Sunday, December 06, 2009

Forced Retraction: What to Do Now?

By Danelle Frisbie © 2009


We frequently receive questions on forced retraction, similar to this one in our inbox:
Help! I just took my [insert age] month-old-baby to the doctor and s/he forcibly retracted his foreskin! I took him from them right away and we are never going back there. But what do I do now?!
First: I would grab my baby from any medical 'professional' forcibly retracting my son and leave immediately as well. How sad that this happens to anyone, ever.

At this point, no matter what happened to your son, the best thing to do now is to leave his foreskin alone. Do not try to 'clean it out' from whatever happened. Do not place any cream on it (which will only interfere with the body's natural healing process). The only exception to this is Calmoseptine (more info below). Do not place anything directly into the foreskin. Do not wash with soap (this will irritate the sensitive prepuce which likely has tears from forced retraction and will hurt your son further).

Allow the foreskin/penis to heal itself as it will quickly do in infancy (the prepuce will likely try to reattach to the glans in an effort to seal over and protect it). When you bathe your son, use only warm water (not soap). Do not ever scrub his penis. I would be the only one changing my son's diaper for a while to ensure that no one else touched or messed with his foreskin while it was healing. The best advice after forced retraction is the best advice before it ever happened: Leave it alone.

If the prepuce or penis or areas around the genitals look sore or red (even from diaper rash or heat rash or simple irritation) the best ointment to pick up is Calmoseptine. You can request a tube from your local pharmacy (for about $6), or on the shelf at most Walgreens stores. Calmoseptine does not interfere with the genitals' natural pH balance, and it is a wonderfully soothing, healing cream that is safe to use all around the genitals of babies. Calmoseptine can be placed around the base of the penis and scrotum - it will help to heal during diaper wearing time, and will get around the foreskin via rubbing. It is really the only 'diaper' cream you will need during babyhood, and is especially good for cases like this.

The following are the four most frequently posed questions we've been asked lately. Because this situation has come up so often, I am going to post some of my reply here.

1) What's the best way to file a complaint against this doctor?
2) What resources/information pages can be sent to this doctor so that other intact boys aren't put through this?
3) Is there anything else we can do to make this doctor become more informed about proper foreskin care (that is, to leave it alone)?
4) How would you go about finding a doctor who is educated about foreskin maintenance?

1) You may drop a brief email to Saving Our Sons at SavingSons@gmail.com with this physician's name and mailing address and a brief note about what occurred. Medical based information on proper intact care and the harms of forced retraction in the clinic will be sent free of charge, directly to this physician. Your name will not be mentioned and it will come directly from DrMomma.org We have seen many previously ill-informed physicians and nursing staff change their ways as a result of being given proper information and being encouraged to research current data more closely. Often, forced retraction is merely due to the inadequate ways in which we teach (or completely forget to teach) on the anatomy of the foreskin and its care in medical and nursing schools in the United States today.

You can report the occurrence to David Llewellyn at TheCircumcisionLawyer.com or to the attorneys at ARCLAW - those specifically working for the rights of babies/children in the areas of genital cutting and harmful medical practices impacting the genital integrity of human beings. They may be able to send a letter on your behalf.

In addition, you may also report this event to attorney, John Geisheker, at Doctors Opposing Circumcision. Find Geisheker's information in the contact section of his site. Have your doctor's name, name/address of the practice, and the name/address/department head's name, and name of the risk manager at the hospitals where the doctor has privileges, if possible.

2) Re-familiarize yourself with the information cataloged on the Intact Care Page and print/give what you find important to your doctor for review. When there are experts in the field of pediatrics and human sexuality publishing on the perils of forced retraction all the time, there is NO REASON for a physician to remain ignorant on the proper care and protection of an intact boy.

In the end, the best pediatric word of advice for baby boys:

INTACT = DO NOT RETRACT.
Only clean what is seen.
Wipe like a finger: outside only, base to tip.

One of my colleagues tells his patients the only tool they need to care for their intact son(s) is a ruler - to slap the hand of anyone who comes near. In a case like this, that would include the doctor.

3) If you are brave enough to engage in dialog on this topic with the doctor, I would ask questions - find out why s/he believes this is necessary, site other pediatric professionals who are publishing (articles such as those above) in this area, and maybe (hopefully) s/he will think twice about what s/he is doing and change the method of practice used so other boys are not harmed. The vast majority of problems with babies and  men's penises occur because someone forcibly retracted or 'messed with' their prepuce when they were infants. This really needs to stop. We need to educate parents so that they can protect their sons even in cases such as this when medical professionals have not been educated on this subject. It is likely that this doctor is not a 'bad guy' but rather, that he never sought out the information and is still acting out 'old school' ways of doing things...from before we understood what we do now about the functions of the foreskin and the important purposes of the prepuce organ in the U.S. (common knowledge that many in intact nations take for granted).

4) I would become very well versed in the purposes of the prepuce and proper care of an intact son myself, and then when interviewing potential care providers (you are, after all, hiring them for their services), simply ask them about their ideas on circumcision, the prepuce, and care of intact boys. You will quickly find out whether or not they are up to date and educated on the subject and will be able to stick with them, or move on. I have interviewed physicians in such a way (on this and other subjects) via phone and email. Of course, you can also set up a brief 10-minute introduction appointment with a physician. Most are willing to meet with potential new patients to see if it is a good 'fit.' If one is not willing to meet before joining their practice, do you really want them for your doctor anyway?

Best wishes to all parents out there navigating these waters. Don't be afraid to bring out the momma bear in you and protect your little cubs!

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25 comments:

  1. Thank you for this. My little one just had his retracted by a nurse at the ER. I am so upset!! Something must be done!

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  2. This is so much more polite than I would feel. My son has to see a urologist soon for a completely un-foreskin related issue and I'm terrified that someone will go pushing about where they shouldn't be. of course, i would hope that the specialists are somewhat more educated. nonetheless, thank you for this.

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  3. My pediatrician (well, no longer), pulled down on the foreskin just a little bit and I've never jumped up so fast. Although it didn't seem to hurt my son, I told her that intact penises never need to be retracted, even a little bit, until they're much older. She said it was to see the urethra and I said he is peeing just fine.

    Needless to say, I'm finding a new pediatrician. I don't even want to take the chance.

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  4. We noticed that when our toddler peed, the stream went way off to the right, and that the tip of the penis was a little bent. Our pediatrician suggested we take him to a pediatric urologist just in case something needed to be fixed it would be best to do it young and before potty training.

    At the appointment with the urologist NP I said I had read online about forcible retraction and I was afraid of this happening, so please do not retract it. She agreed. We took off his diaper she grabbed his penis and pulled the foreskin down to expose the head of his penis. He began screaming and bleeding. My husband who rarely raises his voice shouted, “Whoa, whoa!” I exclaimed, “Our pediatrician never pulls it back that far.” She said, “I pulled it back as far as it can normally go back.” No apology, no explanations of why.

    I guess I should have been more specific and requested she not pull the foreskin back to expose the head of the penis? I guess I should asked if part of the exam would include pulling back the foreskin and if so then we would not go on with the exam?

    After we put the diaper on him and pulled up his pants he was whimpering and grabbing himself. When we went to change his diaper there was blood in it. I was at a loss as what to do, but I am so relieved to find this article and know that I can report her.

    Thank you!

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  5. Anon post on feb 23. I would have called the police and not left until they showed up, and file a report for sexual abuse.

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  6. how do you know if it has been forcibly retracted?

    www.facebook.com/NirvanaBirth.com

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  7. glad my friend sent me the link to this! we went to a sick visit today so it was not my son's normal pedi. i assumed they went by the same up to date info on intact care.
    apparently they do not. she took his diaper off and i thought she was looking for a rash , like his pedi normally does. before i knew it she had pulled his skin back and i jumped up and yelled no no no we do not do that to him stop it stop it.
    she said oh just did it as much as it naturally goes back , you need to do this and clean it and put vasaline on it.
    well now of course his penis is red from her doing this. i feel like me and my son teagan were violated today and i just cant forgive myself for not watching her more closely. she did not ask me if she could do it nor did she stop when i told her to. i've emailed the recommended people , i hope something gets done. if he has any more problems from it im going to find and attorney.

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  8. These stories scare me... I am so sorry for the pain caused by such ignorance. Twenty years ago when we refused to circumcise our son, we were very alone. People thought we were crazy to "endanger" his health but that said, the Doctors seemed much more knowledgeable. We were told never pull it back any farther than it would go on its own and to only wash what was showing. I am shocked that these forced retractions are done by educated medical staff. Any medical personnel that does not stop after being told stop or does what you have requested not done, needs reported. Congratulations to all who chose not to alter there perfect little boys. :)

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  9. I hate that I have to watch Drs like a hawk - but I do. It has gotten to the point that I ask them not to touch my children's penises at all. It just is not necessary & frankly I do not trust them at all. I have to bookmark this for future reference sadly for myself or anyone else who might need this info. It is sad that I need to. :(

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  10. Breastmilk also helps with rashes, cuts etc. It's the only thing I use on my son. I don't know what I'll do when he stops breastfeeding!

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  11. My son's doctor has retracted his foreskin during exams & I didn't know it was a problem. He doesn't do it all the way, just a little to see the tip. Is that the same? And I had done it 1 night b/c he said his penis was bothering him & since the doctor does it I thought it was ok. I know not to do it during diaper changes or baths, but I didn't know that soap was bad near there either. Now I'm wondering if all this damaged him. Is what the doctor did so bad? I now wonder if that is part of the reason he hates the doctor. I thought he was just being a 2 yo or younger when it has happened. I feel so horrible. I didn't research this well before b/c I just didn't know it was a big deal. I just knew what I stated above. I wish more info was shared before we left the hospital.

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    Replies
    1. Don't retract it at all. Not even a little bit.

      Delete
    2. Don't let anyone or yourself retract it at all, not even a little bit. They do not need to see anything inside!

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  12. My 5 year old intact son hadn't retracted at all. I hadn't ever looked into it but told the doctor at a visit about it. He forcibly retracted his foreskin and my son was screaming out in pain. I wish I had looked into in first and learned about it. I am kicking myself silly about it now. I just started researching because after following the doctor's advice to keep retracting it daily and put oil on it to stop it adhering, he's getting a bump of skin on one side. Obviously I'm never pulling on it again but now I don't know if I should have the bump checked out or just let it heal in peace. Who would I even take him to, in order to get accurate care?

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  13. My son was forcibly retracted recently during a catheterization to check for a kidney infection (though we told the nurse not to retract). He's 2 years old, and the nurse pulled the foreskin all the way to the end of the glans. I'm curious how long we should expect it to take to heal completely. He's complaining about painful urination again, and I'm not sure if it has to do with the retraction or an infection. Anyone have any ideas?

    (I was going to post this on the FB page to get more responses from people with experience with forced retraction, but would rather be anonymous and didn't see a way to message the moderator. Thanks.)

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  14. My eight year old son has had issues with his urine flow squirting in all directions due to a narrow opening of his fore skin. Our GP sent us to a specialst who straight away forced his fore skin back. It was so very tight my Son was in a lot of pain. He told me it should start to pull back after the age of three or four and to go home and forcibly do the same thing every night until his skin had stretched.My Son's fore skin was red and close to bleeding all day and night. He couldnt walk properly because of the pain.He couldnt even touch it never mind pull it back.I feel sick now after reading information about this.I am now worried about lots more than squirting urine!!

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  15. Please let me know if you have ever heard of this..I really need some help! A couple of months ago I started noticing two white lumps under my son's foreskin. They look like bits of fat, almost like the cellulite you can get on the back of your arms. So my questions are:

    1. Could this mean that he was forcibly retracted by someone without my knowledge? He has been going to the daycare at my gym, and I just realized that I forgot to mention this to the workers there.

    2. Is it anything to worry about?

    3. I called his ped. and he said that it wasn't normal and to bring him in. I am so nervous that he is going to be retracted, or that my pediatrician will say he needs to be circumcised.

    If you know anything about this, please please email me at barefootfae@yahoo.com Thank you so much.

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  16. i didn't realize this was an issue & now i have questions!
    my son is 5 years old & had his foreskin pulled back when he was a baby, i can't remember what the reason was for. since then he has had 1 or 2 infections where we had to take him to the doctor & they gave us some cream, we put the cream on for a couple days inside the foreskin & he got better. we were told to pull back as far as the foreskin would naturally go to gently wash it when he takes a bath/shower, so we do this at least every other day making sure it is clean so he doesn't get smegma build up or an infection again.
    it pulls back easy & painlessly to a point now (slight trouble at first when he was younger, wish i knew about this article then & let it adhere/heal) & my son being 5 now washes it him self.

    everything seems totally fine...so MY QUESTION is now that the foreskin is not adhered & has been pulled back easily as far as it will go for years now, should we just keep doing what we're doing since it seems fine or should we now leave it alone after reading this??

    i feel like if we leave it alone now he will have smegma build up & could get infected since it smoothly pulls back/no adhering.

    when boys reach this age of 10 that keep being mentioned & the foreskin pulls back to a point (like my sons does not at a young age) they are supposed to pull back & clean right?

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  17. I have tried to get an answer out of the hospital where my son was born, about whether or not they force retract newborn boys, but they always just say that they don't know or they give me some weird answer and they won't let me speak to a doctor or nurse. I want to know if there are any signs that could tell me if they retracted him or not and if he has adhesions from it? He is almost 7 months old now, he doesn't seem to have pain peeing, but sometimes the tip of his foreskin, the outer ring if you will, is a pinkish red color and I have no idea why!! Unless that is normal sometimes? I am so worried that he may have been retracted as a newborn and now its all fused together :( Somebody give me some advise?

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    Replies
    1. It is normal for the end of the foreskin to be pink/reddish. Just as the end of the clitoris is also pink/reddish. This does not mean forced retraction ever took place. If you feel it looks especially irritated (if the red color deepens) you can use some Calmoseptine on the end (don't put it into the penis/foreskin - only smear on the exterior of the penis/foreskin/scrotum). This will reduce inflammation and irritation and soothe and heal the developing tissues of the genitals. You can buy a tube upon request at your local pharmacy. This is what you are asking for: www.calmoseptine.com

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  18. Ugh. I feel sick. My MIL was babysitting my 17 month old yesterday and gave him a bath (which she usually doesn't do, but I guess he had a real dirty diaper). He's had a not so nice rash and I guess she decided she should clean him up real well and so she started to retract his foreskin to make sure it was clean under there. AHHHH! I almost flipped when she told me on the phone! Thankfully he put up a fuss, so she "didn't get too far" whatever that means. It looks different now :( I'm so ticked off at myself that I never instructed her not to. When he was first born I feared that she would do something like that, but she never bathed him, so I didn't worry. Now I am kicking myself. Praying now that it will heal up well and his rash won't spread to where it used to be perfectly protected. Grrr.

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    Replies
    1. This just happened to my son. I am feeling so guilty. I meant to say something to make sure they knew not to but it just totally escaped me. I was so worried about so many other things, having to leave my son with my parents for a little while, that I totally forgot to make sure they knew not to retract his foreskin. He has a preputial cyst and they pulled back his foreskin to get a look. I won't see him again for over two weeks so I have no way of knowing if they caused damage.

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  19. My son is intact and i had to take him to see his Dr. because the tip was red and swelled and the Dr. retracted it and said he needs it to be retracted and cleaned with soap and water every day my son is 4and a half should i do it plz help

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    Replies
    1. The suggestions above for "What to do now" are useful. I'd follow those, and also see additional citations at the Intact Care Resource page: http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html

      Best thing to do is leave it alone and let it heal, and drop an email to SavingSons@gmail.com with this doctor's name and address so some materials can be sent directly to him.

      Delete
  20. My son had his penis retracted by a nurse this past week at an unplanned ER visit. I had no idea this would be done- he had to have a cath, not his first and the first time they did not retract his foreskin so I stupidly assumed they would not this time. I was trying to console him and when I looked down I saw what she had done, she said, " oh you haven't ever retracted his foreskin before. It won't bother him, this is worse for you then him. He won't remember this."
    I am so angry and sad that I couldn't protect him. I feel like this has caused him more harm and pain than what we were even being seen for!

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