# 4-year old just diagnosed with phimosis today. Please help?



## JacksonsMom

Hi. My four-year-old son Jack is intact and because of a bacterial infection in his penis that was diagnosed on New Year's Eve, we took him to a pediatric urologist today. He had an ultrasound and a VCUG done. (The VCUG was horrible. My baby was very brave.) Then we saw the urologist and (after being very respectful and thorough with answers to our questions) he said Jack had phimosis and recommended circumcision. He said most boys are able to fully retract their foreskin by his age, and his hasn't retracted at all. He described Jack's foreskin as very tight, and it would probably only get worse. He told us to think about it, gave us some steriod cream to put on his foreskin daily to see if it would soften the skin and start retracting it (meaning Jack would do the retracting himself, not us), and told us to come back in a month with a decision.

My husband and I put so, so much thought into whether or not to have a circumcision done on our son in the first place (we now have another son, and he is not circumcised either). But now that one bacterial infection has occured--with no definite answer as to what caused it--the urologist's case sounded compelling today. We just need help deciding what to do. I am so confused. We've read that most boys can't fully retract until up to age 8 and beyond... then the urologist tells us that it should happen by age 2. Oh geez, I'm just desperate about what to do. Has anyone had a similar experience with their son? I would be so grateful to hear other stories and how they turned out. Thanks.


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## Friday13th

It's really, REALLY, REALLY normal for boys to not be retractable at four. Some don't retract until they're teenagers. Assuming he can pee, there is no reason to be using a steroid cream.

Also, urologists in the US pretty much only know how to do one thing with the foreskin-cut it off so I would not be taking his opinion seriously.

Did they do a culture for the bacterical infection? They should have. And btw, not being retractable has NOTHING to do with an infection. I'd run far and fast from that doctor.


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## smeep

Quote:


Originally Posted by *Friday13th* 
It's really, REALLY, REALLY normal for boys to not be retractable at four. Some don't retract until they're teenagers. Assuming he can pee, there is no reason to be using a steroid cream.

Also, urologists in the US pretty much only know how to do one thing with the foreskin-cut it off so I would not be taking his opinion seriously.

Did they do a culture for the bacterical infection? They should have. And btw, not being retractable has NOTHING to do with an infection. I'd run far and fast from that doctor.

Ditto.

Think about these two questions. If there was ONE bacterial infection with no known cause, why would you think it sounded compelling? Do we traditionally lop off the outer labia of girls when they have ONE bacterial infection?

I'd be willing he has an extremely high number of circumcision referrals. If it were me, I'd tell him no way and give him a paper with references on ages of retraction, what TRUE phimosis is, and the often unnecessary circ recommendations for so-called phimosis and why it's harmful.


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## ErikaB

Does your son still have the bacterial infection? I'm assuming not. If not, the Phimosis is not a negative condition rather just the 'state' of your son's penis. Some boys can retract at your son's age, others can't retract until puberty. 'Only get worse?' Worse meaning the opening will get tighter? The likelihood of that is rare. Just make sure you or your son rinses himself with plenty of water when bathing but my unprofessional opinion is you do not need a cream to force your son's foreskin to do something it will do in it's own good time. There is a rare condition called paraphimosis (spelling) where the foreskin retracts and becomes stuck, but this can usually be manually corrected and does not need to be corrected with circumscision. Sorry for any typo o's. I'm not wearing my glasses. I live in a state where none of the doctors or nurses seem to circumcise their kids so this encounter with the urologist seems kooky to me. I'd do some research and get another opinion. You might want to also make sure the soap you are bathing your child with is gentle and that you rinse well. Once the foreskin is retractable, rinsing with water should be all that is needed for cleaning. The penis usually takes care of itself as long if you don't fuss with it too much!! If your son does still have the infection, circumscision is still not the cure. Ditto to all the other replies. Great advice!


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## Dave2GA

Go to www.cirp.org/library/normal. There is the truth about retractability. This doc is just plain ignorant. And what bacterial infection? Did he culture it? Bacterial infections are rare in intact boys. Usually any inflammation is due to contact with an irritating substance such as high pH in a pool or bubble bath soap. From what I have read in this group it can also be caused by separation of the foreskin from the glans. My sons did not retract fully until 8.5 and 11. Look at the chart in the Kayaba article at cirp.org. It shows how many boys are just like your son. This is NORMAL.


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## eepster

Circumcision for "phimosis" is a *"billable proceedure."* It is very easy for the urologist and very lucrative.

Being nonretractable is normal at 4 yo and harmless anyway.

Steroid creams are for older teenagers and adults who are bothered by phimosis and have already tried stretching excersises without results.

Do *not* return to this "Dr."


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## MommytoB

Also, how did the doctor diagnosis a bacterial infection - what was going on that made the ped think of a bacterial infection did he look and diagnose or did he use swabs.

my boy is 4 1/2 and partial retractable and the average child of most retraction to occur is 10-12 sometimes even older.

So far no one has found a foreskin educated doctor in utah yet!

For one bacterial infection with a diagnosis of phimosis i think the doctor wants to get his yacht payment.


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## Claire and Boys

neither of my boys are retractable..they are aged 4 and 2. The urologist is trying to make money out of you by soliciting and unnecessary procedure.


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## Fellow Traveler

Quote:


Originally Posted by *JacksonsMom* 
Hi. My four-year-old son Jack is intact and because of a bacterial infection in his penis that was diagnosed on New Year's Eve, we took him to a pediatric urologist today. He had an ultrasound and a VCUG done. (The VCUG was horrible. My baby was very brave.) Then we saw the urologist and (after being very respectful and thorough with answers to our questions) he said Jack had phimosis and recommended circumcision. He said most boys are able to fully retract their foreskin by his age, and his hasn't retracted at all. He described Jack's foreskin as very tight, and it would probably only get worse. He told us to think about it, gave us some steriod cream to put on his foreskin daily to see if it would soften the skin and start retracting it (meaning Jack would do the retracting himself, not us), and told us to come back in a month with a decision.

My husband and I put so, so much thought into whether or not to have a circumcision done on our son in the first place (we now have another son, and he is not circumcised either). But now that one bacterial infection has occured--with no definite answer as to what caused it--the urologist's case sounded compelling today. We just need help deciding what to do. I am so confused. We've read that most boys can't fully retract until up to age 8 and beyond... then the urologist tells us that it should happen by age 2. Oh geez, I'm just desperate about what to do. Has anyone had a similar experience with their son? I would be so grateful to hear other stories and how they turned out. Thanks.

I agree with the previous posters. You are right, the doctor is wrong. There are a couple of questions that have been asked but I'll repeat that we need to know.

How was the original infection diagnosed? By sight or did he do a culture?
How was it treated?
Does he currently have an infection? Or has it been successfully treated.
With regard the diagnoses of phimosis the most important question is simply

Can your son urinate properly? That is to say is there good 'flow'. Ballooning is normal just FYI.
At your son's age not many boys will be retractable, as has been said by other posters the average age is about 11. You can read quite a bit about the normal development at this site:

http://www.cirp.org/library/normal/

You might want to read a bit more about phimosis here:

http://www.cirp.org/library/treatment/phimosis/

Now I want to underscore that it is very unlikely that your son has a condition that requires circumcision. Circumcision is only necessary in cases where there is significant trauma or scarring of the foreskin and even then it might not be necessary. There is a less invasive option known as prepuceplasty that can be used in place of circumcision, you can read a bit about that here: http://www.biomedcentral.com/1471-2490/8/6 But I want to reiterate that the need even for that is rare.

I think your son is probably just fine and if there isn't any obvious problem (like really obstructed urine flow) I would not bother.


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## MCatLvrMom2A&X

What every one else said the Dr. just dosnt know what he is talking about. Do you really want to risk your ds's life going under GA and watch him suffer over the next weeks for no reason? Of course not.

Why did he have a VCUG done by the way? Did you make sure no retraction happened during the test?

My ds is the same age yours is and he is no where near retractable and it is 100% normal.

Do not use that cream it is meant for teenagers and adults who can do stretching exercises to go with it.

A thread you may find helpful now and in the future http://www.mothering.com/discussions...d.php?t=764732


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## 123

Well, my older son wasn't retractable at 4 and was retractable at 7. My younger son is partially retractable at 4, about the same amount he has been since he was about 2. Eventually he'll be retractable, too. My brother says he started getting retractable by 9 and was fully retractable by 13. He's now in his mid-twenty's and has no problems with his genitals.

Boys become retractable at different ages. It's perfectly normal for a 4 year old to be completely non-retractable. I would see if you can find a recommendation for a foreskin-friendly doctor in your area and get a second opinion. Phimosis is perfectly normal for a 4 year old.


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## Dabble

Please don't believe the doctor that your son should be retractable by now, or that he has phimosis. I was told the same garbage about my 15-MONTH old son by a pediatric urologist who wanted him circumcised. He later told us that his opinion about the foreskin is "the sooner you get rid of it, the better"









Your instincts are guiding you correctly here, mama. Don't let the doctor hurt your son!


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## pumpkinhead

I am speechless...

No, I'm not. Your son had one suspected bacterial infection and a VCUG was done? And an ultrasound too? Tell me that this was a persistant and recurrent infection. It wasn't just one infection, right?

I have only met one boy child who was retractile by age 4. Many, MANY boys do not become retractile until they reach puberty. My oldest is 6 and not retractile. He still has a tight phimotic ring, but it is loosening as he gets older. 4 is not at all unusual. Many, MANY babies are born with a tight phimotic ring. Unless it is getting progressively tighter and is causing him pain and discomfort, it's normal.

I don't know why, but I am still shocked at such ignorance from the medical community.


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## Night_Nurse

Quote:


Originally Posted by *JacksonsMom* 
... We've read that most boys can't fully retract until up to age 8 and beyond... then the urologist tells us that it should happen by age 2.

I'm so sorry you're going through this and I hope your son is feeling better. I can't speak from personal experience as my son was retractable by about 2.5 yrs and he's never had any infections. But like many have said, becoming fully retractable can happen at any time and it's not uncommon for boys to be non-retractable until older boyhood or teen years. Your urologist is wrong. Please know that doctors in the US make profit for every surgery they perform. You understand what I'm saying, right? He could say "Boys AND girls get infections all the time and we don't always know why so we just treat it and take a wait and see approach. If your son has multiple infections or still isn't retracting by age 18 then come see me again. We can talk about circumcision or non-surgical options then". He _could_ say that, but then he would not make any money off of your son's circumcision and the one or two post-surgical follow up visits, would he??? I'm sorry to sound cynical about it but I really don't think one infection is reason for surgery. If nothing else, know that your son not retracting is completely normal at age 4 and it would be wise to seek a second opinion with a foreskin-friendly doctor if you you feel like you should go ahead with the surgery.
In countries where intact is the norm and physicians themselves are likely to have an intact penis, circumcision for childhood non-retraction and one infection is practically unheard of.

Good luck to you and your son!


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## JacksonsMom

I want to THANK ALL OF YOU for your information, advice, and stories about your own sons. My husband and I read through all of them again and again. Just to answer a few recurring questions:

How was the original infection diagnosed? By sight or did he do a culture?

Jack's pediatrician did a culture--there was a puslike substance coming from his penis and she cultured it. It was positive for bacteria. She did say that was very rare to see a bacterial infection at Jack's age, and she mentioned STD's. (AAAH, red flag). The only time Jack isn't with one of us is when he is at preschool three times a week, two hours a day. No babysitters, no daycare, never. We trust his preschool teacher, and know that Jack would have told us about any unusual or uncomfortable experiences. But the red flag was still waving for us, of course...

How was it treated?

Antibiotics cleared up the infection within a couple of days. He has not had any trouble since that time.

Why did you do a VCUG after just one bacterial infection?

Because we didn't know any better, I guess. And we were scared. We can't go back in time and undo it, it's done. Everything was normal, so I guess all that other "stuff" that could be going wrong was ruled out. (Trying to look for the silver lining.)

I loved the comment that no one has found a foreskin-friendly doctor in Utah yet. I am not surprised. We haven't found another intact boy yet! (Except for Jack's brother, Charlie, 10 months.) It's kind of disheartening to realize that we don't have a lot of support around here, but we have an abundance of ignorance. But we both so appreciate you all taking the time to answer our questions with your real-life stories and experience and knowledge. We're not returning to a urologist, we're not filling the steroid prescription, and now we can--again--say with confidence that we will not circumcise our Jacky. Thank you all again. Thank you for reminding us why we decided not to circumcise in the first place. Thank you for reminding us what we're trying to do and what our family is about.

And thank you for allowing us to heave a BIG SIGH OF RELIEF!!!


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## Fellow Traveler

Quote:


Originally Posted by *JacksonsMom* 
I want to THANK ALL OF YOU for your

I loved the comment that no one has found a foreskin-friendly doctor in Utah yet. I am not surprised. We haven't found another intact boy yet! (Except for Jack's brother, Charlie, 10 months.) It's kind of disheartening to realize that we don't have a lot of support around here, but we have an abundance of ignorance. But we both so appreciate you all taking the time to answer our questions with your real-life stories and experience and knowledge. We're not returning to a urologist, we're not filling the steroid prescription, and now we can--again--say with confidence that we will not circumcise our Jacky. Thank you all again. Thank you for reminding us why we decided not to circumcise in the first place. Thank you for reminding us what we're trying to do and what our family is about.

And thank you for allowing us to heave a BIG SIGH OF RELIEF!!!

You're very welcome. I hope you'll stick around and contribute. If you have more questions feel free to ask.







And Utah is one of the states that dropped medicaid coverage for circumcision so there may be more boys than you realize who aren't, just perhaps not in your circle of friends.


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## Dev

Please share this knowledge with the urologist who incorrectly diagnosed your 4 your old son Jack with "phimosis" and who recommended circumcision! This doctor will give similar diagnoses in the future and many trusting parents will only agree to his recommendation of unnecessary, harmful amputative surgery. I have a hard time comprehending how this occurs in our country at such an alarming rate in the 21st century.
Bless both you and your husband for doing your research and asking questions to protect your boys.


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## Quirky

seriously, the urologist is so wrong it's scary. and i realize it's over but why on earth did they put him through a vcug? that's to check for kidney reflux and would only be indicated if he were having recurrent UTIs. weird!

You should provide this to the urologist:

http://www.doctorsopposingcircumcisi...etraction.html

It's possible you could save other boys from unnecessary circumcisions.


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## Dabble

Quote:


Originally Posted by *JacksonsMom* 
We're not returning to a urologist, we're not filling the steroid prescription, and now we can--again--say with confidence that we will not circumcise our Jacky. Thank you all again. Thank you for reminding us why we decided not to circumcise in the first place. Thank you for reminding us what we're trying to do and what our family is about.

And thank you for allowing us to heave a BIG SIGH OF RELIEF!!!

Good for you mama! Please stick around Mothering and help other parents with your son's story. I was in your exact shoes two years ago and owe so much to this board! If you want to do more reading, here is my *big sigh of relief* thread, which also links to my original "please help!" thread. The people here are simply awesome.







:


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## pumpkinhead

It was not your fault that the VCUG was done. Not at all!

Just FYI, most of the time, doing any sort of external culture of a penis is practically useless. IF the swab touches his skin, it will grow bacteria whether there is an infection or not. This is because the skin is normally covered in bacteria. A culture of the penis isn't going to tell them anything usefull.


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## MCatLvrMom2A&X

That is funny that you say that pumpkinhead as I was under the impression that was the first step always in finding out what is growing there be it yeast or bacteria. I know it is the first thing we tell parents to have done if they suspect an infection.

I know the skin always has bacteria but on the tests they run I am sure they would know if it was normal or if the numbers where higher than normal and be able to tell if it needs treatment or not.

The only way to get a culture without causing harm is to touch the swab to the tip of the foreskin without retracting. So that is the only possible way to get a culture of possible infection.


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## Jeff B

Someone with the Utah Birth Network may know of a doctor in your area who knows about proper care for intact boys.

http://www.utahbirth.net/


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## Yulia_R

The doctor is 100% wrong, most of boys are still not retractable at 4. My son is 3.5 and is not anywhere near to being retractable. It is TOTALLY normal to not retract till much later.

Steriod cream will not help, forskin will reatach as soon as you stop using it and will retract when it is RIGHT TIME for your boy.

If someone manipulated his foreskin (let's say another doctor) it could create micro-tears and actually CAUSE this infection. Even if it is infection, it's easily treatable with antibiotic and does not require amputative sergery (would you amputate your son's finger if it got infected??). If your son is treated with antibiotics, make sure you keep him on good probiotics, at least 10 billions a day for at least a month after that to prevent yeast taking over (it's not just for intact boys, but for all people to keep gut flora healthy while being treated with antibiotics).

Make sure no doctor ever manipulates his foreskin
A Warning For Parents of Intact Sons http://www.mothering.com/discussions...d.php?t=129378


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## Yulia_R

And one more point. Does your son actually had a discharge from his penis? Did the doctor take a culture it? In case your son just had a swolen, red penis with no discharge, it could be a separation trauma which usually resolves on its own within 48 hours.


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## pumpkinhead

Quote:


Originally Posted by *MCatLvrMom2A&X* 
That is funny that you say that pumpkinhead as I was under the impression that was the first step always in finding out what is growing there be it yeast or bacteria. I know it is the first thing we tell parents to have done if they suspect an infection.

I know the skin always has bacteria but on the tests they run I am sure they would know if it was normal or if the numbers where higher than normal and be able to tell if it needs treatment or not.

The only way to get a culture without causing harm is to touch the swab to the tip of the foreskin without retracting. So that is the only possible way to get a culture of possible infection.

The thing is, even with selective media, a culture of the foreskin is always going to grow something. It's really not a good diagnostic tool. It could grow a whole whack of E.coli or even aspergillus, but these might not be what is causing the infection.

If you can clean the area with alcohol or something and then get a clean swab of only the pus, that might tell you something.

What I am saying is that taking a culture of the foreskin really isn't going to tell you definitively what is causing the infection. As a complete last resport it might be useful, but not as a first step. If you're looking for something that really shouldn't be there like group A strep or chlamydia, a swab and selective media will give you that information.

My way of thinking mirrored yours until recently. I had the opportunity to work in the central infectious diseases micro lab at a local hospital for a 6 month term. I learned a lot.


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## A&A

Quote:


Originally Posted by *Friday13th* 
It's really, REALLY, REALLY normal for boys to not be retractable at four. Some don't retract until they're teenagers. Assuming he can pee, there is no reason to be using a steroid cream.

Also, urologists in the US pretty much only know how to do one thing with the foreskin-cut it off so I would not be taking his opinion seriously.

Did they do a culture for the bacterical infection? They should have. And btw, not being retractable has NOTHING to do with an infection. I'd run far and fast from that doctor.









:


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## A&A

PS. Where in Utah are you? Dr. Justin Alvey at WeeCare Pediatrics in Kaysville is foreskin friendly!!!

I personally know five intact Utah boys. It is changing, even in this state. You know how you create more intact Utah boys? You educate pregnant mamas!!


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## MCatLvrMom2A&X

I definatly see what you are saying pumpkinhead. Thank you for explaining it more


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## AleksFeodoraSnyder

Hi,
I have a 19 mo. old that has a similar problem. He is 19 months old now. At around 1 year he had a UTI, due to trapped urine in his forskin. They suggested then that he would probably need a circumcision. I was really against it, and the doctor gave us an alternative to the procedure, he gave us a cream that was supposed to help loosen the forskin. However, once we stop the cream the forskin becomes really tight.
When our son was born, all the "what to expecting, when you are expecting" books directed us to not touch his forskin or pull it back, so as to not harm it. My husband is circumcised, so we followed those directions. When our son got the UTI, The Doctor told us that our son has a lot of scar tissue (probably due to repeated infections unbeknowest to us) [Maybe we should have lifted the forskin back to get the last dribbles out?] that has developed into a ring, he and his assistant had a hard time finding the opening to the urinary tract when they wanted to test his urine for a culture. The doctor confirmed that it wasn't his kidneys, or anything else. The UTI was probably caused by trapped urine and the resulting bacteria. I've waited 6 months in the hopes that the cream and "massage" helped my son's forskin. However, his forskin once we stop using the cream shrinks into a tiny ring where you can't even see the opening to the urinary tract. He can still pee, but it dribbles to the side.
I don't want my son to get another UTI, last time it was very scary, he had blood in his urine, lots of doctors visits, and just a lot of stress.
I am from a culture/religion that it is very important to stay intact, and i am getting a lot of "peer" pressure from my sister-in-law that the doctor is "full" of it (she hasn't seen my son's ring, she lives far away), and everything i read says that a lot of circumcisions are done unessarily. Some of that literature has confused me, and made me wait this long. I've come to the conclusion that there are a lot of "intact" advocates out there, and when someone (like my son) who really needs this procedure, might be waiting longer than they should.
Does anyone know of some medical literature out there that suggests keeping the forskin when the urinary tract is partially obstructed? Is it possible to keep him intact? Am i doing the right thing by scheduling his circumsion?

Thanks, A.


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## Yulia_R

AleksFeodoraSnyder, let me ask you a question: how could the doctor know about the scar tissue? Did he retract your son??

Also ask your doctor if a little girl came in with a UTI would he blame it on "her urine being trapped in vagina"??? or would he just tell her parents that UTI do happen, give her antibiotics, warn the parents to not let her have bubble/soapy baths and that would have been all there is to it?

By "trapped in the foreskin urine" I assume the doctor meant balloning which is TOTALLY normal (some boys have it others don't, but it is 100% normal stage in a separation process) and does not cause UTIs.

As long as he can pee he's fine. Foreskin does sometimes direct urine into funny directions and this is normal as well.

The opening is SUPPOSED to be tiny in babies/young boys, it opens up a little during urination and then closes back up tightly right after that. This is 100% normal and is a nature's way to protect the glans from bacteria coming in.

As long as your son can pee, he is FINE and NO one should ever mess with his foreskin except him himself.

The doctors doesn't seem to be knowledgeable on the issue; of course the foreskin would re-adhere back to the glans once steroid cream is discontinued, what else would he expect??? Once again, TOTALLY normal. It will separate in its own time, the opening will loosen up in it's own time as a last step of the separation process.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
Hi,
I have a 19 mo. old that has a similar problem. He is 19 months old now. At around 1 year he had a UTI, due to trapped urine in his forskin. They suggested then that he would probably need a circumcision. I was really against it, and the doctor gave us an alternative to the procedure, he gave us a cream that was supposed to help loosen the forskin. However, once we stop the cream the forskin becomes really tight.
When our son was born, all the "what to expecting, when you are expecting" books directed us to not touch his forskin or pull it back, so as to not harm it. My husband is circumcised, so we followed those directions. When our son got the UTI, The Doctor told us that our son has a lot of scar tissue (probably due to repeated infections unbeknowest to us) [Maybe we should have lifted the forskin back to get the last dribbles out?] that has developed into a ring, he and his assistant had a hard time finding the opening to the urinary tract when they wanted to test his urine for a culture. The doctor confirmed that it wasn't his kidneys, or anything else. The UTI was probably caused by trapped urine and the resulting bacteria. I've waited 6 months in the hopes that the cream and "massage" helped my son's forskin. However, his forskin once we stop using the cream shrinks into a tiny ring where you can't even see the opening to the urinary tract. He can still pee, but it dribbles to the side.
I don't want my son to get another UTI, last time it was very scary, he had blood in his urine, lots of doctors visits, and just a lot of stress.
I am from a culture/religion that it is very important to stay intact, and i am getting a lot of "peer" pressure from my sister-in-law that the doctor is "full" of it (she hasn't seen my son's ring, she lives far away), and everything i read says that a lot of circumcisions are done unessarily. Some of that literature has confused me, and made me wait this long. I've come to the conclusion that there are a lot of "intact" advocates out there, and when someone (like my son) who really needs this procedure, might be waiting longer than they should.
Does anyone know of some medical literature out there that suggests keeping the forskin when the urinary tract is partially obstructed? Is it possible to keep him intact? Am i doing the right thing by scheduling his circumsion?

Thanks, A.

Even if your DS truely does have true phimosis (very rare) there are much much less drastic treatments than circucision, which is the complete amputation pf the foreskin.

The steriod treatment is meant for _adult_ men who have nonretractable foreskins (which is usually caused by repeated forced retraction during infancy.) It is only effective on adult men and needs to be combined with excercises that are inapropriate to do on a baby.

The most drastic treatment I would suggest any parent agree to in a situation like yours would be a dorsal slit, and I think it's highly unlikely that even that is necessary.

It is obviuosly impossible for any of us to dx your DS over the internet, but realize that we have heard story after story of Drs reccomending circ for what are just parts of _normal development_.

The first things we need to know are:

Why did you suspect UTI to begin with?
Does he cry as he pees (either now or when he had the UTI?)
How were these UTIs dx'd?
Has _anyone ever_ retracted him?
Does he fill diapers or potties with pee?

BTW, starting a new thread will get you more responses, and







to MDC.


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## Yulia_R

Quote:


Originally Posted by *eepster* 
the steriod treatment is meant for _*adult*_ men who have nonretractable foreskins (which is usually caused by repeated forced retraction during infancy.) it is only effective on adult men and needs to be combined with excercises that are inapropriate to do on a baby

exactly!


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## AleksFeodoraSnyder

The doctor showed us the scar tissue. He showed us on the opening of the forskin where the skin has fused, leaving the tiny opening. He didn't pull back the forskin severly. Just to show us the scar tissue. The opening you can tell, used to be much wider and the skin was fused together at the edges.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
The doctor showed us the scar tissue. He showed us on the opening of the forskin where the skin has fused, leaving the tiny opening. He didn't pull back the forskin severly. Just to show us the scar tissue. The opening you can tell, used to be much wider and the skin was fused together at the edges.

There is a sphincter at the end of the foreskin which opens and closes. When the Dr messed with it, your DS will have naturally closed it, the same way he would have blinked if the Dr waas messing with his eyelid.


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## Yulia_R

Quote:


Originally Posted by *AleksFeodoraSnyder* 
The doctor showed us the scar tissue. He showed us on the opening of the forskin where the skin has fused, leaving the tiny opening. He didn't pull back the forskin severly. Just to show us the scar tissue. The opening you can tell, used to be much wider and the skin was fused together at the edges.

The way you described it sounds 100% normal to me, this is exactly how the tip of my son's penis look like. Some boys do have wider opening and some have a very tiny one; both are totally normal. Rigid band, which is on the very tip of foreskin, looks just like you described in some boys. Before they are retractable, it looks sort of like a tiny glued together, wrinkled skin and once again is totally normal. By the way, Rigid band is the MOST sensitive part of the penis.

It is NOT ok for the doctor to retract even slightly. Make sure you read this thread:

*A Warning to Parents With Intact Sons* http://www.mothering.com/discussions....php?t=1050941


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## AleksFeodoraSnyder

We and the doctor suspected UTI because there was blood in his urine. He cried when he went pee, he lifted his legs with pain.

Now he hates diaper changes and has a pink occationally inflamed forskin tip. (he doesn't appear to be in pain).

The UTI was diagnosed with a culture from a sample of urine retrieved from a catheter.

He is in daycare, i don't know if someone has retracted his forskin there. I haven't nor has my husband retracted his forskin.

He has plenty of pee and poopey diapers.


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## Yulia_R

Quote:


Originally Posted by *eepster* 
There is a sphincter at the end of the foreskin which opens and closes. When the Dr messed with it, your DS will have naturally closed it, the same way he would have blinked if the Dr waas messing with his eyelid.

yep, that's right. The sphincter usually opens during urination (just enough for urine to pass through), closing up tightly right after it, keeping glans protected from all sort of stuff: bacteria, poop, dirt, send, ect. The sphincter is very similar to our anus.


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## AleksFeodoraSnyder

Quote:


Originally Posted by *Yulia_R* 
The way you described it sounds 100% normal to me, this is exactly how the tip of my son's penis look like. Some boys do have wider opening and some have a very tiny one; both are totally normal. Rigid band, which is on the very tip of foreskin, looks just like you described in some boys. Before they are retractable, it looks sort of like a tiny glued together, wrinkled skin and once again is totally normal. By the way, Rigid band is the MOST sensitive part of the penis.

It is NOT ok for the doctor to retract even slightly. Make sure you read this thread:

*A Warning to Parents With Intact Sons* http://www.mothering.com/discussions....php?t=1050941

Re: Rigid band. In my son the tip looks like the sides of the opening are fused/glued with a line of discolored tissue, and then a little bit of of puffed skin at the end. It's not totally fused to the end. What kind of medical article do you know of that shows what you are describing?
A.

My son's penis looks very similar to the photo in this website: http://www.steadyhealth.com/articles..._a574_f27.html


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## Yulia_R

Quote:


Originally Posted by *AleksFeodoraSnyder* 
We and the doctor suspected UTI because there was blood in his urine. He cried when he went pee, he lifted his legs with pain.

Now he hates diaper changes and has a pink occationally inflamed forskin tip. (he doesn't appear to be in pain).

The UTI was diagnosed with a culture from a sample of urine retrieved from a catheter.

He is in daycare, i don't know if someone has retracted his forskin there. I haven't nor has my husband retracted his forskin.

He has plenty of pee and poopey diapers.

UTI do happen. Girls have much higher chance of getting them, by the way (and no one suggests to circ them). Some kids are more prone to them than others (for example, one kid can be just fine with bubble baths and another one would get a UTI after each bubble bath; some people can swim in cold water just fine and I personally would pee blood within 12 hours of swimming in very cold water...everyone is different). One thing is for sure, that foreskin is NOT to blame for it. If UTI did happen, you treat it (making sure to give your son probiotics for a while if he had to take antibiotics), you try to stay away from possible triggers and this is all you can do. Circ'd boys get UTI just as well.

Occasionally pink (redish) tip is NORMAL. Just give him some diaper free time.


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## Friday13th

I just want to agree with PP, your son sounds completely normal. He does not need to be retractible at this age, the doctor does not need to be able to see the opening of his urethra.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
We and the doctor suspected UTI because there was blood in his urine. He cried when he went pee, he lifted his legs with pain.

Now he hates diaper changes and has a pink occationally inflamed forskin tip. (he doesn't appear to be in pain).

The UTI was diagnosed with a culture from a sample of urine retrieved from a catheter.

He is in daycare, i don't know if someone has retracted his forskin there. I haven't nor has my husband retracted his forskin.

Catheters have a high rate of false positives, and can acctually cause UTIs.

All the symtoms you describe (including fighting diaper changes, though for 20 mo that's pretyy much normal) can be attributed to occasional retraction by the daycare staff. I would be nonacussatory, so they don't just get defensive and deny any wrong doing.

I would print out literature about not retracting intact boys and go over it with _everyone_ at the daycare.

Quote:

He has plenty of pee and poopey diapers.
Then the urine is getting out and isn't obstructed.

As long as your DS doesn't have any new problemms come up, then I would attribute his past symptoms to probable forced retraction and seek no further medical "treatment."


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## Yulia_R

Quote:


Originally Posted by *AleksFeodoraSnyder* 
Re: Rigid band. In my son the tip looks like the sides of the opening are fused/glued with a line of discolored tissue, and then a little bit of of puffed skin at the end. It's not totally fused to the end. What kind of medical article do you know of that shows what you are describing?
A.

I have never manipulated my son's foreskin (and no one ever should), so I don't know how the opening itself looks like (if you pull the foreskin up). But the way you described the foreskin tip sounds normal to me.

You need to make SURE that no one in day care EVER pulls his foreskin back, not even a little bit.

As a pp said, even IF your son has true phimosis, it can NOT be diagnosed until AFTER the puberty. Even scar tissue (such as circumcision adhesions) retract on their own 85% of the time.

If your son fails to retract after he is 16-18 years of age steroid cream can be used along with stretching exercises. It should take care of it. If not (which is rarely the case) a simple dosal slit will fix the issue. For now you have nothing to worry about. Just make sure no one ever retracts him (except the boy himself), not even a little bit.


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## rhiandmoi

Quote:


Originally Posted by *Yulia_R* 
Also ask your doctor if a little girl came in with a UTI would he blame it on "her urine being trapped in vagina"??? or would he just tell her parents that UTI do happen, give her antibiotics, warn the parents to not let her have bubble/soapy baths and that would have been all there is to it?

Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.


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## chaoticzenmom

That sounds normal to me. Have you looked at pictures of intact penises? Google intact penis and click on images...maybe there will be some reassurance there.

As for the UTI...Does he have one now? Are you using soap or bubbles in his bath?

My new baby has a different looking penis. I was a little concerned because I couldn't find his peehole. I knew he was peeing, I just didn't see any hole. Well, he peed during a change and he definitely has a peehole, but looking for it, it was as tiny as a pinhole. ( The only reason I even looked for a peehole was because his penis was kind of different looking to me. It has some strange lines on the shaft that lead me to believe that it would probably be a buried penis if we had had him circ'd. That's another post though.)

If it were my son, I'd leave it alone and stop seeing any dr's temporarily. Take soap out of the bath, give some cranberry juice on a regular basis and see what happens. Even if he has kidney reflux, that's supposed to clear up on it's own by age 6 (from what I've read) and would be a kidney problem and not a foreskin problem. Also, ballooning is normal. I have 3 intact sons and they're all so different, It would be hard to find anything about them that I considered "normal."


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## chaoticzenmom

I didn't clarify that the pinhole sized hole on my son's penis got much, much larger when he peed, but then went back to practically unfindable.


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## AleksFeodoraSnyder

What kinds of literature can i show my Dr. and my husband to emphasize what everyone is saying?


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
Re: Rigid band. In my son the tip looks like the sides of the opening are fused/glued with a line of discolored tissue, and then a little bit of of puffed skin at the end. It's not totally fused to the end. What kind of medical article do you know of that shows what you are describing?
A.

My son's penis looks very similar to the photo in this website: http://www.steadyhealth.com/articles..._a574_f27.html

If you are talking about the underside of the penis, that is the raphe line. All men are born with it.

The picture is just a drawing of a normal penis. What photos?


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## robertandenith

Fire him. He knows NOTHING about an intact penis. Where are you located? we can refer you to an intact penis friendly ped that will certainly NOT be advising amputation to heal a UTI







I wonder what he will advice for girls with UTI... ?

IF it is a UTI, make sure your son eats lots of vitamin C foods and if you want to supplement go for it. 1000 mg every 5-6 hours will do the trick. BTW, the intact penis, is normal for the glans to look red/purplish/pinkish because that's how internal organs are supposed to look like, just the same as inside of a vagina.

Boys are not supposed to retract until puberty or so, so I recommend to stop that cream. Boys don't need steroid creams.


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## robertandenith

Quote:


Originally Posted by *AleksFeodoraSnyder* 
What kinds of literature can i show my Dr. and my husband to emphasize what everyone is saying?

http://www.asnatureintended.info/upl...74/babyboy.pdf


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## chaoticzenmom

Yeah, that drawing looks like a normal penis. Even my husband, when not erect, has that little thing at the end, as do my 3 sons.


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## AleksFeodoraSnyder

Quote:


Originally Posted by *eepster* 
If you are talking about the underside of the penis, that is the raphe line. All men are born with it.

The picture is just a drawing of a normal penis. What photos?

This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg


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## chaoticzenmom

That's still normal for a child your son's age. When you described it, I thought there would be some crazy abnormal looking stuff, but the two pictures you've posted here look pretty normal.

Is your husband also from a country that doesn't circ? Is he on your side here in wanting to protect your son from circumsision?


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## robertandenith

if he is peeing normal and not complaining, let it be.


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## Anastasiya

Check this out: http://www.mja.com.au/public/issues/...w10610_fm.html

Includes photos.

ETA: I didn't read the article so I have no idea what it says. I only found the pics.... also, I agree that if he's peeing fine then leave it alone. And one more thing - I've also read that cases of true phimosis are just not found in the under 5 age group. So unless your son is a super rare case, I'd think he didn't have "true" phimosis. And lots of kids who do have true phimosis likely have it because they have had their penises manipulated and scar tissue has resulted.


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## chaoticzenmom

Also notice that on Sancta's found pictures, there is pubic hair starting to grow, so it's a pubescent boy pictured there, not a baby.

Looking again, I could be wrong. But my kids don't have hair like that, It doesn't say what age...hmmm

Either way, I'd leave it alone for awhile and re-adress it if he starts hurting again.


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## Yulia_R

Quote:


Originally Posted by *AleksFeodoraSnyder* 
This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

Looks normal to me. Phimosis in babies/young boys IS NORMAL (that is what it is supposed to be like before it naturally separates). What is not normal is TRUE phimosis (which simply means that foreskin fails to retract in adult man), therefore, true phimisis can never be diagnosed on a child.

By the way, did you watch when they cath'd him? Did they retract him?
Many ignorant doctors/nurses would retract the foreskin for cath (which is a HUGE no-no) and can lead to problems and scar tissue.

If I were you I'd:

1. (first and the most important) FIRE this ignorant ped;
2. If your son tolerates cranberry (no rash, eczema, digestive problems afterwards) I'd give him some cranberry juice regularly as well as lots of fluids (these two things are so good that they can actually treat an existing UTI); I am not sure if they have cranberry tablets for kids (they do for adults), but you can definitely check;
3. Make sure no one ever retracts him;
4. No soapy or bubble baths;
5. Encouraging potty-learning (you may want to check Elimination Communication forum here on Mothering. I did EC with both of my kids and my son was out of diapers at by 12 months and my daughter at 18 months of age. I think that all the heat and mosture that full disposable diapers creat is a very bacteria friendly environment.
6. Use only very mild natural soap on your son's penis (if any at all because you really do not use soap on boys' intact genitals, just rinse it with water);
7. Make sure your son eats healthy meals (as well as snacks on something better than crackers/cookies) and try to have sugar free (or low sugar diet). Sugar feeds all kind of bacteria while bringing immunity down;
8. Keep him on good probiotics (at least 10-15 billions a day) for few months; good bacteria keeps bad bacteria in check. I personally like Nature's Way brand (they have tablets and powder for kids)


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## Yulia_R

Quote:


Originally Posted by *rhiandmoi* 
Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.

fused labia is not normal while fused to the glans foreskin IS.


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## Quirky

That picture looks totally normal to me. That's what baby penises are supposed to look like. The foreskin is supposed to be fused to the head (glans) of the penis, exactly like the fingernail is supposed to be fused to the nailbed of the finger.

I agree with the PP that your son sounds normal. What about getting a second opinion from a urologist?

Just FYI, the link between foreskins and UTIs has been disproven. In other words, intact boys are no more likely to get UTIs than circumcised boys. Nor is the foreskin likely to cause UTIs -- it's usually a problem with the kidneys and urethral system.

Cutting off the foreskin may make the boy MORE prone to UTIs by exposing the opening of the urethra to more bacteria.

Plus, one in ten circumcised boys will develop meatal stenosis as a result, where the urethral opening scars and narrows because of chafing. This does require painful surgery to correct.

Leave your son alone. Don't cut off his foreskin. That's 19th century medicine and won't do him any good, and will do him great harm.


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## Quirky

Quote:


Originally Posted by *rhiandmoi*
Well I am pretty sure that if a little girl came with recurrent UTIs and fused labia they would mention that the two probably go together.

And I am fairly sure that no doctor would suggest labial amputation to cure UTIs in girls.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

In that photo, who ever is holding the penis has twisted it. The raphe line is visable on the opposit side from the testes. Whether or not the child in the photo actually has a problem, I don't know, but my immediate impression is that if I twisted and pulled just the right way I could make most intact baby penises look like that (which I wouldn't do for various reasons.)

Does your DS penis seem normal when it is *not* being manipulated? The relavent question is, is his urine truely obstructed? I'm not talking about whether it balloon, or if it goes in a funny direction, those things are harmless. The only problem would be if he couldn't empty his bladder.

You have stated that he has full diapers, and have not described any symptoms of urine retention. Therefore, I doubt the urine flow is blocked.


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## foreskin friendly

Quote:


Originally Posted by *AleksFeodoraSnyder* 
This is a picture i found on Google, it looks very similiar to my son's penis also: http://www.steadyhealth.com/articles...e/phimosis.jpg

This is what his penis SHOULD look like at his young age...

Refer your Dr. to studies done by Oester (or Oster) & Kayaba
re: mean age for full retraction = 10.4 years old (after following hundreds, if
not thousands of intact boys)...

the strange looking membrane that you're referring to is just as a previous post said, very similar to the membrane that connects your nail to your finger.
It is the balano-preputial lamina... tell your doctor to do some continuing education regarding that membrane and the true time table that it normally takes to break down. It is ABSURD to expect that by 2 yrs old, all intact males should be fully reatractible, but that is a myth that continues through the American medical profession and one that ignorant Dr.'s use as a scare tactic to convince otherwise apprehensive parents to be agreeable with a circumcision. Completely unneccessary. I don't even believe that a true diagnosis of phimosis can be accurately given in someone who hasn't already gone through puberty!
Just remember, this membrane is a protective measure that the body has created to PREVENT problems from occuring. Don't mess with it and certainly DO NOT let any medical staff or day care providers mess with it!
That might be exactly the cause of the original problem to begin with!
Physiologically, the foreskin is fused to the glans penis and should remain that way until it naturally seperates on its own, in its own time.
Good luck and keep us updated! Good for you for coming here, following your intuition and preventing any furthur damage from possibly happening to your son!









p.s. - As your son's foreskin starts separating from the glans, you may see pools of smegma underneath the foreskin. DON'T try to manipulate them out from under the skin...they will work their way out in their own time...and with that be VERY leery of any Dr. that might suggest that those smegma pearls are infectious bacteria!! They aren't!


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## Yulia_R

Quote:


Originally Posted by *foreskin friendly* 
p.s. - As your son's foreskin starts separating from the glans, you may see pools of smegma underneath the foreskin. DON'T try to manipulate them out from under the skin...they will work their way out in their own time...and with that be VERY leery of any Dr. that might suggest that those smegma pearls are infectious bacteria!! They aren't!

Yep, during this the penis can be swollen and it can be painful for the boy to urinate (since urine pushes smegma built up toward the opening, creating micro-tears in adhesions on the way). It should resolve on its own within 48 hours. My son had this once and I just had him pee in a warm bath (with a bit of tea tree oil and backing soda in it) which made it less painful for him to urinate. Once the smegma built up was out, the swelling went down within few hours. He was balloning for some time after that (during the torn adhesions that smegma created) and in few months his foreskin completely re-attached to the glans. He is nearly 4 yo now and is not anywhere near being retractable. Which is totally normal.


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## AleksFeodoraSnyder

Quote:


Originally Posted by *Quirky* 
That picture looks totally normal to me. That's what baby penises are supposed to look like. The foreskin is supposed to be fused to the head (glans) of the penis, exactly like the fingernail is supposed to be fused to the nailbed of the finger.

I agree with the PP that your son sounds normal. What about getting a second opinion from a urologist?

Just FYI, the link between foreskins and UTIs has been disproven. In other words, intact boys are no more likely to get UTIs than circumcised boys. Nor is the foreskin likely to cause UTIs -- it's usually a problem with the kidneys and urethral system.

Cutting off the foreskin may make the boy MORE prone to UTIs by exposing the opening of the urethra to more bacteria.

Plus, one in ten circumcised boys will develop meatal stenosis as a result, where the urethral opening scars and narrows because of chafing. This does require painful surgery to correct.

Leave your son alone. Don't cut off his foreskin. That's 19th century medicine and won't do him any good, and will do him great harm.

Re: fused like a nail to the nailbed. My son's forskin is actually loose and not attached, it is however narrow at the tip. Does that make sense?


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## latinalonestar

Others have responded but I wanted to add that you can NOT diagnose phimosis in a child b/c the foreskin is normally not retractable until puberty. Only 50% of boys are retractable by age 10. This urologist is very foreskin-ignorant.

Must read article:
http://www.mothering.com/articles/ne...uncircson.html

As far as infection, did they do a culture? If not I bet there was no infection. Infections are very rare. Your son could have experienced some separation, which is a normal developmental phase that can be accompanied by redness, swelling, irritation, itching, smegma pearls, ballooning, etc. These are all normal. This process happens throughout childhood. This does not mean a boy is retractable b/c the opening still remains narrow.

This sticky is about normal separation:
http://www.mothering.com/discussions....php?t=764732?

As a boy goes through puberty, hormones will allow his opening to stretch. Essentially hormones do what your doctor is trying to do with the steroidal cream. If you use a steroidal cream, the foreskin will go back to being tight b/c your son does not yet have the hormones to sustain the open foreskin. His foreskin has absolutely NO reason to be open at this age. Retraction is something that comes with sexual maturity. Also, steroidal creams are dangerous to a child b/c they can thin the foreskin, making tearing likely. DON'T USE STEROIDAL CREAM.

At this point all your son's penis needs to do is pee. Less than 3% of men are not retractable after puberty, so it is not likely that this will happen to your son unless he has scarring from forcible retraction. Just the fact that your doctor was trying to retract him tells us that he doesn't know about the foreskin and is not respecting it's natural developmental process.

Here are some more links you should read:

Development of a retractable foreskin in a child or adolescent:
http://www.doctorsopposingcircumcisi...kinleaflet.pdf

Avoiding circumcision after the neonatal period:
http://www.nocirc.org/publish/pamphlet7.html

The ONLY medical reasons for circ are frostbite, malignancy, gangrene, or serious trauma. Your son is perfectly normal.


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## Yulia_R

Quote:


Originally Posted by *AleksFeodoraSnyder* 
Re: fused like a nail to the nailbed. My son's forskin is actually loose and not attached, it is however narrow at the tip. Does that make sense?

yes, it does make sense. It means that the process of separation has already started. It may take years till it's completed. The opening usually loosens up the last (which makes sense if you think about it).


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## Tinijocaro

Yes, urologists have a "magic number" that all kids should retract by, but that just isn't reality. I have two boys, one retracted by 4, the other,not until he was about 12. No issues at all.

Of course your ds has phimosis, all boys have it until they are retractable.

Is the bacterial infection cleared up?

Quote:


Originally Posted by *JacksonsMom* 
Hi. My four-year-old son Jack is intact and because of a bacterial infection in his penis that was diagnosed on New Year's Eve, we took him to a pediatric urologist today. He had an ultrasound and a VCUG done. (The VCUG was horrible. My baby was very brave.) Then we saw the urologist and (after being very respectful and thorough with answers to our questions) he said Jack had phimosis and recommended circumcision. He said most boys are able to fully retract their foreskin by his age, and his hasn't retracted at all. He described Jack's foreskin as very tight, and it would probably only get worse. He told us to think about it, gave us some steriod cream to put on his foreskin daily to see if it would soften the skin and start retracting it (meaning Jack would do the retracting himself, not us), and told us to come back in a month with a decision.

My husband and I put so, so much thought into whether or not to have a circumcision done on our son in the first place (we now have another son, and he is not circumcised either). But now that one bacterial infection has occured--with no definite answer as to what caused it--the urologist's case sounded compelling today. We just need help deciding what to do. I am so confused. We've read that most boys can't fully retract until up to age 8 and beyond... then the urologist tells us that it should happen by age 2. Oh geez, I'm just desperate about what to do. Has anyone had a similar experience with their son? I would be so grateful to hear other stories and how they turned out. Thanks.


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## chaoticzenmom

It seems to me that if the steroid cream was working, then the hormones of puberty will work, kwim? If the cream was enough to enlarge the opening, then the scar tissue must not be very tough.

I hope somewhere in here, you're getting some helpful info.


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## robertandenith

Quote:


Originally Posted by *Tinijocaro* 
Yes, urologists have a "magic number" that all kids should retract by, but that just isn't reality.

yes, it's like saying that all girls will have their first period by their 10th year, THEY ALL SHOULD!


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
Re: fused like a nail to the nailbed. My son's forskin is actually loose and not attached, it is however narrow at the tip. Does that make sense?

The natural adhession has broken down, either b/c you DS is an early bloomer or b/c the daycare workers have been forcibly retracting him. Either way, the sphincter at the end is simply still naturally tight when you DS isn't peeing. As long as it's enough for pee (which being a liquid can fit through a pretty small opening) to come out it is not a problem.

Take you DS diaper off and let him play somewhere easy to clean up, then watch him. When he starts to pee, you will see the sphincter relax.

It is likely ballon for a few moments since he sounds partially seperated, this is pefectly natural and harmless. It may spray in a funny direction, this will happen b/c the opening of the foreskin and the meatus don't line up, again this is natural and harmless. He may pinch the tip with his fingers or stick one inside to make the pees go in a very strong steam, this isn't natural, but when DS was 20 mo he thought it was hysterically funny, and it's mostly harmless.


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## enstar780

Quote:


Originally Posted by *JacksonsMom* 
Hi. My four-year-old son Jack is intact and because of a bacterial infection in his penis that was diagnosed on New Year's Eve, we took him to a pediatric urologist today. He had an ultrasound and a VCUG done. (The VCUG was horrible. My baby was very brave.) Then we saw the urologist and (after being very respectful and thorough with answers to our questions) he said Jack had phimosis and recommended circumcision. He said most boys are able to fully retract their foreskin by his age, and his hasn't retracted at all. He described Jack's foreskin as very tight, and it would probably only get worse. He told us to think about it, gave us some steriod cream to put on his foreskin daily to see if it would soften the skin and start retracting it (meaning Jack would do the retracting himself, not us), and told us to come back in a month with a decision.

My husband and I put so, so much thought into whether or not to have a circumcision done on our son in the first place (we now have another son, and he is not circumcised either). But now that one bacterial infection has occured--with no definite answer as to what caused it--the urologist's case sounded compelling today. We just need help deciding what to do. I am so confused. We've read that most boys can't fully retract until up to age 8 and beyond... then the urologist tells us that it should happen by age 2. Oh geez, I'm just desperate about what to do. Has anyone had a similar experience with their son? I would be so grateful to hear other stories and how they turned out. Thanks.

UTIs are actually fairly rare on boys so this is an unusual situation. Girls actually receive UTIs 50 times more often than boys however we do not use this as a reason to push circumcision of them. Similar treatments used for girls also apply here as well. The foreskin does not have anything to do with this situation. The UTI most likely has an internal cause and there are many reasons that can happen. As well, a 4 year olds foreskin does not need to retract, the time at which childre become retractable varies, it may happen when they are 12. If the foreskin has not seperated from the glans yet it definitely should not be retracted.


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## MCatLvrMom2A&X

Unless you have seen him retract there is no way to know if it is still fused to the glans. It looks loose from the outside because the skin is made to be loose.

Like everyone has said if he can pee then there is nothing wrong with him. Pin hole size is normal while not urinating just like the anal sphincter it will relax to allow urine out then close tight to keep germs out.

Normal intact penis side by side: http://www.cirp.org/library/hygiene/...e1/figure3.jpg

Hate this picture on the right because someone is doing a MAJOR







: but the one on the left is a normal intact penis the foreskin is fused to the glans in the left picture. You cant even see the opening on it because of the overhang and the hole is that small.


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## AleksFeodoraSnyder

Quote:


Originally Posted by *Sancta* 
Check this out: http://www.mja.com.au/public/issues/...w10610_fm.html

Includes photos.

ETA: I didn't read the article so I have no idea what it says. I only found the pics.... also, I agree that if he's peeing fine then leave it alone. And one more thing - I've also read that cases of true phimosis are just not found in the under 5 age group. So unless your son is a super rare case, I'd think he didn't have "true" phimosis. And lots of kids who do have true phimosis likely have it because they have had their penises manipulated and scar tissue has resulted.

After looking at the above photos in the attachment; both my husband and feel like our son's penis looks more like the far bottom right photograph. We will definately get a second opinion now. But it really appears that the "poof" at the end isn't there, I guess i didn't remember what it looked like, when i was at work yesterday.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
After looking at the above photos in the attachment; both my husband and feel like our son's penis looks more like the far bottom right photograph. We will definately get a second opinion now. But it really appears that the "poof" at the end isn't there, I guess i didn't remember what it looked like, when i was at work yesterday.

Penises are very variable from one moment to the next. When it's very cold, they get loose and wrinkly. When they are erect they look tight and smooth.

When the Dr showed you what he wanted you to see, he probably was pulling the foreskin taught so that it looked tighter than it really was, and the poof at the end was flattened out.


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## AleksFeodoraSnyder

When i changed his diaper today, there was no "poof"


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## KBecks

I don't know the answer, but I wish you and your boys the best. Don't hesitate getting a 2nd opinion before committing to a decision to circ.


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## eepster

Quote:


Originally Posted by *AleksFeodoraSnyder* 
When i changed his diaper today, there was no "poof"

Was he erect?

DS's flattens out when he is.


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## eepster

Let's look at this from a different angle. Comparing both scenarios:

You get him circumcised

At best he under goes a painful procedure, looses part of his penis, and looses sensitivity
He will be traumatised by the need to change the dressings
He may been confused about is body immage b/c at this point it is fairly formed
He is exposed to general anestethic (if the Dr is half way civilized)
He may have one of the many, many possible side effects/risks associated with circ which includes: excessive bleeding; infection; degloving; nicking the glans; amputating the glans; burns from a cauterizer; meatal stenosis; opening the ureathra; adhessions; death
He gets another UTI and it goes untreated b/c it tends to be less symptomatic in circ'd boys
You do not circumcise him:

nothing happen, he is fine and he keeps all his parts
he gets another UTI, and you treat it with antibiotics
He really does have true phimosis, at the point it becomes an actual problem he has it treated with a less dramatic procedure such as a dorsal slit, or one of the many other options.
Which scenario is better, less risky, etc.


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## Owlpainter

Do not feel bad! I have learned so much from this thread. I had no idea about phimosis and might have made the terrible mistake of circumcision for my intact son if I had encountered this doctor. I feel like an island sometimes when it came to the decision of not circumcising my boy(he'll be two next month)there is so much ignorance on this issue amongst my own peer group and family. It's like they are desperate to have an excuse to cut my poor kid, and then when you have the medical community siding with them...it's really tough. Very smart decision to advise this board. I will remember this in the future...This is my first post!


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## Devaskyla

It sounds like you're describing a perfectly normal infant foreskin. Here's some other image links.
http://www.parentingweb.com/art/infant.GIF (drawing)
http://www.clareloprinzi.com/images/Circumcision2.jpg (photo)


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## Ask a man

I stumbled onto this while using Google to do some research. And while I am impressed by the number of sources cited and the lengthy posts, I feel the need to say some things here since I actually have a penis attached to me. Many of the previous posts seem very opinionated.

To the person who is having trouble with the doctor,

Yes definitely get a second opinion. if you only have one child and he is a male, then preferably go to a male doctor. i mean no offense towards women. But you are definitely not penis experts and a male doctor will in most cases, though not all will have more sensitivity when handling this condition. (very fine female doctors exist, and very inexperienced male doctors exist as well) I am in no way meaning to be biased. But let's face it men have more experience with the organ being discussed here. Also I never went to a pediatrician as a child. I went to a very fine family physician. I never understood why people go to pediatricians. I would suggest maybe even talking to a Urologist. edit: No I would definitely see a Urologist or maybe even two. Remember your young man's penis is going to be one of the most important things in his life. Don't let just anybody mess it up or damage it.

To those discussing the retracting of foreskin,

I am in no way an expert on this subject seeing as how I was circumcised as a child. It seems that many people who do not support circumcision have little knowledge of circumcised male genitals while people who support circumcision have little knowledge of uncircumcised male genitals. Only opinions. Really it's not about hygiene or tradition, children get circumcised because most people don't actually think about the matter, they just do what a physician or their peers suggest or their family members had performed.

However my foreskin seems to have grown back and I can tell you that you must keep it clean. Some of you are suggesting that retracting of the foreskin should only happen after puberty or by the child himself. This can not be correct can it? How will you keep it clean? Smegma?

Also some people commented about some pubic hairs on one of the photos discussed in the thread. If the image you all are referring to is this one:

http://www.steadyhealth.com/4542/Image/phimosis.jpg

I don't think that is pubic hair(s). Here is most likely what happened: The picture was probably taken with an actual camera before digital cameras were around. There may have even been dust etc on the lens. Then the film was developed and a picture was printed. Some time later, that actual photograph was scanned and uploaded to the internet. There may have been dust on the scanner or the surface of the original photograph may have been scratched. Having one solitary pubic hair that thick, long, and dark would be unusual.

Again, I mean no disrespect. But no one here should believe that they already know everything about this matter. And please ask your husband if available or another man whom you trust for help with this.


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## Ask a man

I just realized the last post before mine was made in April of 2009. Still, I hope someone sees this.


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## MCatLvrMom2A&X

Quote:


> Originally Posted by *Ask a man*
> 
> I stumbled onto this while using Google to do some research. And while I am impressed by the number of sources cited and the lengthy posts, I feel the need to say some things here since I actually have a penis attached to me. Many of the previous posts seem very opinionated.
> 
> To the person who is having trouble with the doctor,
> 
> Yes definitely get a second opinion. if you only have one child and he is a male, then preferably go to a male doctor. i mean no offense towards women. But you are definitely not penis experts and a male doctor will in most cases, though not all will have more sensitivity when handling this condition. (very fine female doctors exist, and very inexperienced male doctors exist as well) I am in no way meaning to be biased. But let's face it men have more experience with the organ being discussed here. Also I never went to a pediatrician as a child. I went to a very fine family physician. I never understood why people go to pediatricians. I would suggest maybe even talking to a Urologist. edit: No I would definitely see a Urologist or maybe even two. Remember your young man's penis is going to be one of the most important things in his life. Don't let just anybody mess it up or damage it.
> 
> To those discussing the retracting of foreskin,
> 
> I am in no way an expert on this subject seeing as how I was circumcised as a child. It seems that many people who do not support circumcision have little knowledge of circumcised male genitals while people who support circumcision have little knowledge of uncircumcised male genitals. Only opinions. Really it's not about hygiene or tradition, children get circumcised because most people don't actually think about the matter, they just do what a physician or their peers suggest or their family members had performed.
> 
> However my foreskin seems to have grown back and I can tell you that you must keep it clean*. Some of you are suggesting that retracting of the foreskin should only happen after puberty or by the child himself. This can not be correct can it? How will you keep it clean? Smegma?*
> 
> Also some people commented about some pubic hairs on one of the photos discussed in the thread. If the image you all are referring to is this one:
> 
> http://www.steadyhealth.com/4542/Image/phimosis.jpg
> 
> I don't think that is pubic hair(s). Here is most likely what happened: The picture was probably taken with an actual camera before digital cameras were around. There may have even been dust etc on the lens. Then the film was developed and a picture was printed. Some time later, that actual photograph was scanned and uploaded to the internet. There may have been dust on the scanner or the surface of the original photograph may have been scratched. Having one solitary pubic hair that thick, long, and dark would be unusual.
> 
> Again, I mean no disrespect. But no one here should believe that they already know everything about this matter. And please ask your husband if available or another man whom you trust for help with this.


The reason it is correct that no one should retract is because until the foreskin releases it is fused to the glans like the fingernail to the nail bed. When it does release varies greatly from boy to boy and by someone else trying to retract could cause harm to the boy. Only he knows how far is to far. As for cleaning once the boy is retractable have him simply retract, rinse, and replace it is that simple and if the boy isnt old enough to do that on his own then it isnt important to do it for cleaning. Simply swishing in the bath removes smegma and keeps things clean.

Smegma is not inherently dirty woman have it just like men do and sitting in the bath is enough to clean it off. Not sure about the picture you are referring to or where that came up?

I dont know everything but for the last 6 years I have researched and studied the intact penis and why retraction is bad. If you go to the resources sticky there are many threads there that explain it really well.

Like most here I dont know anyone with intact genitals IRL to ask about them so I have relied on this board as well as my own research on the net. If you look at other countries where circ is not the norm and what their Dr's and what they recommend then it is plain to see that retraction by anyone other than the owner of the penis is potentially very damaging and not worth the risk. Only here in the USA will dr's tell you to retract and clean and that has caused a many of a boy to suffer damage and infection that could have been prevented.


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## QueenOfTheMeadow

Hi AskaMan. I might agree with you if all the men in my life before my children hadn't been circumcised. The fact of the matter is that I do have more knowledge about the intact penis than they do, because I have taken the time to research it. I know what the foreskin is and why it's there. I know the damage circ can cause to the male penis and the harm it can to sexual relations. I understand why no one but the child themselves should retract and that separationg of the foreskin from the shaft can happen at many different ages, as many men do not. So asking my dh about what he thought about circumcision with out having researched it, would have probably lead to my boys being circ'd because all he knew was that it is normally done in the US. After doing the research and sharing that with him, he said he didn't think it was necessary. I wanted facts, not opinions on doing surgery on my child. So, no, just asking a man is not the best option unless that man knows the facts.


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## Papai

Quote:


> Originally Posted by *Ask a man*
> 
> I stumbled onto this while using Google to do some research. And while I am impressed by the number of sources cited and the lengthy posts, I feel the need to say some things here since I actually have a penis attached to me. Many of the previous posts seem very opinionated.
> 
> To the person who is having trouble with the doctor,
> 
> Yes definitely get a second opinion. if you only have one child and he is a male, then preferably go to a male doctor. i mean no offense towards women. But you are definitely not penis experts and a male doctor will in most cases, though not all will have more sensitivity when handling this condition. (very fine female doctors exist, and very inexperienced male doctors exist as well) I am in no way meaning to be biased. But let's face it men have more experience with the organ being discussed here. Also I never went to a pediatrician as a child. I went to a very fine family physician. I never understood why people go to pediatricians. I would suggest maybe even talking to a Urologist. edit: No I would definitely see a Urologist or maybe even two. Remember your young man's penis is going to be one of the most important things in his life. Don't let just anybody mess it up or damage it.
> 
> To those discussing the retracting of foreskin,
> 
> I am in no way an expert on this subject seeing as how I was circumcised as a child. It seems that many people who do not support circumcision have little knowledge of circumcised male genitals while people who support circumcision have little knowledge of uncircumcised male genitals. Only opinions. Really it's not about hygiene or tradition, children get circumcised because most people don't actually think about the matter, they just do what a physician or their peers suggest or their family members had performed.
> 
> However my foreskin seems to have grown back and I can tell you that you must keep it clean. Some of you are suggesting that retracting of the foreskin should only happen after puberty or by the child himself. This can not be correct can it? How will you keep it clean? Smegma?
> 
> Also some people commented about some pubic hairs on one of the photos discussed in the thread. If the image you all are referring to is this one:
> 
> http://www.steadyhealth.com/4542/Image/phimosis.jpg
> 
> I don't think that is pubic hair(s). Here is most likely what happened: The picture was probably taken with an actual camera before digital cameras were around. There may have even been dust etc on the lens. Then the film was developed and a picture was printed. Some time later, that actual photograph was scanned and uploaded to the internet. There may have been dust on the scanner or the surface of the original photograph may have been scratched. Having one solitary pubic hair that thick, long, and dark would be unusual.
> 
> Again, I mean no disrespect. But no one here should believe that they already know everything about this matter. And please ask your husband if available or another man whom you trust for help with this.


Right. And going by your logic there should be no male gynecologists because none of them know what it's like to have a vagina. This is a silly argument.


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## SpiderMum

No, I don't have a penis...but I do have a prepuce! That's what we are discussing here...the prepuce aka clitoral hood or foreskin. In my experience circumcised men know far less about normal male anatomy than most women because they often don't WANT to look into it and possibly have to face that what was done to them in childhood wasn't needed. Meanwhile maternal instinct drives many mothers to protect their children from harm and research circumcision so often the most informed people are in the US on the topic of foreskin are WOMEN.


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## Roxswood

I'm in the UK, its incredibly rare to hear anyone even mention their child's penis here because we just don't mess with them, they're left intact, unwashed (except for just sitting in the bathwater or normal cleaning during diaper changes), untouched.. and funnily enough problems are very rare.

Even adult intact penises don't need much in the way of cleaning, its only a matter of personal preference and maybe consideration towards a partner, but my hubby doesn't do more than shower normally and he never has any problems, and I never have any problems with his cleanliness.


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## Spencesmom

THANK YOU! Thank you for the initial post and for the subsequent replies. My son who will be three in a month, was just diagnosed with balantitis by a doctor in emerg (by sight, no swabs etc...) and prescribed antibiotics. :/
I was told that his phemosis was my fault because I was not slowly retracting him since birth!! I pretty much told him I thought he was insane and that it went against all I had heard from my GP and midwife let alone the studies. He tried to convince me that I was in the wrong and I have been second guessing myself for the past two days despite myself. To see my son in such excruciating pain kills me and I wonder if I'm doing something that might have caused this. It is his first infection and he's been potty trained for over a year now (through the nights for 2months) but that can't be what's the matter can it?


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## MCatLvrMom2A&X

It may be Separation Issues and not an infection at all. Here is a thread http://www.mothering.com/discussions/showthread.php?t=764732 if you havnt read it already that explains the difference between separation pain and infection and how some boys have pain during separation and what to do about it when it happens.

BTW your GP and MW are totally right about leaving it alone and the ER Dr. is giving out advice that we know is damaging. You are 100% right and he is 100% wrong.


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