Has my toddler been damaged by forcible foreskin retraction?
July 27, 2010 7:18 PM   Subscribe

My uncircumsized two-year-old's pediatrician forcibly retracted his foreskin today. My son is now experiencing pain and swelling. How concerned should I be?

I took my son to his doctor today because I was concerned that he may have had a urinary tract infection. His urinalysis was negative. His pediatrician told me that he would like to do a physical examination of the area to look for any other possible causes of the symptoms that he was experiencing, and I said ok. He was pulling back my son's foreskin slightly (he said he was just checking for redness), and he commented that his foreskin was "tight for his age." I thought that was odd since I am under the impression that foreskin retracts on its own anywhere between 5 and 15. Anyway, as he was inspecting my son, he suddenly retracted his foreskin completely. I was completely shocked, as was my son, who started crying from the pain. Now this evening, the tip of his foreskin is swollen and red and he says it hurts and that it hurts when he pees.

I am completely freaked out. I have done extensive googling and am now worried about everything from urinary tract infections to permanent damage that could lead to lasting sexual dysfunction. I have given my son ibuprofen and applied vaseline to the area. What else should I do and how concerned should I be? Has this doctor potentially damaged my son for life?
posted by mudlark to Health & Fitness (29 answers total) 4 users marked this as a favorite
Get a second opinion— go to a different doctor. Then decide how to act:

1) Do nothing because it's all okay.
2) Change doctors because the previous one isn't careful enough.
3) Malpractice suit.

Do not attempt to make plans for any next step before getting some expert advice from another doctor.
posted by Electrius at 7:25 PM on July 27, 2010 [1 favorite]

Response by poster: Additionally, I should add that I am a single mom and this is my only child, so feel free to assume that I know absolutely nothing about foreskin, being uncircumsized, or having a penis. Any and all help is appreciated, and even the simplest information on this subject is probably more than I currently have :)
posted by mudlark at 7:27 PM on July 27, 2010

Personally, (based just on "swollen and red") I'd be concerned and would go to a (possibly different) doctor.

Our experience with our son:
2 years old (I think): penis pain, particular when peeing. Took to doc we were concerned it might be a UTI. He had a quick look and said UTI for boys was extremely uncommon, and it was likely balanitis. Got some cream (on prescription, antibacterial I think). He also said we should start pulling back the foreskin regularly, but we kinda knew this was bad advice (foreign doctor), and confirmed this by talking to a paediatric nurse we knew. Pain cleared up quickly, within a day or two.

Later, maybe late 3 years old, not sure: (based on advice) We encouraged our son to pull back his own foreskin, just a little bit, at bathtime. Initially he found this a bit difficult, but it became easier and easier. Now at 4.5, he does it every night with no problems, and it all looks pretty normal.
posted by antiquark at 7:30 PM on July 27, 2010

Also, if he plays with himself in the bath, don't discourage it. It helps loosen up the layers, and will be a good start to the foreskin retraction in a couple of years.
posted by antiquark at 7:32 PM on July 27, 2010

Response by poster: I will be changing doctors, but getting another doctor and an appointment will probably take days. Also, we live in the south, and they don't seem to see a lot of uncircumsized children around here. I don't think a lot of local doctors really know how to treat them.

And, this all happened this afternoon, maybe five hours ago. Could he a;ready be showing signs of infection?
posted by mudlark at 7:34 PM on July 27, 2010

I remember retracting my own foreskin when I was little. It was a jolt of pain but within a day or so, it was fine. I was more startled than anything.

I would not freak out (or do the "extensive Googling" thing). The penis takes damage and recovers quickly. There are probably some raw spots from the retraction that would cause peeing "pain" but I doubt anything severe or worrying has been inflicted. Occasionally, as an adult, you can accidentally abrade the penis. It heals up in a flash.

As for infection, just keep an eye on it but unless there are classic signs of infection (pus/discharge etc.) I wouldn't expect that. Mr. Penis is designed to operate in a dank, moist environment to begin with.
posted by teedee2000 at 7:52 PM on July 27, 2010 [1 favorite]

Yikes! Poor lil guy and poor you! A similar thing happened to my son at the pediatrician when he was about 3, but it was only a partial retraction. There was soreness, redness, broken skin and a lot of freaking out on my part. It all turned out ok though. Get a pediatrician's advice on how to treat it until it heals. I think I used something similar to Neosporin to keep the area protected. The problem was that the damaged skin kept "weeping" and would stick together or to other skin, making it hurt when it moved. I think it was better within days and completely healed after about a week. After that, I did not allow anyone to retract it except my son, and eventually it fully retracted when he was about 4. My second son's didn't fully retract until later- like 5 or 6.
posted by Ochre,Hugh at 7:53 PM on July 27, 2010

@ Electrius -- A malpractice suit? I hope you are being sarcastic. The little guy's weenie isn't a Faberge egg. It can take punishment; the pediatrician knows that, hence the cavalier manner. I would change doctors if you don't like the doctor's brusqueness but let's not overreact here. Remember, your son could have accidentally done this to himself on his own.
posted by teedee2000 at 7:56 PM on July 27, 2010 [4 favorites]

I completely and totally understand that this is distressing but more than anything, I would just deal with the situation as it is right now. Your son's penis is red and inflamed because his foreskin was retracted; this is terribly irritating and will hurt but is not in and of itself a sign of infection or long term damage.

I would get him to a new doctor ASAP because he's in pain, but in the interim I would dose him with whatever over the counter pain reliever you're comfortable with, and keep him dosed overnight for relief.

I am not, by the way, trying to minimise what was done to your son. I am just suggesting that there's no need right now to jump to the worst case scenario; all you can do at the moment is deal with the symptoms of the injury as they're presenting.
posted by DarlingBri at 8:00 PM on July 27, 2010

As a male, I can help but feel that this is a non-story.

I feel like I'm stepping out on a limb to even reply, and fighting the urge to duck :)
posted by lundman at 8:13 PM on July 27, 2010 [4 favorites]

It's a non-story to adult males. To a 2 year old and his mother, it's not a non-story; that said, this is a temporary injury that will heal itself soon, just like any other minor tissue damage.
posted by dfriedman at 8:21 PM on July 27, 2010 [1 favorite]

I'm with teedee2000. Had a very similar experience when I was younger as well. IANAD but as an uncircumcised male, I think your son should full retract the foreskin when he pees. It's good to learn this early--speaking from personal experience here.
posted by johnnybeggs at 8:23 PM on July 27, 2010 [2 favorites]

Response by poster: Thank you all for your comments. I am definitely freaked out, and perhaps overly so. It looked so painful when it happened .And yes, now the skin at the tip of the foreskin is "weepy" as Ochre,Hugh described--it's sort of sticky-looking and very red. And I just feel awful for letting it happen in the first place, even though I know that I didn't realize what the doctor was about to do.

I do see that I should probably worry a little less about permanent damage until I have some reason to do so. I guess I was unsure if it was a foregone conclusion or a vague possibility, or maybe somewhere in between. I have no idea how resilient penises are or even if the foreskin will now reattach itself or if it will stay separated. I'm really sort embarrassingly clueless :(
posted by mudlark at 8:24 PM on July 27, 2010

Just keep an eye on it over the next few hours to see if it worsens. It sounds like your son is a possible candidate for later term circumsion, as sometimes the foreskin is just too tight to retract.

Nothing wrong with being overprotective of that area of the body.
posted by fantasticninety at 8:29 PM on July 27, 2010

mudlark- don't be embarrassed and don't blame yourself. you guys will both be fine!
i remembered something else that may help: let him pee in the tub or shower with water running over the area. it won't hurt as much and will help keep it clean.
posted by Ochre,Hugh at 8:32 PM on July 27, 2010

Guess that perhaps sounded callous but it was not meant as such.

I had the same problem myself, and tore mine a few times in my 20s. Chose to have circumcision at 25 for that reason. I wish I didn't have had to, but that isn't important for this discussion.

I had to take my 3yo boy in for the very same reason, and his reaction was certainly strong (pain, surprise, shock) but over just as quickly. I had to spend three weeks retracting it and applying salve for him, and it quickly became a non-event. I don't really think the cream works, so he'll probably have to decide himself what he wants to do with it when he grows up. It's not until you enter the teens that it can be a problem.

Practicing peeing with it fully retracted is a good idea, but I could easily do that as a child, so it is no indication of avoiding future annoyances. :)
posted by lundman at 8:59 PM on July 27, 2010

Certainly this doctor's bedside manner leaves much to be desired, but he didn't do your son any harm. A malpractice suit would be ludicrous.

I had a tight foreskin as a child. The only way to correct it short of surgery was to forcibly retract it -- repeatedly, gradually and firmly. I did this myself, under the instruction of my doctor. The skin eventually stretched out and loosened.

By the time I became sexually active, I was pretty glad that had I manned up and done what needed to be done, ahead of time.
posted by randomstriker at 9:04 PM on July 27, 2010

I have no idea how resilient penises are or even if the foreskin will now reattach itself or if it will stay separated.

It's is a bit like a tear in your mouth/lips, if you've ever done that. Annoying, and you can't quit poking at it.

Oh yeah, as an adult took about 1 week to heal after I tore mine. Also, as a child, it was fun to hide smurfs, and other things, under the foreskin. It's very versatile and a great hiding place!

I mean, I heard of a guy who used to do that, not me.
posted by lundman at 9:06 PM on July 27, 2010 [7 favorites]

@ Electrius -- A malpractice suit? I hope you are being sarcastic.

I was just emphasizing that without information, every avenue of action is equally stupid.
posted by Electrius at 9:07 PM on July 27, 2010

To respond only to your concern of general "cluelessnes" about the care and misadventures of the uncircumcised penis, I often recommend this primer written by a pediatrician who does a lot of education (to the medical community and parents) about what is and isn't necessary for the uncirc'ed pediatric patient. My husband (who's circ'ed) and I learned a lot about the uncirc'ed penis from this article and feel like it gave us a nice head's up (har) about what we may encounter from medical folks when they encounter our uncirc'ed son. I am sorry you had this experience, and I hope your son is feeling like himself soon :)
posted by rumposinc at 9:29 PM on July 27, 2010 [5 favorites]

p.s. I should have said that yes, the primer is from the sometimes polarizing magazine Mothering, but the primer includes all of its sources and is written in a straight-ahead and useful way. Also, I was directed to this article by a pediatrician who is very moderate in his view of circumcision, but picky about evidence, so I feel like it's one of those good, gets-everything-in-one-place sort of articles. FWIW
posted by rumposinc at 9:34 PM on July 27, 2010

Best answer: I can't believe I'm linking to
something from Yahoo Answers, but it's an atypically useful bit of information from a mother with four uncircumcised sons.
posted by davejay at 9:39 PM on July 27, 2010 [3 favorites]

The advice is from a father, but yes, it is atypically useful.
posted by lover at 10:08 PM on July 27, 2010

Response by poster: Thanks again for all of the information and advice! Between the Mothering article and the Yahoo Answers parent, it seems clear that the answer here is that he will be ok with a few days of care :) And I now know to be on my toes and what to say to medical personnel regarding the care and treatment of this area.
posted by mudlark at 10:54 PM on July 27, 2010

yep, yahoo has it right. sadly most doctors don't have a clue about this; i know, I was one.
posted by dougiedd at 12:44 AM on July 28, 2010

He'll be fine. Our foreskins fully retract eventually when we're kids. It hurts then just as it would hurt a two-year-old. The penis is much tougher than you might think.
posted by fso at 8:14 AM on July 28, 2010

We had the same thing happen to our son at about the same age.

We had hoped he would grow out, 5 years later it looks like he will definately need a circumcision.

Malpractice suit.
posted by jkaczor at 10:01 AM on July 28, 2010

If he'd been treating an adult patient, it would be seriously bad medicine to do a physical act like that on someone's body without any warning or explanation.

From wart removal to throat swabs to speculum insertion, heck even applying a blood pressure monitor or a stethoscope, the doctor should explain what they're about to do to the patient, make sure it's okay, and talk them through it.

Even if two years old isn't old enough for informed consent, it's plenty old enough to not have your body handled without explanation or warning, and even if not for him, then for the parent/guardian making the medical decisions.

What I'm saying is, while I have no idea about the underlying medical issue and I'm glad you got some good information about that and I hope it really clears up and is well fast, I wouldn't go back to a doctor who treated his patients' bodies in such a peremptory, proprietary way.

Hopefully a malpractice suit will be completely unnecessary, but I think a clearly worded feedback letter to the doctor and to his clinic/practice would be a really good idea for their own good and the good of their future patients, if it has a chance of influencing the doctor's behavior, even if you don't actually ever go back.
posted by Salamandrous at 4:06 AM on July 29, 2010 [2 favorites]


What a super great, erudite point. Absolutely, at age two, a provider should let the child know that he/she is going to examine and touch his penis, and certainly both the parent and the child should know before the practitioner does something invasive--and retracting a foreskin (at any age) is invasive.

The original poster should consider your response carefully when thinking about how to address this practitioner.
posted by rumposinc at 11:42 AM on July 29, 2010

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