UTI Testing on Boys: DO NOT RETRACT!

It is very troubling every time I receive an email from a parent telling me that their doctor/nurse/medical tech said it was necessary to forcibly retract their infant's foreskin (causing immense pain and tearing and possible future problems) for routine check-ups and testing. Forced retraction often occurs by medical staff because they were simply not taught how to insert a catheter, extract a urine sample, or properly examine the natural, normal, intact penis.

In fact, in my graduate research (Frisbie 2006), I found that the vast majority of medical school urology textbooks only contained depictions and descriptions of circumcised penises! When U.S. medical students practiced on cadavers, these too, were often circumcised. It is no wonder our doctors and medical staff do not know what they are doing with and to our intact boys.

Forced retraction is the primary reason for the vast majority of all prepuce related problems in infancy and later in life. It is so, SO important that you (as your son's mother or father) become VERY well versed in the proper care of the penis and prepuce (foreskin) so that you are able to protect your little man while he still cannot speak up for, or defend, himself.

Dr. Paul Fleiss (a pediatrician who has studied the foreskin and circumcision extensively for 30 years) and Dr. Frederick Hodges (who has studied and written in the field of urology) wrote a book called, "What Your Doctor May Not Tell You about Circumcision". If you are able, PLEASE get this book, read it, and share with other parents you know. Amazon Link. Half.Com Link

In this book, Drs. Fleiss and Hodges discuss forced retraction and how it is NEVER medically necessary - NEVER. They specifically discuss doctors and nurses who go 'looking for UTIs' and tell parents they must retract the foreskin. This is NOT necessary.

Not only do babies NOT produce lubrication (even pre-pubescent children produce very, very little), the prepuce is securely attached to the glans of the penis as an infant - much like your fingernail is securely attached to your finger. It does not need to be forcibly torn away in order to get a sterile urine sample.

Fleiss and Hodges write:

You are a lioness defending her cub...We would never pull out our fingernails to improve hand hygiene...Be on your guard. Never let a doctor or anyone attempt to retract your son's foreskin. Optimal hygiene of the penis demands that the foreskin of infants and children be left alone. Premature retraction may tear the skin of the penis causing your child extreme pain. There is NO LEGITIMATE MEDICAL JUSTIFICATION FOR RETRACTION. If any doctor suggestions [forced retraction] for your son, firmly refuse, stating, "Just leave it alone."


Drs. Fleiss and Hodges also inform parents:

Doctors have made up some strange reasons for wanting to retract a child's foreskin during checkups. None of them are valid. They may sound convincing, but I assure you, they are ALL WRONG. If a doctor tries to retract your child's foreskin, stop him. Tell him that this is inappropriate, unnecessary, and traumatic. Please, be on your guard. Many parents have made their feelings clear only to have doctors retract their son's foreskin anyway, causing the child enormous pain and trauma. Regardless of your child's age, and even if your child's foreskin is already fully retractable, doctors have no business fiddling with your child's penis and foreskin. Sometimes they say they are looking for a urinary tract infection (UTI). This is absolutely ridiculous, but many doctors have actually said this to parents. [Sterile urine samples can be easily obtained from girls AND boys from simply wiping the outside of the genitals first.] Doctors who [attempt retraction for UTI testing] are usually circumcised and upset at the sight of an intact penis. They are unfamiliar with it and anxious. You know more than they do about this body part. You MUST take charge. Protect your child from any attempt to retract or tamper with his foreskin.

If you are able to find a doctor who is up to date in his/her research and skills in caring for an intact boy, as well as in favor of keeping boys intact, this is certainly optimal. Until the time when all medical staff are trained in the proper care and protection of intact babies and children, we, as parents, must do our job as the informed, watchful guardians of their well-being.

Dr. Fleiss currently practices pediatric medicine in Los Angeles, CA.

Dr. Hodges currently teaches at Yale University.



Read the International Doctors Opposing Circumcision Statement on Forced Retraction.

Read this additional article by Dr. Geisheker & Dr. Travis: Only Clean What is Seen: Reversing the Epidemic of Forcible Retraction.

A colleague of mine recently put together a video for the site, As Nature Intended, calling for all professionals to STOP the harmful forced retraction of our boys:

12 comments:

  1. I love that you shared this - came across you on FB! I happened to pick up Dr. Fleiss' book *the day before* taking my intact son in for a check-up with a student ped who was convinced she needed to retract his foreskin. Before reading Dr. Fleiss, I was clueless. Thankfully, I threw down, picked him up, told her it was medically unnecessary and would not relent. She insisted it *was* necessary and told me her son was intact too and she regretted leaving him intact due to "all the problems they'd had". Uh... maybe that's because you kept yanking his foreskin back, lady. I never took him back there. My son, 7 years later, has still never had any infections, or any other problems that a nice soak in the tub didn't resolve. He retracted on his own sometime after turning six.

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    1. Isn't it amazing how little is known about foreskins? Our illustrious medical community loves to keep us in the dark while they ply their godly trade. Child abuse is about enlightening parents. Let us help each other to bring about an end to the dark ages. Do not be afraid to share this information. Parents are not idiotic, they probably have computers and we have the right and the obligation to show them. We owe it to their kids, actually because their kids will become the adults of tomorrow.

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  2. Hello, I have been reading your blog for a while now, it is very informative. I want to share this article with my fiancees cousin who is a l+d nurse. we had a conversation about foreskins, she believes they should be retracted to prevent hardening. that didnt make sense to me with the research I have done, and I voiced my opinion, she was disagreeing with me very strongly. I dont want to make an enemy out of her but I do want to inform her, so at that time I did the nod, close my mouth and didnt say anything more that day. Do you have any suggestions on how I could do this tactfully?

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  3. Nicole - would it be possible to just say that you came across some interesting material written by physicians in the fields of pediatrics and human sexuality and that you'd like to get her ideas about it all?

    You could print off this (or better yet - get a copy of the book, "What your doctor may not tell you about circumcision") as well as these other articles below. (I frequently print them, put them together in a folder, and ask for people's ideas on the subject after reading them...)

    I have found that if you ask people to give you their feedback, they are more likely to actually read the literature, and give you their 2-cents - whatever that may be - but at least they have read something that caused them to think (maybe?) about things in another way.

    Forced retraction (i.e. messing with the foreskin) of ANY boy of any age is NOT okay. The boy himself should be the ONLY one who ever retracts his foreskin - in his own time, whenever he naturally does so. We know that 95% of problems are a result of other people forcibly retracting/overcleaning or 'stretching' as your friend suggests. NOT a good idea...

    This is one reason I encourage ALL parents to be fully informed on the care of an intact boy and go with him to any and all appointments to make sure that NO ONE - no nurse, no tech, no doctor - forcibly retracts his foreskin. This is not a subject taught in medical school, and it is CERTAINLY not a subject taught in nursing school. Other people's hands should be kept away from your baby's penis. Period.

    It seems like if we know all the functions of the foreskin, it would be obvious that it is best left alone. Just as our eyelids are best left alone to do their thing...and our fingernails should not be forcibly retracted from the fingertips they cover and protect.

    Reversing the Epidemic of Forced Retraction: http://drmomma.blogspot.com/2009/09/only-clean-what-is-seen-reversing.html

    Protect Your Intact Son: http://drmomma.blogspot.com/2009/08/protect-your-uncircumcised-son-expert.html

    DOC statement on forced retraction: http://www.doctorsopposingcircumcision.org/info/info-forcedretraction.html

    Ask The Experts:
    http://drmomma.blogspot.com/2009/09/ask-experts-forced-foreskin-retraction.html

    Functions of the Foreskin:
    http://drmomma.blogspot.com/2009/09/functions-of-foreskin-purposes-of.html

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  4. Nicole there are plenty of new literature in some pediatric texts about the proper care of an intact penis of a boy. New data says that NATURALLY the foreskin (at birth) is FUSED to the glans [just like hymen in little girls] and throughout boyhood til puberty these structures will separate, and will completely break with masturbation and sexual intercourse. See now? Forcibly or even gently retracting our boys to clean under their foreskin is like masturbating a child. THAT'S A NO NO. This retraction will cause bleeding, tearing then will lead to infections.

    Please visit my website for more educational material and the list of the pediatric texts where they state the proper infant care.

    http://www.asnatureintended.info/circumcision.html

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  5. Thanks for the help!! I really appreciate it.

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  6. I am currently 8 months pregnant and stressed about this issue already because this weekend my husband (who is intact) informed me that is mother suggested to his sister who has an 8 month old she start retracting the foreskin and even cleaning it out with a Q-tip!!!She said that she did this with her two boys, and come to find out my husbands brother "had to be circumsized" because of some sort of problem as an infant. I bet it had something to do with her forcibly retracting his forskin... This is my mother in law and what is worse she hardly speaks a word of english...I informed hubby and I think he ast first said okay to shut me up later I sent him tons of info and links and I think he now has a better undertanding, but his mother who has also been buying me bottle which I believe to be a hint to bottle feed I believe thinks that she knows best and you wont convince her otherwise. It keeps me up at night to think I am going to have to prevent her from changing his diapers in fear she may try to retract his penis... I am very freaked out by this, also I think she will slip in formula if I leave the baby with her...She is very emotional and needy and these are just the issues with the baby that hasn't even been born yet lol...UGGHH what do I do???

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  7. Kody - I never let my husband's mother watch our son for those SAME exact reasons. Never. She could see him, hold him, when I was around to protect him. But she never changed his diaper and she never fed him or took care of him without me right there. It is sad when we can't trust other people to respect our children and our parenting decisions, but you have to do what is best for your baby - even if this means protecting him against people who may be related to you by marriage or blood.

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  8. KodyK - I am very sorry to hear that this is stressing you out so much. :( Hopefully you will come to find a safe space when your baby arrives and you are able to protect him from anyone who isn't fully informed about proper care of an intact baby. There is AMPLE amounts of information today, so no one should remain in the dark on the issue. Maybe you (or someone you know) could translate some things for your mother in law?

    You should also pass along this information to your sister in law so that she does not harm (without meaning to) her own son.

    You are correct that it is likely your husband's brother had problems because of his forced retraction and 'cleaning' as a baby. :(

    Here is more information in case you are interested in researching this subject further:

    Raising Intact Sons:
    http://www.drmomma.org/2009/11/raising-intact-sons.html

    Basic Care of the Intact Child:
    http://www.drmomma.org/2010/01/basic-care-of-intact-child.html

    Phony Phimosis Diagnosis:
    http://www.drmomma.org/2010/01/phony-phimosis-diagnosis.html

    Protect Your Intact Son:
    http://www.drmomma.org/2009/08/protect-your-uncircumcised-son-expert.html

    Only Clean What is Seen: Reversing the Epidemic of Forced Retraction:
    http://www.drmomma.org/2009/09/only-clean-what-is-seen-reversing.html

    The Functions of the Foreskin:
    http://www.drmomma.org/2009/09/functions-of-foreskin-purposes-of.html

    Medical Testing: Do Not Retract:
    http://www.drmomma.org/2009/09/uti-testing-on-boys-do-not-retract.html

    How the Foreskin Protects Against UTI:
    http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html

    Forced Retraction? Now What?
    http://www.drmomma.org/2009/12/forced-retraction-what-now.html

    Doctors Opposing Circumcision Statement for Physicians and Nurses on Forced Retraction: http://www.doctorsopposingcircumcision.org/info/info-forcedretraction.html

    Forced Retraction: Ask the Experts
    http://www.drmomma.org/2009/09/ask-experts-forced-foreskin-retraction.html

    National Organization of Circumcision Information Resource Centers Publication on care of the intact penis:
    http://www.nocirc.org/publish/4pam.pdf

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  9. Forced retraction can be devastating, not only in infanthood but also into adulthood. Please see this link:

    http://www.thewholenetwork.org/3/post/2011/2/a-childs-cry.html

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  10. I am so distraught that I can't even sleep, last night I was told by pediatrician to go to the er for catheter urine sample because the one taken the day before with a bag came back inconclusive. With images of my poor baby suffering from a UTI, I quickly took him to the ER. The nurse proceeded to tell me how she sees this time and time again, improper cleaning of intact babies and went ahead to show me the "proper way". Unfortunately, I now realize that this whole time of me leaving it alone was right. I just instinctively would leave it alone. And now, after coming back from the hospital, and seeing the foreskin red, I immediately started reading about this online and realize what has happened. I am sickened and furious at not only the nurse but myself for not knowing. I scared of what consequences will follow and so so upset that I didn't do the right thing for my little boy. So much more has to be done to educate everybody, I am horrified to think about what happened to my son and the pain that was caused to him

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  11. My son was cathed at six months at Children's Hospital because of an unknown fever. They told me they "had" to retract because they couldn't get a clen sample if they didn't. Guess what - my pediatrician told me a few days later that the sample grew 3 bacteria (none of which caused the fever) which was a sure sign that the sample was... CONTAMINATED. More than year later it still makes me made when I think about it. They all try to tell me hat it won't cause any lasting harm ,but my hert fears thy are wron, even if it was only once. I will also be checking with my church's childcare coordinator to make sure that the caretakers ALL know not to retract during diaper changes. I feel like an idiot for not asking when he was born.

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