Baby boy repeated UTIs?!

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I also am curious what specialist you went to see. We saw a nephrologist and a urologist after a VCUG and Ultrasound, and the urologist was better qualified to identify the reflux AND provide information on likelihood that it would self resolve.

First off, I recommend getting a second opinion before proceeding with anything. If he's got low grade reflux, depending on the specialist, they may not have caught it.

Secondly, your specialist doesn't sound very expert to me. The foreskin is meant to be tight for an infant (it is attached to the glands like your fingernail is attached to the finger). The foreskin is designed to be tight as a means of keeping infection out. I'm going to guess that at least once or twice they mentioned "phimosis" (diagnosis of tight foreskin - which, by the way can't be diagnosed until after puberty)

UTIs are generally an issue with the inside plumbing NOT with the foreskin. Again, I would refer for second opinion. Get copies of the VCUG and Ultrasound for another specialist to review.

Know that some of the studies regarding the benefits of UTI prevention in circumcision are flawed. I have heard about at least one where they compared full term, uncatheterized infants who were circumcised to uncircumcised premies who had catheters - both being premature and having catheters were far more likely to cause issues with UTIs than the fact that they had foreskin. Some studies that I have actually read compared different demographics - sometimes took samples from different hospitals, different city areas, etc. They did not control well for samples of both circ and uncirc in similar demographics.

ASIDE FROM THAT, there are studies that show that there is no difference in the rates, or that uncirced infants (when it is properly cared for and they are not forcibly retracted) are less likely to have UTIs

All studies show that AT BEST, the increased benefits are ONLY for the first 6 months to 1 year of life. So basically you'd be removing his foreskin to prevent UTIs for 6 months, assuming that the study is right, and for a few weeks of that he'd probably be at increased risk for infection due to the circumcision wound.

Beyond the UTI benefit/lack of benefit itself, there are the numerous risks that come with anesthesia and ANY surgery - and yes, even death is a potential complication. I have also heard stories of infants losing part of their glands due to a poorly done circ.

So, my recommendation is a second opinion. If that second opinion gives you the same options, I would recommend going with the topical steroid cream. I have heard from others with intact sons that this is the route that they went when infection became a repeat issue.

Best of luck.

ETA: during both of my consults with the nephrologist and urologist, they both recommended circ (I will give your specialist a bonus point for actually recommending the steroid cream as a circ alternative, which mine didn't even bring up). It helped for me to be well informed about what the foreskin is, its function, its benefits, and to have done my own direct research reading UTI studies and literature. It helped me be more aggressive and shoot down the doctor's suggestions because I was informed and well aware of what I'd be taking from my son (and for questionably little to no benefit) by circumcising him.

Son had a UTI (only one, fortunately), so we have gone through the VCUG and Ultrasound procedure. However, my son was found to have grade 3 reflux.

Do option 1. Don't circumcise your child, he'll appreciate it I promise.

Try the cream. Your sons UTI is unlikely related to his foreskin and more likely due to a urinary tract abnormality. Circumcision does not prevent UTI. The foreskin is supposed to be attached. Your doctor, probably circumcised, was never thought normal penile development. The foreskin is fused to the glans and it retreats as your child matures. NO attempt should be made to retract your sons foreskin this can cause damage.

BREAST MILK IS THE GREATEST PREVENTIVE UTI MEDICINE.

In infancy, antibacterial substances, such as the simple sugars in breast milk, the oligosaccharides, are passed from mother to child during breast feeding and are secreted in the babies urine.(9) The penis retains these substances in the foreskin. University studies have shown that their substances protect against urinary tract infections, as well as infections in other parts of the body (10). Babies excrete in their urine 300-500 milligrams of obligosaccharides a day. These compounds prevent virulent strains of Escherichia coli from adhering to the mucosal lining of the entire urinary tract, including the foreskin and glans.

Try and follow up this sites research.
"Recurrent UTI: Some doctors recommend circumcision in cases of recurrent UTI. However, there is no medical evidence to support this recommendation. Recurrent UTIs are associated with congenital abnormalities of the upper urinary tract"
http://www.cirp.org/library/disease/UTI/

Do not hesitate to contact my email at craig.ginsbe@yahoo.com for detailed advice that i can not fit here.

Circumcision to prevent a urinary tract infection (UTI) ?

Cutting off a part of your sons penis is not a logical way to prevent an easily treatable UTI. The myth that circumcision prevents children form a UTI’s in the first six months of life was based on a egregiously flawed “study” that was fabricated by circumcision advocate Thomas E. Wiswell in 1985(24).

When children are born prematurely they are not circumcised due to the potential risks that come with a traumatic and unnecessary surgery on a very tiny infants penis. Premature infants are placed in the NICU where they can not obtain breast milk, and since they are premature, their immune system is weaker in general. As discussed earlier, breast-milk is highly efficacious at preventing UTI(25). These lack of controls in certain studies may generate the appearance that genitally intact males are more susceptible to UTI’s during the first six months of life. There is not any claim that circumcision reduces UTI in adult life. The claim that circumcision prevents UTI has long since been put to rest by the AAP Task Force on Circumcision in 1999 which states:

“Few of the studies that have evaluated the association between UTI in male infants and circumcision status have looked at potential confounders (such as prematurity, breastfeeding, and method of urine collection) in a rigorous way. For example, because premature infants appear to be at increased risk for UTI, the inclusion of hospitalized premature infants in a study population may act as a confounder by suggesting an increased risk of UTI in uncircumcised infants. Premature infants usually are not circumcised because of their fragile health status. In another example, breastfeeding was shown to have a threefold protective effect on the incidence of UTI in a sample of uncircumcised infants. However, breastfeeding status has not been evaluated systematically in studies assessing UTI and circumcision status”(26)

Women by design are far more susceptible to UTI’s due to a shorter urinary tract. It would be no more logical to remove the labia minor to prevent UTI in women. A UTI is also a potential complication of circumcision. The plain fact is that UTI in boys is generally uncommon and almost exclusive to boys with urinary tract abnormalities. Even if circumcision did prevent UTI, it would not be logical to subject 200 children to a dangerous penile reduction surgery on the off chance that it might prevent a single boy from experiencing an easily treatable UTI.

Using circumcision to prevent infections is a cultural superstition and it is no more scientifically valid then the notion of amputating your eye lid on the off chance that it may reduce the risk for conjunctivitis (pink eye). If this was a common practice in our culture we would have all kinds of rationalizing literature for this as well. The removal of your eye lid like like the removal of the foreskin detracts form the primary function of those body parts and it is not any more logical then amputating the entire penis to reduce STD’s or the amputation of one eye to prevent eye cancer by 50%.

On another note new study's have shown that circumcised baby's are at a greater risk of getting a UTI(http://www.cirp.org/library/disease/UTI/) read that link to find its academic refrences

(9) Hanson LA, Karlsson B, Jalil F, et al. Antiviral and antibacterial factors in human milk. In: Hanson LA, ed. Biology of Human Milk. New York Raven Press; 1988. pp. 141-57
(10) Coppa GV, Gabrielli O, Giorgi P, Catassi C, Montanari MP, Veraldo PE, Nichols BL. Preliminary study of breast feeding and bacterial adhesion to uroepithelial cells. Lemcet 1990 Mar 10;335(8689):569-71.
(24)Wiswell TE, Smith FR, Bass JW. Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1983 may;75(5):901-3
(25) Gothefors L, Olling S, Winberg J. Breastfeeding and biological properties of faecal E. coli strains. Acta Paediatr Scand 1975 Nov;54(6):807-12
(26)AAP Task Force on Circumcision. Circumcision Policy Statement. Pediatrics 1999;103(3):686-693.

What did this specialist specialize in?
BS? Because that's what it sounds like.

When a baby boy is born his foreskin is attached to the head of his penis. So it's not going to be "tight". At least if it was you wouldn't be able to tell. Even so, if your son was circumcised his penis would be exsposed to everything in his diaper, the foreskin protects the head from all that now. So if your son is getting infections from simply urine being "trapped" there (which I'm sure is his claim) then he would get worse infections from his urethra being exsposed to feces in a diaper. Plus when you are giving him a bath, that area is going to get cleaned anyways so a tight foreskin diagnosis really is BS.

I had multiple UTI's as a child, and I was circumcised at birth. Some people are just more suseptable to them. I grew out of my infections however I still will get symptoms over the littlest thing. (like sitting in a hot tub). I would avoid surgery at all costs. A circumcision is a way worse thing to go through than a few UTI's. Esspecially if they are caught early they aren't too bad, it's just a pain in the butt to have to go get anti-biotics.
I would use the medication to prevent any future UTI's then if he's still having issues then you can concider getting him a partial circumcision ( a full one isn't neccessary he should keep everything he can).

I dispise being circumcised, I restored my foreskin after being cut for 17 years. I'm almost 20 and still can't find a single good thing about circumcision. Pros and cons are opinion only not facts. I see no pros to circumcision and no cons for trying a cream for a few months.

-Connor

Circumcision won't prevent UTIs - by opting for surgery, you're increasing your son's risk of infection: http://www.circumstitions.com/Utis.html You really need to see another doctor. A doctor who would recommend circumcision for a 6 month old based on a 'tight foreskin' knows nothing about the development of the normal penis, and you'll be fighting uphill battles. If you're hunting for a better doctor, try this list - these doctors come recommended as having more experience and knowledge than average when it comes to foreskin and intact development: http://www.thewholenetwork.org/intact-fr…

'Tight foreskin' or phimosis is an utterly phony diagnosis in a child. In infancy, and for many years later, the foreskin is naturally long and tight with a narrow opening, and is fused to the glans with synechia: http://www.doctorsopposingcircumcision.o… http://www.cirp.org/library/normal The reason for this is to keep infection OUT. The opening of the foreskin doesn't widen until manipulation by the owner and puberty hormones enable it to - retraction is only necessary for sex. The most common cause of infections and scarring is premature retraction - how are you cleaning him? http://www.fathermag.com/health/boy-care… Please, run from anyone who tries to retract your infant son's foreskin.

I hope this is of some help - circumcision is SO over prescribed in the USA. I'm in New Zealand, where very, very few boys are circumcised, and I don't hear of any of the 'foreskin problems' so rampant in the USA.

On a 6 month old baby boy, the foreskin is supposed to be fused to the penis. It's not supposed to be pulled back at all. I can't believe your specialist doesn't even know that it's normal for a baby's foreskin to be tight.
In infancy, UTIs are often caused by people trying to pull back his foreskin. The way to care for the foreskin is to leave it alone, and just wipe the outside of the penis gently with lukewarm water.

I don't see why circumcision is an option, either. Circumcised baby boys can also get UTIs, and the circumcision itself can bring on a whole host of infections (and other risks).
About 2% of intact baby boys will get a UTI, and about 1% of circumcised baby boys, so there is a slight reduction...but considering that circumcised baby boys are far more likely to get other types of infections (such as staph infections) it's really not worth doing it.

Have you gotten different opinions from various doctors and tried different antibiotics? That's the best thing to do. Also look into what else could be causing the UTIs. For instance, him sitting in soapy water can cause UTIs. Some boys are very sensitive to irritants and get a lot of UTIs, but tend to grow out of it in a couple years.

I'm against infant circumcision when there's no medical indication for doing it, but since your son has a medical problem, all in all it's your choice. But I would see circumcision as a last resort, because of the risks (and pain, and loss of a functioning body part) involved with it. And keep in mind that a full circumcision wouldn't be necessary.

: Use a topical steroid cream twice a day for 6 weeks with a low dose antibiotic for 4 to 6 months to prevent him from getting any more UTIs.
He will get to keep all of the nerve endings and the protection they wouild otherwise cut off. I think he will be like almost all men that have a natural penis, it is something you want to keep.

The second approach sounds crazy and creepy -- cutting off important parts of his penis. What worries me is how he got to this point. Has anyone retracted his foreskin to clean? Boys that are natural should not have their foreskin touched by others. Some BAD US medical advice was to pull it back and scrub with soap. That causes problems including infections. Natural boys really have no problems if you don't retract THEIR foreskin.

You should know that infant boys are EASIER to care for when they are natural (intact). The foreskin does not retract until late childhood or even puberty, so you do nothing special, just wipe the outside of his penis clean and leave it alone. Furthermore, to prevent painful and bleeding erections later in life, doctors are now commonly leaving more skin behind- in a cut boy this means you may have to push the left over skin back at every diaper change and clean beneath it to prevent it from adhering or infecting. The very thing that mother's think they avoid by circumcising! In short- Intact = wipe like a finger, NEVER retract Cut= vaseline, clean thoroughly, push back remaining skin to prevent adhesions etc (the last step perhaps for several months or years).

**FIST PUMP!**

Yes, it's day surgery, but it's much better for him to have the anesthesia. The longer you can prolong the start of antibiotics in his life... the better, and twice a day for a topical steroid that gets wiped off with the next diaper change isn't going to resolve much. I'd opt for the circumcision if it were me. The general anesthesia is only administered to keep him comfortable, at six months he's not going to sit still, not to mention he has way more muscle control and it would be dangerous for him to be fully alert. Children six months told are far more active than newborns. Really, it's not a big deal, urologists perform this procedure quite often on infants his age, it's a very quick procedure. Far better for him to do it now than to have him continue to suffer UTI's into his adulthood.
Relax, schedule this procedure and you'll have a far healthier young male in your household and everyone will fell better, UTI's are more painful than this procedure.