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Old 08-07-2008, 05:50 PM   #1
bethanyb
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Phimosis after circumcision - help!

Has anyone experienced this or heard of it happening? My son is 5 weeks old. He was circumcised 3 weeks ago. (I did not want to have it done, but it was important to my husband.) We didn't really know what to expect it to look like, but about a week ago we decided something wasn't right and took him to the doctor. The foreskin was growing over the penis and the opening at the end seemed to be closing in. The doctor who did the circumcision had never seen this happen before. She first prescribed antibiotics because it looked a little swollen and she wanted to be sure there wasn't an infection. We went back today for a follow up and it's only gotten worse. The opening is now down to only the size of a pin. The doctor had talked with a pediatric urologist who recommended a steroid cream. We are now using the cream and are going to see the urologist Monday. If the cream isn't working, they will have to do surgery to fix it. Obviously, I'm really wishing we hadn't done the circumcision at all, but I would like to find out as much as I can so we can make an informed decision on how to treat it now and there doesn't seem to be much available. I did find one article that indicates this occurred in 2.9% of the circumcisions done at one particular clinic over 5 years:
http://linkinghub.elsevier.com/retri...22534705636129
If it is this common, I can't figure out why there isn't more information. I would appreciate any help or personal experience. Thanks!

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Last edited by bethanyb; 08-08-2008 at 10:34 AM.
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Old 08-07-2008, 09:06 PM   #2
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Re: Phimosis after circumcision

Maybe you should look up urethral meatal stenosis. That's usually associated with scar tissue in the absence of remaining foreskin, but sometimes it can be caused by damage to the frenular artery during circumcision.

I hope everything works out for your family.
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Old 08-08-2008, 12:49 PM   #3
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Re: Phimosis after circumcision

I don't think it could be phimosis, since phimosis is a very tight foreskin opening, which is caused by the Frenar band being extremely tight. Since the Frenar band was removed during circumcision, it cannot be phimosis at all (phimosis does not happen in babies/children anyhow).

The only thing I could think might have happened, is sometimes when babies are circumcised, their penises are drawn into their bodies (look up buried penis for examples). Perhaps in your sons case, his penis was being pulled into his body and what was left of his foreskin attached and tried to heal itself over the raw parts on the end, which compounded into the situation he is in now?
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Old 08-08-2008, 10:00 PM   #4
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Re: Phimosis after circumcision - help!

This happened to my nephew. As the pp mentioned, it is not phimosis. For my nephew it was burried penis. The penis actually pulls into the fat pad at the body, and then the skin adheres over the open wound. They had to constantly re-rip him and apply creams to it at every diaper change for years. Normally you do not have to rip adhesions (though many dr's will incorrectly recomend it) but in some cases like my nephews they become unable to pass urine because the skin adheres over the urethral opening and in other inappropriate places. My nephew will be 5 soon and he still has alot of problems. He cannot pee standing up like a normal little boy because of the constant adhesions, and there is a good chance he will need surgery eventually to correct it. It isn't a botched circumcision, it is just one of those complications.
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Old 08-09-2008, 10:56 AM   #5
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Re: Phimosis after circumcision - help!

Unfortunately this is more common then you were made to think by your dr.
http://en.wikipedia.org/wiki/Meatal_stenosis
If he is still able to pee, I would leave it alone. It will re adhere, then later will begin to retract like an intact child. The more you mess with it (or the drs) the more scarring there will be. I am sorry this happened to you
This is a list of complications, it has some more info on meatal stenosis
http://www.circumstitions.com/Complic.html
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Old 08-10-2008, 01:12 AM   #6
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Re: Phimosis after circumcision - help!

poor guy
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Old 08-10-2008, 01:23 AM   #7
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Re: Phimosis after circumcision - help!

was it possibly a botched circumcision where they didn't remove all of the foreskin?
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Old 08-10-2008, 05:07 AM   #8
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Re: Phimosis after circumcision - help!

Quote:
Originally Posted by kristinc View Post
was it possibly a botched circumcision where they didn't remove all of the foreskin?
The trend these days is to leave as much foreskin as possible. These are called "loose circumcisions". This is not a "botched circumcision" when this happens. It is done for the welfare of the child and is in their best interest if the child is not going to be left intact.

In the days where most of our DH's were circumcised they removed as much foreskin as possible. This is the style of circumcision many of us are used to seeing.

This led to multiple problems for men as they matured. When removing the entirety of the foreskin on an infant it is hard to tell how much is "too much" if you know what I mean. Many men suffer from what is known as a "hairy shaft" because too much skin was removed and when aroused the hairy skin from the scrotum is pulled up onto the shaft, others suffer extremely painful er*ctions (because so much skin was removed that there is not enough to appropriately accommodate an er*ction), other men had so much skin removed that when they became teens and began to experience er*ctions the skin on the shaft of their p*nis actually split in multiple places.

So physicians have started performing "loose circumcisions" and leaving quite a bit of the foreskin to prevent these problems. The trade off is that there is a much higher rate now of penile adhesions. However, if left alone and treated properly most of these should resolve themselves over time. This is done so the boy has enough skin to grow into.

Last edited by sadiekat; 08-10-2008 at 05:12 AM.
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Old 08-10-2008, 06:29 AM   #9
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Re: Phimosis after circumcision - help!

My son has I believe what you are all calling 'buried penis' I had no idea that this was that common. I first noticed within the first month, after we had removed the wrapping from his circum. That all went well no over growing of anything so my doctor told me it was just that his pubic area was fat and therefor pulled him in. He is now 18 months and thinning out however, he is still fatty in his pubic area and still buried. he has no problems peeing but I'm totally concerned because nobody wants their kids to have problems that result in worse as they get older....I don't want surgery though does anyone know of exercises that can be done??
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Old 08-10-2008, 07:19 AM   #10
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Re: Phimosis after circumcision - help!

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Originally Posted by Blessedwith2 View Post
My son has I believe what you are all calling 'buried penis' I had no idea that this was that common. I first noticed within the first month, after we had removed the wrapping from his circum. That all went well no over growing of anything so my doctor told me it was just that his pubic area was fat and therefor pulled him in. He is now 18 months and thinning out however, he is still fatty in his pubic area and still buried. he has no problems peeing but I'm totally concerned because nobody wants their kids to have problems that result in worse as they get older....I don't want surgery though does anyone know of exercises that can be done??
There isn't really anything you should or can do. The absolute worst thin you can do is to allow a Doctor to cut any more skin from your son's p*nis. Removing more skin could make the problem much worse, and will further damage the sensitivity and structure.

Hopefully it will become more exposed as your son grows. If not when he is older he can make the decision to have something surgical done about it or not. A good rule of thumb is that if he can pee to leave it alone!

My son has had to have several procedures performed due to his severe circumcision complications. (We will never circumcise another little boy). His were all necessary because he could not urinate. They also did not remove any additional skin. They had to widen the urethral opening. He has suffered meatal stenosis and meatal ulceration which occurs in up to 10% of circumcisions. It has been extremely painful and traumatic for him.

Here is an explanation from one paper for "Buried Penis"

Quote:
Both groups of authors suggested that the penis was forced into a subcutaneous position by wound contraction following circumcision. They attributed concealment of the penis to readherence of mucous membrane of the prepuce to the glans penis and the tendency of the penis to retract into the fatty mons pubis where it was trapped by the contraction of the circular circumcision wound above it.

We propose a much simpler explanation: failure to completely separate the inner surface of the prepuce from the glans penis. Circumcision, when correctly performed, eliminates the possibility of phimosis by excision of the a sufficient portion of redundant prepuce in order to leave the glans penis exposed. Usually, more of the inner preputial surface than the outer requires excision, so that very little penile skin need be discarded. If the inner surface of the prepuce is not adequately dissected from the surface of the glans penis, mot or all of the inner surface of the prepuce remains. Penile skin is then pulled into the circumcision device and amputated immediately, or in a week’s time in the case of the plastic bell clamp. The circular wound contracts as it heals12 and confines the glans penis in a subcutaneous position.

Last edited by sadiekat; 08-10-2008 at 07:23 AM.
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