reason. Here is a great link.

http://www.nocirc.org/publish/4pam.pdf

Kathleen - posted on 10/08/2010

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Ballooning is good. That means his foreskin has begun to naturally retract....please trust your gut ...don't cut. As long as your son can urinate everythings fine.

[deleted account]

I feel sorry for all the boys that have had unnecessary surgery because of these doctors! Even by the age of 10, only about 40% of foreskins are retractable!

Lindsay - posted on 10/08/2010

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urine is sterile, so it wouldn't be causing an infection! it is SUPER NORMAL for foreskin not to retract on its own until puberty or even later! DO NOT forcefully retract your son's foreskin, that CAUSES MORE PROBLEMS!!!! and don't get him circumcised because of some money hungry docs who obviously don't know anything about a proper INTACT penis, aside from wanting to cut it off! to reiterate, it is PERFECTLY NORMAL for your 4 yr old's foreskin not to retract yet, and it doesn't even "have to" for many more years! As long as he isn't in pain, it is perfectly fine!!!!!

Alison - posted on 10/07/2010

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Everyone has said what I want to say, but I wanted to lend my support. I know it can be scary when you think something is wrong for your child - what a big responsibility we have as parents!

But ballooning - and a smaller hole in the foreskin - is a completely normal stage of penile development. Other people have explained this, and they have done it well.

Many doctors in the US were trained when circumcision was seen as normal, and therefore - though meaning well - do not have the skills or experience to advise parents of intact children.

You did well to keep him whole - keep fighting for him. As the foreskin continues to separate, the hole in the end will enlarge. There is NO NEED to EVER retract the foreskin!

The foreskin has so many wonderful uses and a real purpose to being, so it would be a real shame to let a misguided health professional amputate a healthy part of your son's body!

Best wishes to you and your son.

Heather - posted on 10/07/2010

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I just realized that maybe you don't have time to go through the whole blog post (which I wrote to consolidate a lot of info into an easy to access place), so two quick bits:

"is "ballooning" a cause for concern?

No. It's caused by the natural separation of the foreskin leaving pockets behind in which urine pools. It does come out eventually and in the meantime, urine is sterile. Apparently, some boys like to play a game that causes ballooning (which is messy but harmless). The biggest concern is that there is an obstruction to voiding, but under study, this was shown not to be so. As long as there is no pain or infection, this is a normal process, particularly around the age of 3 and should go away as he gets older."

When should the skin retract?

This is the most common source of concern for parents of intact boys. The first study done on this subject only followed boys for 5 years who were forcibly retracted from infancy and thus, states that 90% of boys will retract by age 5. This study was refuted over and over and the current advice is that it will retract by puberty. Now, the misunderstanding comes with "by puberty." In fact, it is by late puberty that one should expect retraction (age 15-17, though 5% of men remain non-retractile until the early 20s when, anecdote suggests that most of the remaining men gain the ability to retract, but no studies have been done). At age 12-13 (early puberty), 40% of boys remain non-retractile.

So, the answer is, it should retract by age 17, but a very small number of men don't retract until age 20 or later. Only the boy should retract his foreskin and he should be advised not to do so where he experiences pain. Forced retraction can cause iatrogenic phimosis, which causes the foreskin to be too tight to be retracted or scarring from torn adhesions that can cause the foreskin not to retract properly later and can cause severe pain when retraction occurs.

My son has been diagnosed with phimosis and I've heard that circumcision is the only treatment. Is this true?

First, there are two different kinds of phimosis. Phimosis is a condition where the foreskin either cannot retract or when it does, it chokes or creates a "waist" on the penile shaft, resulting in damage or pain. Pysiological phimosis is the natural period in which the foreskin is non-retractile. Pathological phimosis is problematic and typically caused by Lichen sclerosus, scarring caused by forcible retraction or Balanitis.

Pathological phimosis can be treated with steroid creams (4-6 weeks), balloon stretching, dorsal slit, preputioplasty and finally, circumcision, but pathological phimosis is an adult condition, typically. If the boy is experiencing issues with pain, inability to urinate or frequent infections and phimosis is diagnosed, it may be in his best interest to look begin non-surgical treatments first and if the condition persists, consider corrective surgery with circumcision as a last resort.

Hope that helps.

CynDaVaz - posted on 10/07/2010

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"unfortunately for my son if his foreskin doesn't get pulled back every day it becomes tight again"



It should *never* be pulled back until it is ready to retract on its own. Never, ever, ever! The reason it gets 'tight again' is probably because the (ripped) skin is trying to heal itself. Forced retraction tremendously increases his risk for all sorts of issues.

CynDaVaz - posted on 10/07/2010

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"His penis balloons during urination and sometimes it shoots out to the side which he thinks is hilarious.
He suffers no discomfort when passing urine and never complains about his penis."

As long as your son is not in pain, he should be fine. My son's foreskin also ballooned somewhat during urination and yes, the pee did often want to fly everywhere. LOL

Many doctors don't know how to properly advise parents about foreskin, so when one of them recommends circumcision, please bear this in mind.

And you are right. Circumcision is extremely traumatic - and what makes it worse is that it's unnecessary the vast majority of the time.

CynDaVaz - posted on 10/07/2010

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"The fact that it's fused is not a good sign."

No - this is *completely* normal! The foreskin remains fused until retraction. The mistake many parents - and yes, even doctors - make is to attempt forcible retraction. This is a HUGE no-no!! Forced retraction raises the child's risk for infection - and it can cause damage.

Bec - posted on 10/07/2010

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I am going thur the same thing with my 5 yr old son. The pediatric surgeon we are seeing is great and has explained in great detail why it needs to be done. She also said that if the foreskin doesn't go fully back by the age of 4 it never will. I also don't want my son done but if it needs to be done I would prefer to do it now then when he is a teenager. There is a cream that you can put on the foreskin which makes it stretch, have you tried this? We have been using it for the past 2 yrs, it does work but unfortunately for my son if his foreskin doesn't get pulled back every day it becomes tight again and as I'm sure you know 4/5 yrs old are not to keen on having it pulled back. Good luck with it, I feel your pain!

Iridescent - posted on 10/05/2010

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The symptoms you're describing can be really serious, and should be treated, but you should check into what other options there are without a full circumcision. Can they just slit it and leave him intact? Can they dilate a catheter in it to enlarge the opening? The damage it can cause the bladder and kidneys proves it needs treatment, but type may be varied.

Tracy - posted on 10/05/2010

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I'm assuming you're taking him to pediatric urologists? If not, you may want to for another opinion. From what I've heard, sometimes this tight foreskin can become quite painful and eventually prevent him from being able to urinate properly. Which can cause MORE trouble. The fact that it's fused is not a good sign. He may not be complaining now, but that coudl happen down the line. From the urologist I had to take my son to, he did NOT like to perform surgeries unless there was no other way. Circumcision can be pretty painful, which is why its done so young. Infantile amnesia, they won't remember. I seriously doubt it something your dr is taking lightly. But again, if he's not already under a peds urologists' care, take him to one

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