Wednesday, January 12, 2011

Circumcision......the hidden complications!

One of the biggest decisions we had to make when I was pregnant for the first time with a boy was whether or not we would have him circumcised. For my husband and I, it was an easy decision. We took the literature, read through it and ultimately and quickly decided that we would have the procedure done. We know that it is the "popular" decision with nearly 70% of all parents deciding the same fate for their sons. We never had any problems with any of our 3 boys after the procedure was done. It was done quickly (although definitely not painlessly!) and we had no problems with healing after we got home from the hospital.

During a visit to the pediatrician last week with Aiden who is now almost 1, the Doctor looked at his "plumbing" so he calls it., as he does routinely *lol* So he does this and he looks at Aiden's diaper area, scrunches up his nose and tells me that it just doesn't look right and that it appears that something had happened called Penile Adhesion which is one of the hidden complications of a circumcision.  Here is what I found on the subject.

Penile Adhesion:

Penile or prepuce adhesion can occur after a circumcision if the remaining skin is not retracted after the circumcision has healed. When a circumcision is done, tissue which would normally be intact is split. Unless proper care is taken, the epithelium of the inner prepuce at the point where the foreskin was removed can reattach to the epithelium of the glans. The result of this is a penile adhesion. Usually the adhesions can be released by simple retraction. Sometimes, however, the fusion is so complete that simple retraction will not work, and the child must be referred to a urologist. Another problem is that smegma or bacteria can collect under the adhesion if it covers the preputial cavity and cause infection. Professionals must look for this problem, and parents must be taught how to care for the normal circumcised penis so that penile adhesions do not develop. This article discusses the formation and identification of penile adhesions, the process by which adhesions can be released, when a referral to a urologist is necessary and the proper care for the circumcised penis.

Ok, so in plain terms, the extra skin had reattached itself to the shaft of my babies penis and I had no clue. I change his diaper a dozen times a day and never had I thought it looked odd or like there was a problem. So before I could even blink an eye, the Doctor had quickly retracted the skin using his fingers which caused me to almost have a heart attack and Aiden let out a blood curdling scream like I have never heard. I could have reached out and punched the Doctor right then and there for hurting him like that!! *lol* Seriously though, no parent likes to see their child in pain especially like that without warning!!!  He told me he should be ok in less than 5 minutes....WRONG! He cried himself to sleep on the way home and screamed and cried for days after. He was all red in the diaper area. I applied triple antibiotic ointment and took special care to make sure it healed as quickly as possible. It is still pink today but luckily doesn't seem to be bothering him almost a week later.

So after having 3 boys, this was new to me. Nobody had ever mentioned this possibility to me or I would have made EXTRA sure I was pulling that skin back from the beginning when we left the hospital and going forward to make sure that it would never reattach like that!  The Doctor told me to take extra care now when he has a bath and when I change him to always pull the skin back to make sure it doesn't reattach and that I might even have to train him to do so when he is bigger to prevent any problems in the future.

Anybody else ever had any problems after a circumcision either immediately after or later down the road? I am curious to see if anybody else has ever heard of such a thing!










18 comments:

Sheri said...

One of my nephews had that but they didn't realize it until he was MUCH older (like 5?). My boys did fine, thank goodness but I watched closely because I remembered my nephew.

Amber said...

My little guy, who is just a couple of days shy of 11 months had a penile adhesion. Though the pediatrician and nurses did lots of commenting on how much foreskin he has I wasn't warned about it. I did pull it back for cleaning, but apparently not far enough. At his 9 month appointment it was the same deal--she quickly pulled back and I was left with a screaming baby boy. It was about a week before he didn't shriek during a diaper change. I felt awful!

Alliejean said...

Yeah, I noticed it for the first time when Jake was about 3 months old. I guess I was being too gentle pulling it back at diaper changes. It almost happened again a so we just have to be really careful about it. Several of my friends have had this happen with their boys too. I think it is one of those really common things that just doesnt get talked about.

Heather said...

This happened to my nephew when he was younger. So with our son, at least a few times a day, I pulled the skin back and cleaned and wiped things. Vaseline for a few months on it can keep it from adhering again. But you will need to keep an eye on it and teach him to tell you if it hurts or itches. My 11 year old nephew still has issues with his to this day. I am sorry that he cried for so long, poo little guy. It probably hurts when he pees too, keep putting ointment or vaseline on it for a few weeks to a few months to help it heal and keep it from re-attaching.

Ashley said...

Poor little guy!!! My son isn't circumcised (so, obviously different than your circumstance) but have read all sorts of things that you SHOULD NOT pull back the foreskin, and that is will retract naturally between age 2-3. Otherwise, you can permanently damage your child in that area.

It just worries me that they are just pulling it back like that if it had reattached. Circumcised or not, it seems like its a harmful thing to do!!

Midwestern Gone Idahoan said...

Having had two boys - I never had this problem - but my doctor told me about it and told me to take extra care in that area.

~Stacy~ said...

yes, my 2nd son did around 6 mths old, the Dr pulled it back leaving him screaming and bleeding a little. I took care to pull back the skin but it reattached again. Dr pulled it back one more time around 10 mths or so. I am so glad that was the end of that!

Antonia said...

wow, that sounds awful. poor little guy. i hope he never has any problems again.

for us, it was an easy decision the other way. we never did have any boys, but with my first pregnancy, i didn't know what i was having. we decided then that if we had a boy we would not have him circumcised. we have two girls so never had to deal with it anyway.

ape2016 said...

I feel so bad for your baby and you (oh, the mom guilt!) My mom was a fanatic and she nagged me constantly to pull the skin back with every diaper change and clean religiously. I guess I am glad that she pounded the lesson in my head because we have never had any problem. Thanks for sharing with your readers. If you save educate one mom, then it will have all been worth it.

Brandi Elam said...

Oh, poor baby!!! I feel so bad for him! :(

Glad he seems to be doing better now!

Anonymous said...

Meatal Stenosis is also a complication you only find in the circumcised.

Also age 10 is the average age for the foreskin to naturally retract not 2-3.

Anonymous said...

I'm pretty sure the numbers are down to 30% of baby boys are circed.. not 70%. The more complications are talked about and it's understood how unnecessary they are, less mom's choose to do them.

I know with an uncirc'ed boy, it is CRUCIAL to NOT pull the skin back!!!! You really open things up to complications by pulling it back. The foreskin pulling back naturally occurs later in life - somewhere between the ages of 2-14...

Samantha said...

My son had this happen and at around 1.5 years old, he went in to get extra taken off so it wouldn't attach. I hated that he had to have this done. He was a preemie when he was born so maybe it just didn't heal properly.

dannyscotland said...

This is the thing I dread most about having a boy if I ever do someday. My husband does not want to circumcise, and I always figured we would. My friend's husband is uncircumcised and has always wished he was. But then there are the complications. I had no idea this was even an issue. I guess if/when the time comes, I'll have to talk to my pediatrician and see if he recommends anything and what he has to say about this condition. I really really appreciate this post, by the way.

Kirsten said...

Oh, your poor little guy. I hope he doesn't have any more trouble with it!
I refuse to get into the circumcision debate (we know what we will do if we have a boy, doesn't matter what anyone else says), and I hope the comments don't turn nasty here. :)

Jolie said...

Whoa. I had no idea there was so much to think about regarding this. When my boy was born (8 yrs ago) we did the procedure, and it was traumatizing to me then. I can't imagine if I had to deal with this after affect issue in the Dr office! We had it done while we were still at the hospital, the day after he was born. They brought him in after the procedure and he looked plumb worn out. The nurse gave us explicit directions that for the first diaper change to call them in, so they could show us how to do w/out hurting him, and they'd remove the gauze and such, showing how to be sure to not get the diaper stuck to his raw area and apply vaseline to help. Can you believe it, the nurse comes in for the 1st change, and the diaper was stuck?? HOLY COW. Poor kid screamed his head off. My hubby went out and bought 3 tubes of vaseline, the kind that just squirt out, and I lubed that little guy up like crazy every diaper change for like 2 weeks to make sure he healed and never ever had a diaper stick while I was on duty. Maybe that's why it all worked out for us, I don't know. But I know anyone who has a baby boy I give them a big squirt tube of vaseline and advise they'll be glad they have it!
Thank you for writing this post, it's something a new mom could really use to prepare for this moment. I don't know how folks managed back in the day of the pioneers when you couldn't get experiences shared!

KOTFrank said...

Thanks for bring this up. Reading the comments makes it seem circumcision adhesion is very common.

http://bit.ly/ZDEfA Imagine having penile wounding that must be torn apart everyday for a year.

Meatal stenosis occurs in about 10-30%. I recommend http://newborns.stanford.edu/CircComplications.html Complications of Circumcision from Stanford School of Medicine

Further PTSD is another complication that USA doctors still don't talk about. The Royal Dutch Medical Association calls out the known problems of circumcision (2010) http://tinyurl.com/254kvyp

http://www.jurology.com/article/S0022-5347(05)63612-9/abstract termed "infrequent but important complication" circumcision can cause phimosis

Laura said...

It happened w/ our first son and the same thing happened at a Dr. visit (he pulled it back w/ out telling us). I noticed a few weeks back my youngest was starting to have the same problem so I pulled it back myself a little and problem solved. I had a talk w/ the hubby and we are trying to make sure nothing more happens.

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