PSA: Uncircumsized infants and care

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Ok lol again this is related to our Peds ER visit the other day.

My son is uncirc'd and is 5 months old. He was in ER for rule out intusseption, we were sent by our ped. They wanted a urine sample because my husband has a rare kidney issue, and since we were there why not. I was ok with that. (BTW it was to check potassium in urine).

Nurse wanted to cath.

Me: How do you do that with him being uncirc'd.

Nurse: Oh we just pull foreskin back

Me: We were told never to pull it back... it can create adhesions be painful.

Nurse: (I'm not kidding I"m quoteing her.. she repeated herself). "I don't know where YOU PEOPLE get this information from. Its a myth its fine to pull the foreskin back".

Me: (Dumbfounded, and asked her excuse me to make sure I heard her correctly).

Nurse: Who told you that anyways?

Me: Our ped. (gave peds name) and according to www.aap.org

Thankfully PA stepped in and said no need to cath and we did a urine bag.

Soooo without further Ado... link to the AAP site with quoteing from its article on care of uncircumsized memberes. Just to pass the info on to others.

http://www.aap.org/publiced/BR_Uncircumcised.htm

As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until the foreskin fully separates, do not try to pull it back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding, and tears in the skin.

I know your all great pedi nurses and already knew this.. but I just wanted to spread the word even more.

Thanks for listening!

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thank u so much 4 this info. i believe it is an individual thing. my 5 year old son, 11 year old stepson and husband is uncircum. and they have never encountered any problems. we teach the boys how to take care with washing and thats that.

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Specializes in Pediatrics Only.

I'm sure for your situation a bagged urine was fine, but other times you need a straight cath and it does not harm the patient to retract the foreskin to do so.

Also, there is no reason why you cant straight cath an uncircumcised child- I've done it before and I'm sure I'll do it again without any problems.

I've also had it where the foreskin is so tight because parents have not retracted it to provide proper cleaning that it is literally cutting off circulation to the member. Not to mention what can develop under there from being improperly cleansed.

This is coming from a pedi nurse here..

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I'm sure for your situation a bagged urine was fine, but other times you need a straight cath and it does not harm the patient to retract the foreskin to do so.

Also, there is no reason why you cant straight cath an uncircumcised child- I've done it before and I'm sure I'll do it again without any problems.

I've also had it where the foreskin is so tight because parents have not retracted it to provide proper cleaning that it is literally cutting off circulation to the member. Not to mention what can develop under there from being improperly cleansed.

This is coming from a pedi nurse here..

On an infant there is no need to retract the foreskin.. just like you don't go cleaning up in a female's lady parts... the foreskin has its own self regulating mechanisms.

My sons foreskin is very tight.. he will retract it when good and ready UNLESS medically necessary. In our situation it wasn't necessary would have caused great pain and potentially scaring.

(Also you can cath without retracting the skin if you just pull it back enough to see the urethra, but NOT over the head of that glans.. that way your not forcibly retracting if the foreskin is tight. (PA told us this one)

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I've also had it where the foreskin is so tight because parents have not retracted it to provide proper cleaning that it is literally cutting off circulation to the member. Not to mention what can develop under there from being improperly cleansed.

This is coming from a pedi nurse here..

FALSE! You do NOT have to retract it back AT ALL...EVER! That is the decision of the owner of the member! Retracting too early and forcibly is painful and can cause a host of problems! Proper cleaning is washing it like you would a finger, until it NATURALLY retracts.

Intact = DON'T RETRACT! Only Clean what is seen!!!!

This is from a nurse, a midwife, a mother of a intact boy, ex of an intact man, sister of an intact younger brother. ALL of whom were just fine being left as they were, and NEVER forcibly retracted!

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From the AAP's healthychildren.org website:

"Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teen years. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until the foreskin fully separates, do not try to pull it back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding, and tears in the skin."

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Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

I've cath'd multiple uncircumsized boys, just clean well and cath. In fact just had a 5 year old in for emergency circ. Apparently he or someone else forced retraction in tub, got caught caused swelling. They brought him to e.r. and had to be split to relieve pain.

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