GP just advised to get 3.5 yo circumcised - Advice Needed

I took DS to the GP on Monday as he had been complaining his penis was sore. GP said he had an infection (Balanitis) and gave him some antibiotics. We went back today and GP said it looks normal again (was a bit red on Monday). He said to me today "We'll need to cut it", I asked if he meant the foreskin and was referring to a circumcision, he said yes, the hole is too small. I really think he is jumping the gun. I don't normally see this GP, but it was hard to get an appointment

This is DSs first ever infection down there and I think its because although he has been toilet trained for over a year, he used to sit on the loo, recently he started standing and due to his short stature he has let his penis touch the toilet bowl time and time again, I think I have now got him mostly out of this habit, but I think that's the culprit for the bacteria. We will now be much more diligent with hygiene down there.

When DS as a baby our Paed prescribed steroid cream for the tip of DSs penis as his pee-hole was very small (same issue) and it was basically to thin the skin, this was effective then, so perhaps this is an appropriate action now, although will this keep happening when we stop using the steriod cream again. Perhaps I will book him in to see our regular GP and ask about this.

However, DS is due to have a paed follow up at age 4 (3 months time) so I am thinking I will just make an appt and see him sooner. I really think a circumcision recommendation after one bout of Balantis is over the top and at this stage, and frankly I really don't want to go down this path unless absolutely necessary.

Anyone had anything similar occur?

I haven't experienced anything similar, but I'd definitely be seeking a second opinion and tryin other options/see what happens first. I agree that it seems like the doc is jumping the gun.

I also agree that I'd be getting a second opinion. It does seem like a bit of an extreme reaction to go straight to circumcision.

You obviously didn't get it done at birth for a reason so I would be getting a trusted opinion so that you aren't pushed into something you aren't keen on.

I would definitely get another opinion! My ds has had balanitis (sp?) twice, I think both times was even before he was 12 months, but there was never any mention of circumsizing him over it. Considering this is the first real drama he's had down there, I wouldn't be worrying about too much yet. Good luck with your regular GP, hopefully he gives you a better explanation than the first doc if he happens to agree that something needs to be done x

It does sound a bit extreme to suggest a circumcision based on one infection. Definitely get a second opinion.

This is over the top. My DS has had a fairly major infection in his penis once but the multiple Drs who looked at him said it would be unlikely to reoccur as long as his penis is kept clean (baths are the best for this).

They said when he gets older, his foreskin will pull back naturally and all will be good.

If it was a recurring problem, I would then look into it, but not for a one-off.

I'd wait to see what the paed says. I'd trust their opinion more.

Just a question: Is he able to pull the foreskin back at all himself? DS has a delightful habit at the moment of pulling his penis out of his pants and pulling the foreskin back and forth. He only does it when it is "big" which seems to happen a lot at this age, lol.

Do you know if there is a urologist (pref paediatric) nearby. We were referred to one. He was very ancient looking and I was worried, but he said he's been in the industry for years and said that years ago my DS would have been instantly circumcised due to his issues. But he said now a days everyone was a lot more reserved in their actions. He said that a wait and see approach was far more common now and often time resolved all these things. He was very experienced and I valued his honest approach and many years in the 'industry'. He'd kept up on research and I felt very happy when we left his office.

If you feel this is too hasty, then a second or third opinion is well worth seeking.

I really have no intention at this stage to do it, I really think the GP just gave a stock standard recommendation, no other options were offered

MyLitta, yes, he's quite adept at rolling it, stretching it as boys tend to be. I think I will just focus him on hygiene and talk to another GP about the 'hole size' issue and follow up with my paed in April unless prompted earlier by any other issues

Hey MN, is the 'hole' his urethra (where the wee comes out) or is his foreskin very tight??

My DS was circumcised for medical reasons (different reasons to the issues you're dealing with) and I would definitely get a referral to a paediatric urologist before making any decisions. Shame you're not inMelbourne, I could recommend a magnificent one!

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Hey MN, is the 'hole' his urethra (where the wee comes out) or is his foreskin very tight??

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I guess that is exactly what I was asking as well. From your response Nay it sounds like the issue is more about the size of the end of his urethra, rather than the size of the opening in the foreskin (if he's able to pull is back over the head of his penis). I wonder how circumcision would help that?

I would seek a second opinion too. Ds had his first ever infection and while it was mentioned in passing as a "if it continues and becomes a real problem then we will come back to this discussion"

We were told salt baths, making sure he pulls it back and shakes it off or pulls back and dabs with paper after each wee. After a bath making sure it's dry under there too.

Yep, the urethra I believe

Get it done. Sorry to go against the grain and be blunt and all that, but DH has just needed a circumcision+ as he had this problem as a child, never did anything about it, ended up needing not only a circumcision but also some penis reconstruction type surgery in his 30s. I'm getting Liebling done when the schools break up, get it done early.

The GP gave us some signs to look for that would indicate that circumcision should be done as a preventative measure. These include not being able to retract the foreskin (Liebling was OK as a toddler, or almost OK and the nurse wasn't worried when I spoke to her, but it's getting worse now - but it wasn't something I checked between the age of about 18m to almost 6 years) and also some "bubbling" when weeing: basically, the wee is caught under the foreskin and it looks like it bubbles up before being able to escape.

I haven't been in this position before, but I would also suggest a second opinion. I honestly don't see how circumcision could help?? I wonder if as he grows, if it will resolve itself? Good luck, hope you get some answers :)

Circumcision for a narrow urethra makes no sense?? The urethra is not touched during a circumcision, as I'm sure you know. Coincidentally, one of my DS's issues is a narrow urethra. The urologist had a very difficult time passing the scope down the urethra during a hystoscopy as the urethra was so narrow - one of the smallest he has seen according to my son's urologist. We discussed the possibility of a procedure to widen the urethra, but ultimately decided not to at his stage. It seems fairly impossible to me that a GP would be able to accurately assess the size of a urethra in a male child from a simple examination when my sons paediatric urologist couldn't accurately assess his urethra without surgery. What's more, I find it very poor that he would seemingly recommend a circumcision in such a callous manner and particularly for a reason which appears to be be unjustified.

I believe that balanitis is more common in uncircumcised males, but I think you said this is your sons first infection? Seems to be jumping the gun to me. If the problem is a very tight foreskin, which can't be retracted for cleaning, I have heard of circumcision for this reason. Circumcision will not affect the width of the urethra. I would ignore the advice of this doctor and move on. If your DS has another infection, I would get a referral for a paediatric urologist

I hope your DS is feeling better.:D

Well I took DS to another GP and she said he's perfect and there is absolutely no medical reason for the suggested circumsion.

Happy now!