# Intact 8 Year Old with Pain



## queenofkings

I just posted in another thread, but I wasn't sure if I might get more answers with a fresh post - so I apologize in advance for the redundancy.

Here is the gist of it - my 8 year old son has been having intermittent pain in his penis for the past few weeks. At first I brushed it off, thinking that he had somehow irritated his penis and sent him to the bath each time it bothered him. The warm water seemed to help tremendously, but it didn't eliminate the problem in the sense that it kept happening.

I let it go on for a couple of weeks, because I wasn't convinced that it was really something deeply concerning. The pain seemed to just randomly occur, and I turned up nothing on Internet searches that alarmed me. Since the baths seemed to help so much, I really continued to believe that perhaps he had irritated it and the bath would eventually flush the irritant out.

Honestly, I never realized how much I don't know about penises.

It just kept happening - maybe a couple of times a day - but no swelling, no tenderness, no redness, and no discharge. One night though, he was so distressed that I drove him to the clinic where they tested for a UTI. Here, I witnessed ballooning during urination. UTI test came back negative and the doctor looked at DS's penis (which wasn't hurting by this time), and said it looked fine and he seemed fine. Nothing to worry about.

But the pains continued. I did more online searching, and someone told me about her DS's penile pain and a lump under his foreskin that turned out to be a build up of smegma, and once that came out, he felt fine. I saw no lumps under DS's foreskin, though, but I encouraged DS to gently move his foreskin around to see if it would come back at all. I never touched it myself, but I watched him and saw absolutely no retraction happening at all - I began to worry about phimosis, because the opening of his foreskin is just a dot. I wondered if he was having erections, and the tight foreskin was causing him pain.

During one bout of pain, DS went into the bathroom and then told me that something had come out. Maybe smegma? I hoped that this meant that the pain would subside. Nope. So I took him to his pediatrician, who said he is fine.

Still, it is breaking my heart that I can't help him somehow and make the pain stop. I know not to retract him, but should I be concerned that he has not retracted at all at his age, and that he is having pain? This has been going on for weeks now.

Today, more pain. He was afraid to urinate, so I ran him a bath and had him urinate in the tub. When he stood up, there was a couple of drops of blood at the tip of his foreskin (diluted, obviously, but it alarmed me to see that pink water). I am so worried that I am not doing the right thing for him.

Help!


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## MCatLvrMom2A&X

During the separation process pain can be part of it. Him ballooning is a sure sign separation is happening. This thread http://www.mothering.com/discussions/showthread.php?t=764732 had a lot more detail about the process. The bleeding could also be pointing to new separation going on though on the extreme end of what is normal it can be normal.

I am glad you Dr. isnt an alarmist and hasnt scared you with circ talk But I do think that a swab culture of the tip of the foreskin is the way to go here just in case he has a mild yeast infection going on. It would cause issues without being overly dramatic. If the culture comes back showing nothing then you can be almost sure that the issue is separation and hopefully he will stop having discomfort within the next few weeks or months.

The non retractable foreskin isnt a problem even with the small hole since he can urinate normally. Avg age of retraction isnt until 10.5 yo and even well into puberty is normal.


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## queenofkings

Thank you for your response!

Is there anything that I can do to ease his pain? I feel so helpless.


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## queenofkings

Fifth time in the bath today so far for urination and now he is refusing to pee. I am thinking, based on all that I had read so far, that his glans has pretty much (if not completely) separated from his foreskin now, but the opening of his foreskin is still so narrow that the ballooning effect of collected urine is stinging the freshly separated area?

If that is the case, I am praying that this will not last much longer.


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## MCatLvrMom2A&X

I would take him in for a swab just to make sure that he dosnt have yeast or a bacterial thing going on. If you Dr. is foreskin friendly then talk to him about your concerns and see if he has any suggestions even possibly the steroid cream even though he is younger than I would like to see anyone use it but he obviously needs a bit of help to move things along.

That is just my personal opinion and what I would consider doing if it where my ds.


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## brant31

What type of pain or discomfort is your son experiencing? That could be an important clue as to what is going on.

Does it burn when he urinates? Is it not painful when he's flaccid, only hurts as the penis tumesces? Does it hurt if he pulls the skin forward when he's flaccid? Can he comfortably roll it side-to-side? And I know this may sound funny, but sometimes encouraging a boy to pinch his foreskin as he urinates can help dislodge something like sloughed smegma pearls. Let it balloon as far as is comfortable, have him shake the penis a bit using the pinched tip, then let it flow out into a small plastic tub. Look carefully for anything coming out.

Very often pulling the foreskin forward helps greatly during the separation process. And remember, separation doesn't happen all at once. Usually the front half of the glans is the first area to resolve, then the synechia breaks down gradually (over weeks, or months or even years) toward the corona of the glans. It's not unusual for a boy to not see his sulcus, or groove behind the glans, until years after he can reveal most of his glans. My last coronal adhesions didn't completely resolve until I was 9 or 10.

What you're looking for is whether the site of the pain is the glans corona, or the frenulum, or the urethra, etc. Can you get him to help identify the spot that hurts? If he can roll his foreskin from side-to-side a little, he can detect and tell you whether the discomfort is coming from the corona area, the middle of the glans area, or the distal end (near the meatus). It's possible he has a tiny tear, either in the frenulum or the preputial sphincter (possibly acquired during an erection) and it hasn't healed completely. Of course, he would definitely feel this when he urinates. On the other hand, the pain may not be foreskin-related at all. At 8 years old, though, your son can articulate a lot about this condition in response to the right questions.

It sounds like your son still has a very tight preputial sphincter, which is quite normal. It's impossible to make any generalizations about this until well into or after puberty, since so much changes at that time with hormonal changes and natural exploration. You can be thankful that your son has the protective quality of a snug foreskin, keeping pathogens away from the glans and urethra. The words of Sir James Spence almost 50 years ago in The Lancet (Britain's leading medical journal) are worth keeping in mind:

"What looks like a pin point opening at 7 months will become a wide channel of communication at 17 [years]. Nature is a possessive mistress, and whatever mistakes she makes about the structure of the less essential organs such as the brain and stomach, in which she is not much interested, you can be sure that she knows best about the genital organs..."

http://www.cirp.org/library/general/spence1/


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## MyBoysBlue

My DS is 4 and he doesn't seem to be quite as uncomfortable as your DS but he does occasionally say his penis hurts. It's never red and the pain is always fleeting and usually moments after he's peed. I think it's just raw spots that have just recently separated that seems to sting from the urine. I don't think he is retractable but I have no way of knowing as I haven't tried to find out. I've heard of people letting their boys pee in a warm cup of water so that it dilutes the pee and stings less, it might help if he is still in pain.


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## mommyminer

Brant31 -- Thank you for the info you provided. I come here to educate myself about issues I may encounter with my 3yo intact son and to educate myself so I may assist the families I serve. I never have heard anyone suggest pulling the foreskin forward or rolling it side to side but it makes sense.


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## queenofkings

Just an update, the pain subsided after a couple of days. He hasn't mentioned it in *knock on wood* almost a week now, so I think we have crossed that hurdle. Brant, thank you for your post. The pain started out intermittently (without any obvious cause) and then in the last few days occurred only and specifically during urination. I think that the urine was stinging him where the new separation had occurred., and initi Initially pu In

I am just relieved that he seems to be back to his regular self!


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