Friday, June 03, 2011

Ballooning in the Intact Child

By Jennifer Coais © 2011



Penis Balloons! They are the occasional delight of growing up as an intact boy.

I always have to giggle when I hear stories about pediatricians who ignorantly warn parents that their son’s ballooning penis is now prone to infection or other complications and must be treated promptly. This makes me laugh primarily because my own son, who is now three, delights in this normal developmental process every single day, and has done so since he was around ten months of age. In fact, I'd venture to say that most intact boys will enjoy the fun of making penis balloons at some point or another during their childhood, whether his parents realize it or not. Honestly, though, I don’t know whether to laugh or cry because these types of statements from medical doctors are not only ridiculously false, but they speak to a serious delinquency in the basic understanding of the intact penis. This is a topic I revisit time and time again with parents and it seems that, despite all the information now available, parents are still being fear-mongered into unnecessary, harmful treatments and/or prepuce amputations on the grounds of one of the most normal, natural phases of the development of the intact child: ballooning.

What is Ballooning?

Ballooning occurs when the foreskin begins to separate or has separated from the glans (head) of the penis but the foreskin opening remains narrow. As a boy urinates the urine will fill the empty space between the foreskin and glans, and create a ballooning effect. As the urine escapes through the narrow opening the balloon will slowly decrease in size (deflate) and the foreskin will return to its normal state.


ballooning penis of a two year old male child


What Parents Need to Know

1. As discussed in Basic Care of the Intact Child, the foreskin is fused to the head of the penis at birth by a thin membrane known as synechia. At some point this natural adhesion will begin to release, allowing the foreskin to differentiate from the glans. This can happen at any age, but is quite common in toddlers and in early childhood. Keep in mind that just because the foreskin has separated from the glans, it is not an indication that the foreskin can be retracted. In order for retraction to take place a second process must occur, a widening of the foreskin opening.

The opening of the foreskin generally remains very tight and non-elastic during infancy and early childhood. This serves to protect the developing penis from feces, bacteria, viruses, and harmful pathogens. Essentially, the opening acts as a sphincter and only relaxes to allow urine to pass. With the release of hormones, predominantly during puberty, the tissues of the foreskin will become more elastic and the opening will widen. Naturally, when the foreskin opening widens in later childhood, ballooning that may have once occurred no longer happens as the urine stream is unobstructed by the once narrower opening. As noted in The Phony Phimosis Diagnosis, retraction of the foreskin is a sexual function and usually occurs after the age of ten. Full retraction of the foreskin may only take place at the end of puberty -- this is normal. Ballooning may occur for many years during toddler/childhood until a boy has the hormones of puberty kick in.

2. Ballooning actually serves a few important purposes in the development of the intact penis. The body, in fact,  knows exactly what it is doing! First, because separation of the foreskin often occurs many years before the opening widens, ballooning serves to rinse out any expired skin cells from underneath the foreskin. It’s nature’s perfect way of keeping things tidy and ridding the body of old skin cells. Second, this process serves to maintain a differentiation between the glans and foreskin during the years in which a boy remains non-retractable. Ballooning serves to gently, and over time, stretch the two organs into their own separate space, discouraging a re-adhesion of the foreskin to the glans (re-adhesion is something we commonly see in boys who have had their foreskin amputated via circumcision surgery - the body attempts to heal itself with the tissues it has left, and there is no natural ballooning process that can take place, because no foreskin any longer exists). Third, ballooning aids in helping the entire foreskin separate from the glans over a normal duration of years. Typically only a small portion of the foreskin will separate from the glans at a time, and the pressure of the urine will slowly release other areas of the foreskin, little by little. Of course, just as every girl experiences a unique separation of her prepuce ("clitoral hood") from the glans of her clitoris, every boy experiences separation unique to his foreskin and the glans of his penis. It may happen all at once, almost overnight, or over many years - all variations are normal. Nature makes very few mistakes, and this ballooning phase, when it occurs, is not only normal, but beneficial to the overall development of the intact child.

In this ballooning child, you can see that the prepuce (foreskin) has separated on one side from the glans where ballooning is taking place, while still remaining tightly adhered on the other side. This is normal, as the prepuce typically takes several weeks, months or even years to separate completely.


3. Ballooning will not cause infection, in fact, it is quite the opposite. As mentioned above, urine serves to wash out dead skin cells. Urine is sterile, and a narrow foreskin opening prevents fecal bacteria, a primary cause of urinary tract infections (UTIs), from entering the urethral opening, while urine flushes out anything that potentially enters or meets the tip of the penis. Urine does not linger or fester under the foreskin - it exits, and takes with it the body's natural waste cells and any other irritants that have come into contact with the penis. For more about the ways that the foreskin serves to protect against UTIs, see this article.

4. At onset, ballooning may be accompanied by discomfort, itching, redness and/or swelling. Often, a boy’s foreskin will separate from the glans with few or no symptoms. However, in other cases a boy will experiences one or more of these symptoms at the onset of separation. Swelling and redness are common because the foreskin is very vascular and, like the lips of the mouth when stretched or irritated, it tends to react to small traumas in this way. Some boys will experience discomfort as urine stings the freshly separated glans that is now exposed for the very first time in this child's life. This discomfort may be acute (like a quick sting) or more pronounced, depending on the situation, and is commonly mistaken for a UTI because the pain only occurs when the boy is urinating, and almost always when a child is very young and the glans has separated for the first time. The good news is that the freshly separated glans smooths over within a few days and the stinging with urination will cease. Sometimes parents can ask their son to urinate in a bucket or bathtub of water as a way to ease this temporary discomfort; however, this will not work for a many boys as the foreskin opening is simply too small to allow the water to dilute the urine prior to contact with the glans. [Note that the intense pain and stinging that would occur if the foreskin is torn and cut from the glans in infancy due to circumcision is much more intense than this natural, gentle separation of the two organs with normal development.]


After ballooning, the penis returns to its previous state.


Premature separation caused by forced retraction or manipulation of the foreskin by a care provider can make for a very painful separation experience later. After forced retraction occurs (especially if it has been a repeated event) the foreskin typically re-adheres to the glans in an effort to heal itself. Tiny tears and areas of scar tissue are left from forced retraction, that are then torn and cause an increase in pain when natural separation occurs months to years later. This is one of the many reasons that no one should ever manipulate, "mess with," or retract an intact baby or child.

Foreign microbodies on the hands of well-meaning care providers can change the pH of the genitals when introduced into the penis during forcible retraction. This change in pH may increase the likelihood of yeast spore overgrowth. Yeast infection has been known to instigate premature and painful separation episodes, so parents should be watchful for any symptoms that could indicate a yeast infection (creamy discharge, itchiness, bright red spots around the groin or anus). As with girls, yeast infection is most common during the diaper wearing years, or after exposure to chlorinated swimming pools or other harsh chemicals that interfere with the body's natural pH. Yeast (naturally present on all human beings) is only problematic when it gets out of hand and is easily treated with acidophilus and other medications. Check out Basic Care of the Intact Child for more about yeast. Symptoms of normal separation can come and go throughout childhood, as the foreskin continues to differentiate itself from the glans. These symptoms resolve themselves, are not cause for concern or doctor's visits, and do not require special medical attention. For more about this subject in particular, please refer also to Painful Urination During Prepuce Separation.

In Closing

Hopefully, as circumcision rates in the U.S. continue to plummet, information on the normal penis and its natural development will become as commonplace as it is in the rest of the intact world. For now, we can be thankful that there are research based locations like peaceful parenting, where physicians, educators, and parents can come together with experiences and informed insight. I can remember how worried and uncertain I felt when my first son started to balloon. At the time I knew little about this normal phase of development. Thankfully, I had a fantastic network of well-educated mothers and professionals to help me decipher what was happening, and can now share this important information with others. Don't be afraid to speak up as well, you may be the only one who ever does in your circle of influence.

79 comments:

  1. Good to know. Thanks again for sharing your wealth of knowledge and wisdom! ♥

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  2. wow, I didn't know that. Going to show this my husband latter, he is pretty convinced that somthing is wrong.

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  3. thanks for posting this. I often wondered if there was something wrong with my two sons who have ballooning when they urinate...good to know it is totally normal and okay.

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  4. Glad to know my instincts were correct, my son is 7 months old and this started happening a little last month...I figured it was ok!

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  5. Awesome. Thanks for sharing - If I hadn't read this and saw my son's penis like that I totally would have freaked out hahaha. Now I know not to worry ♥

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  6. I don't have a son yet, but I might in September (it's a surprise), and I've never heard of this. Thanks for helping me be better prepared!

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  7. My boys are now 17 and 14 and I remember when theirs did this. I just shrugged it off as normal. I had actually never seen an intact penis before so I just figured it was all normal. LOL

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  8. I took my first intact boy to the urologist for ballooning. Under a year old, ped referred me. The urologist said that he needed to be circumcised for it. I assumed it was normal and decided to trust his body! My sons ballooned the entire length, not just the tip like in those pics.

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  9. Glad to know! Would have really been freaked out if this happene to us but now I know.

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  10. I saw this often with my oldest. I thought it was totally normal, although I didn't know there was an actual term for it.

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  11. My 7 yr old does this on purpose. He squeezes off the tip of his foreskin and makes it balloon up purposely while peeing. My husband said he did that too as a kid.

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  12. Wow great info, I've heard of this being "normal" but wasn't completely sure why until this post.

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  13. My 5 year old retracts his foreskin regularly, is this something that should be discouraged? It also retracts on its own at times... usually when he is in his carseat (and he complains about the crotch strap hurting him when this happens).

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  14. Anonymous, Your son may retract his foreskin if he feels like it. The rule is that only the boy himself can manipulate his foreskin. If the foreskin retracts by itself and the glans (head of penis) is exposed and rubbing against clothing it can be a bit uncomfortable for intact boys and men. This is why they might reach down and adjust their foreskin to its forward position. The glans remain very sensitive since they are used to being protected by the foreskin (which is a primary function of the prepuce) and they are only designed to be exposed during times of self manipulation or sexual arousal. Just allow him to readjust himself as necessary. ;)

    Christie, The picture above shows a partially separated foreskin so the ballooning is localized to the areas that have separated from the glans. The balloon may be larger or smaller depending on the age of the boy and the amount of foreskin that has separated from the glans. All variations are normal.

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  15. I would think that if he does it himself, he'll stop if it hurts. That's my $0.02, though it may not be worth much, since I don't have any sons. My one other thought is, good luck making your son leave his penis alone - parents have been trying that for centuries without success!

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  16. EXCELLENT article Jen!!!!! I"ll be reposting on Informed Parenting- this information is so important for parents- especially since so many parents with intact boys do NOT have experienced parents to turn to for this kind of advice.

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  17. what a great article and glad to see pictures so i know what this looks like and that it is normal. With a cut dad and me being a gal, I have to learn a lot of info to do right by my son!

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  18. The way I figure, if a body part isn't in pain, there's probably nothing wrong with it.

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  19. My husband was the one who noticed ballooning in our son. We never go to the doctor, but he insisted we did for that (hubby is cut). We are lucky, I guess because the doc told us it was due to an egg allergy (??) and didn't try to retract him. It went away on its own, of course.

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  20. our son likes to wrap his around a straw and make it balloon up...

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  21. I didn't notice it with my son until he was potty trained. In diapers you don't see them ballooning! I wonder how many boys actually have this happening, but their parents have no idea because they are still in diapers?

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  22. There are no cut boys among my circle of friends, acquaintances, and mothering sisters, so I didn't even know this wasn't given knowledge!!
    We've lost so much of the common knowledge about the normal human body in just a few generations of mutilation. :/ Good info to pass around!

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  23. Great article! I recently went through an experience with this and ds2. We ran into a urologist who was also warning us about damage & later surgery to "correct" it, fortunately I knew enough after hearing this advice to question everything else he said, along with his urgency. We decided to wait until we could see ds2's regular ped who was educated in India and the US both, so is familiar with intact penises. Of course, she agreed he's in the range of normal

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  24. Ballooning is also helpful to the potty training mom... it gives you a warning before the urine starts to flow so you (I) can make sure the urine is flowing in the right direction. ;-) I don't know if other little boys are as fascinated with their genitals as mine are (though I suspect they are) and it's nice to have a warning before the pee shoots across the room.

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  25. Our son had ballooning as an infant, probably for about a year. As someone inexperienced with the intact penis, his was the first intact penis I had seen in person, I was a little concerned and mentioned it to our pediatrician. She got all alarmed and told me he needed to be circumcised immediately and had me in tears over it. She told me that I shouldn't be upset, that circumcision was normal (gah!!!) and we got into a heated discussion over why I was so opposed to it. She is old school, very uninformed and admitted she had her own son circumcised and recommended it for all boys.

    (We no longer see this pediatrician with our son, due to her willful ignorance and refusal to learn and also the fact that she attempted to retract my son's foreskin - thankfully I stopped her and she did not retract, but she attempted it, which could have caused lifelong damage! I think about it and pray she did no damage, but I will NEVER see her again. Parents, if you have intact sons, do NOT allow anyone to retract them EVER, it can cause major damage and PAIN. If any local parents want the name of this dr to avoid for her ignorance and attempted retraction, email me and I will gladly give it, I do not want anyone to subject their boys to this woman!)

    She gave me a referral for a urologist and I went home and cried and was so upset, not wanting him circumcised. Thankfully, I did my own research and found out that ballooning is a NORMAL process that boys with intact penises go through as the foreskin gradually separates from the glans as it is meant to, slowly on its own over time. I made sure to let his pediatricians know that it is normal. I shudder to think how many other boys they have referred for circumcisions over this normal process. :(

    Thankfully my son is still intact and whole. Parents, do your research! And NEVER, EVER allow your sons to be retracted.

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  26. My little man is a ballooner - the first time i ever saw I was worried but my husband (being a brit) said its normal. I slowly noticed women online saying their boys were circumcised because of it :(

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  27. I am so glad that I read this NOW. I am finding out soon what we're having, and if it's a boy, we'll be leaving him intact. I would've freaked out over seeing his penis balloon, had I not read this now and known it's normal. THANK YOU, THANK YOU, THANK YOU!

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  28. I cringe to report what a pediatric urologist said at a presentation on circumcision at our hospital a few years ago. A pediatrician asked ballooning in a 9 month old. The urologist said [mind you, this is information is NOT correct] that he would get infections from the urine pooling under there - referring to the space under the foreskin as a "cesspool". He told the large group of pediatricians attending the presentation that they should tell the parents to push back on the boy's foreskin with every diaper change "till its tight and shiny, and eventually it just pops out." And I'm sure they all believed him, since heck he's a pediatric urologist and is the expert, right? (not) This doctor also said he had three boys, one circumcised that went fine, one circumcised that had complications, and one with hypospadias, so he claimed that he had "experience with all of it" - of course, he had no personal experience with raising a son with an intact penis. SHEESH! Be on your guard for doctors, including urologists who are misinformed about the normal variations of the intact penis. A must-read article for all parents of intact boys is "Protect Your Uncircumcised Son" - which gives all the reasons why a doctor might sometime say a boy "needs" to be circumcised - and what you need to know to realize that this is almost NEVER true. http://www.mothering.com/health/protect-your-uncircumcised-son-expert-medical-advice-for-parents

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  29. Thank you for this post. I will have my first intact son in august. My older boys were circ'd at the request of their father and being ignorant to the process or the long term affects I went along with it. I have told him that we will not be doing that to this boy so it is really good to have this information for the future conversations I have with him when this process occurs. He too is circ'd so I imagine it would indicate some problem if he saw it. I definitely need to arm myself if I have to fight for this boy.

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  30. I remember my sons first pediatrician telling me a story because I told him not to retract. He told me I had to retract it because otherwise I would end up having to circumcise him like this other patient that he had. The little boys father was concerned because they were having to "milk" the urine out of the little boy's penis. The father apparently was VERY anti-circ, but the doctor insisted the boy needed to be circumcised because of this. Obviously- I found a new doctor! Thank you for the great article- I have not experienced ballooning yet (he's 18 months old) but it is great to have the information on hand- in case my circumcised hubby gets upset if it happens and wants to take him to the doc!

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  31. I'm so happy of all the great information I'm collecting about intact boys! My son is the first intact boy in both my husband and my own family. I hope he is the first of many more to come! ♥

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  32. I had no idea this had a name until I got online lol. One of my brothers (the only one who began retraction earlier than average at around 4 years) had this. He thought it was theeee coolest thing ever and would go "pew pew pew!" while peeing into the toilet (to simulate a gun).

    Ah, boys.

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  33. My husband said he remembers it as being so cool, you could make it shoot really far if you tried.

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  34. Thanks for the article. I've heard about ballooning before but wasn't exactly sure what it was about. It hasn't happened to my one year old yet, but it's nice to be informed so I know what to expect in the future.

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  35. Thanks for this aritcle, and the one about basic care for the intact child. As I type this, I am wearing my intact 2 1/2 week old son, but this was a foreign world to me just 4 years ago, before I married my (also intact) husband, who was appalled to hear that all 5 of my brothers, plus 4 out of my 5 nephews (one of my brothers quit, and didn't circumcise his second son. It was normal to me, I thought all men were circumcised (I had a lot to learn), and now I find articles like this very helpful!! Thank you for posting, it's so good to get informed ahead of time, before dealing with doctors, etc.

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  36. Thanks so much for this info! It is amazing what we don't know that we don't know. I stumbled upon this particular article when I saw a link on the side. Not sure if we're having a boy yet, but I can see that if so ~ I have a LOT of learning to do!

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  37. I did not know this! I have an intact 7 year old and I have never seen this happen with him. Very interesting article! Thanks for enlightening me.

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  38. Never knew about this but I'm glad I do. My son is only 8 months so when it doesn't happen at least I'll know what's going on.

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  39. Thanks for this article, I am glad I did not take the Dr advice when my son are between 18mon and 2yr of age and this happened. They told me it was an infection and that I need to schedule a circumsision Immediately! I called my urologist who seen him the very next day for me as a favor when I had an appt anyways, since it did not sound right to me, and he told me there was nothing to worry about, so I am glad I listened to him. Now I know for when my baby has it happen to him too. I go tmad at the Dr the other day again when she said I MUST retract my four year's to clean it! Um no!

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  40. Thank you for this! I have three boys and my youngest will be one in a month. this is the first time with an intact child, and I found this EXTREMELY helpful!

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  41. As the first time mother of an intact son ( i have 3) I am SO grateful for this article! I had no idea about this and would more than likely have become concerned having never seen it before. This is the type of information we need, so that we can again begin to pass these pieces of knowledge down to our daughters as more and more of them choose peace for parenting! p.s. I cited two of your articles here http://thegreentraveler.blogspot.com/2011/06/circusicion-and-fun-with-foreskin.html

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  42. Thank you, thank you, thank you for this post! My 19 month old son is having his first ballooning today. After getting nowhere with the pediatric nurse, I called a friend who also has an intact boy and she knew exactly what was happening before I could completely describe it. I'm going to print this article and take to my peds office and ask that they inform all the parents of intact sons of this normal occurrence. Would save them lots of phone calls I'm sure.

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  43. my son recently had to go on an anti biotic because his intact penis became inflamed and hurt him my doctor said it was some kind of infection in the skin of the foreskin and that the anti n=biotic was the only thing to clear it….any experience with this? I was very weary to put him in the medicine but it cleared it up quickly and then I stopped giving it him and he has been fine every since. I love to hear from other moms as far as this goes…

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  44. My son is 10 and has been ballooning for several years. The foreskin opening is still tiny how long does this process usually take? I am starting to worry that he will never be able to retract and that it could cause isssues.

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    1. The article said that it changes with coming of age hormones. Your son is still 10, and on the young side for puberty. I wouldn't worry.

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  45. I'm glad I stumbled upon this!! My son is intact, however his Father is still very vocal about getting him circumcised and something like this would only help his side. Thankfully now that I know about it, I can inform him of something that just might occur in our son!! Thank you!!

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  46. My 9 year-old son is ballooning and has pain on urination. It is so bad that he doesn't' want to go. He has no signs of infection, but his grandmother tried to retract the foreskin when he was with her, not knowing that's not good to do. He was okay for a few weeks after that and is bad again for two days now. Do I need to worry about damage? What am I looking for? If it's just normal separation, how long will this particular episode last? I've tried having him urinate in the bath, but the opening is too tight to let the water in to dilute the urine. I'm going to try to get him to drink more, but he's really frightened of going potty. Thank you.

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    1. He was able to empty his bladder fully today. Thank you so much for this article. We'd have gone to the emergency room if I hadn't read this.

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  47. glad to know that ballooning is normal but can any one tell me that he/she have seen or know someone whose child with ballooning and enacted foreskin is able to retract it now or after few years .I have a 4 yr old son who started ballooning recently his urologist is saying that its too late for him as ballooning should not happen this late n its time to have him circumcised.

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  48. Does it goes away? I think my child is experiencing now. I was freakin out!

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  49. I'm so glad I read this, it's been happening to my son! Thanks for sharing!

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  50. This is more of a puestion and I pray someone responds to it, my son is 37 mths and the hole on his penis seems small I brought him from the dr today and he told me I needed a urologist the skin doesn't retract at all you can barely see the tip of his penis should I be concerned, all this came from me taking him to the emergency room cause he said his weinie hurt, they gave me antibiotics and told me to rub yeast infection medicine on him. I think he is better now but I am still worried the dr today said to rub corisone cream on him and work with retracting him but don't do it hard or cause him pain HELP!!! please thank you and God bless you can respond to susan.snelgrove@att.net

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  51. my son is 10 years old and today he screamed from the bathroom and I went to check I saw his foreskin is retracted. he says it hurts and helped him to put it back. he still says it hurts. Any idea why the foreskin retraction hurts?? Im a single mother.

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    1. You might be interested in this article too on painful urination during prepuce separation: http://www.drmomma.org/2010/01/painful-urination-during-prepuce.html

      There can be acute pain when two organs are tearing apart from one another (in this case the prepuce and the glans). However, doing it little by little, over the course of many months or years, when a boy is able to understand what is taking place (or at least have something done to relieve it) is much better than the horrific pain of having the two organs surgically separated (too often without anesthesia and always when a baby will be urinating on the open amputation site) in infancy as happens with circumcision.

      This pain actually does NOT happen to most boys, but it does for some during this stage of development, and it will not last forever... He can pee into water if it hurts during this time and that will help it feel better. :)

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  52. I have a question regarding an event that happened some time ago. One day, when I was a little girl, my mom took me and my little brother to our ped, and I remember that day as one of the most terrifying days of my life, and hated the doctor afterwards for hurting my brother, ha. Anyways, I remember her holding my brother down while she did something on his penis, she said she was making sure the glans was clean or something, but my brother, who was about 5 at the time, thrashed and screamed and cried a lot, and I was crying by the time it was over. Is there any chance that she might have caused permanent damage to my brother? I fear that she might have forcefully retracted his foreskin, and I think this would be important information for me, if I ever have a son. Thank you.

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    1. This happened to my brother when I was little, though I wasn't in the room, and apparently, my mom did NOT consent. All I remember is that it hurt my brother very much, for a long time, and my mom was pissed about it. It was a really scary time for me, too. I don't think my brother has permanent damage, but I know some boys who are forcibly retracted do.
      If you ever have a son, you have every right to tell a doctor to leave his penis alone. You don't even have to remove his diaper during a check up if you don't want to. Just remember, YOU are the client. You can deny anything.

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  53. I've been online ALL DAY trying to find similar symptoms to my 11 month old's issue and this seems to be as close to it as I can get. He's intact, and this afternoon when I changed his diaper I noticed that his penis seemed to be swollen and a bit "ballooned" but it's near the base NOT the tip. It feel pretty firm and noticeable to the touch, but it doesn't seem to hurt him when I press on it. It looks a lot like the pictures above except at the OTHER END of his penis. His skin isn't red or irritated and he's had wet diapers today, so I'm just wondering if it something I should be concerned about.

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  54. Today my 2 year old was grabbing his crotch and complaining so I took the diaper off and saw his penis inflated for the very first time. Right away he peed and the skin went back to normal. If I hadn't seen this very informative article I would have worried myself sick, now I know this event is part of his development. Thanks so much!

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  55. We were about to fix up an appointment with a surgeon for circ. Again for the same reasons. Thanks a ton for posting this article. Now I want to leave my kid on his own to deal with this over years to come.

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    1. I'm with you on that. We were advised circumcision today and I rejected, I just somehow knew it's wrong. After looking it up on the internet I found this and many other articles - I feel so much more confident now.

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  56. One way to help prevent the stinging is to ensure your little boy's urine is fairly dilute, by promoting his fluid intake. Dilute urine stings less than concentrated urine.

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  57. Thanks a ton for this post. but i want to know what do i do when my seven year old son howls in pain.

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  58. I just came across this post/site. I cannot tell you how grateful I am to find this. My son’s penis started this today. I left a message for the on-call doctor who replied back telling us to take him to the doctor tomorrow - that’s it. I was confident in all of my intact penis research and had never come across this until now.
    Thank you so much!

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  59. I'm so happy I found this post. I'm originally from Europe and we moved to the US recently, with a newborn son. We went to the urology with my now 2 year old son, because the pediatrician was not able to tell me whether it is normal that his foreskin is still attached. The urologist first said it should only retract around 6years of age, but then when he took a look he said it's very tight and recommended circumcision. I was SHOCKED! It's uncommon to do that in Europe, unless the family is Jewish. Then he said ballooning is abnormal, again I was shocked.. I didn't have background knowledge to argue so I didn't say anything but I knew I will not follow this doctor's advice. Just to make sure I'm right, I looked up opinions on the internet and came across this article. I was happy to read all the reasoning.. I find it very surprising that doctors in the US are advising circumcision to many parents. I'm not sure whether it's because they don't have the knowledge on this, or because they are circumcised them selves..

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  60. Thank you for your article. I had my son in for a routine check and the NP asked if he was circumcised or not. I said not, so she asked to look. Then she asked if there was ballooning when he urinates. I said yes. She said he must have Steroids immediately and if that didn't work in 6 weeks he must go to a specialist for circumcision. He is five years old!!! I was so shocked and upset and started to doubt myself. This article has made me realize I should trust my instincts and I will let nature take it's course! Thank you.

    ReplyDelete
  61. My boy is 4 months old, and was ballooning for a while. His foreskin seems looser now. It looks like the last picture on the blog. He's never been retracted, to my knowledge. This seems way too early to me :/ He's my very first little one so I'm still learning, but should I be worried? Could someone have retracted him while I was away? DH and I know NOT to retract him for any reason. We went to a dr, and the doctor started to push down at the base of his penis and I stopped him immediately. He said he was "just checking to see if it was too tight" but I said no way, and we no longer see him. Could that have been enough to retract him? I'm freaking out a little now. I knew ballooning was normal, but the opening widening at 4 months? It also doesn't balloon every time any more. We practice EC, so when he pees I look to see if it's ballooning. Please someone reply. I'm freaking out now.

    ReplyDelete
    Replies
    1. Anon - while it is possible he was retracted by someone, it may just be that your son is beginning to retract (separation of the prepuce from the glans) early. The average age of retraction is 10 1/2 years -- but many boys retract later and many retract sooner, and all are on a continuum of normal. As long as you don't force things, and use some TLC (i.e. leave it alone - warm water soaks, no soap, Calmoseptine if there is irritation/redness at some point) things will be fine. :)

      Feel free to email if you have further questions. DrMomma.org@gmail.com

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  62. This was very helpful. Thank you for publishing it.

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  63. Thank you so much for your post!!!
    I have recently changed pediatricians because the first one urged us to get my 2 month (at the time) circumcised...and pulled his skin back to see his tiny opening!!!! My new pediatricians did the same thing to see it and just check him out during his 4 month physical...and noted that the opening was tiny and that we might consider a circumcision...

    I'm glad I found your site!!!! I will go with my first instinct and not cut my son. He is 5 months now and I have seen him balloon once...is this too soon? Have the two previous pull-backs affected him in any way???

    Thank you!!!

    ReplyDelete
    Replies
    1. At 5 months of age, your son's body will likely heal itself just fine and the initial retraction will not cause lasting issues. Usually these occur when there is repeated retraction (causing many tears and readhesions to develop).

      As far as when ballooning occurs - it is most common between the ages of 2-5, but can occur at any time. All babies are different and develop at different rates. It may be that your son has started the process of prepuce separation early, but several years may pass before the prepuce itself opens up to retract naturally.

      There is an "Intact Care" tab at the top of this website (DrMomma.org) with links to further information on related topics.

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  64. Hi, is it normal for a 5 month old to get this ballooning over the entire length of his penis not just the end? I have seen him wee before and it hasnt happened. But today he weed twice when i was changing his nappy and it happened both times. He has been unwell and is on antibiotics. Is that anything to do with it? Thanks JoJo

    ReplyDelete
    Replies
    1. This just means that the prepuce has likely separated from the shaft/glans at the base of the foreskin vs. the tip/front. It can happen in the early babyhood months because it normally takes a longer amount of time for the actual prepuce opening to widen and loosen. As long as urine is escaping, this is okay. The ballooning will gently stretch tissues and the (sterile) urine will rinse the inside out when he pees.

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  65. Hi,is it normal for 3.5 years old to get this ballooning over the entire lenght of his penis not just the end?The doctor told me to use a cream betamethasone dipropionate.What do you think about it?Thank you

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    Replies
    1. This can also be normal - it merely means that the prepuce is loosened over the length of the shaft, but still closed at the tip (which is sometimes the last place to open). At 3.5 years, your son is still very young. The average age of retraction is 10.5 years. You may be interested in this article on Extreme Ballooning also: http://www.savingsons.org/2014/03/extreme-ballooning-in-intact-child.html

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  66. Hi, I am so thankful for this article. My son who will be 5 next month has been complaining about itching as well as some pain on the tip of his penis. I took him to the doctor who checked it and told his foreskin is very tight and he needs a circumcision. I was very shocked as i never imagined this could be the case. However I was not ready to do this. Then I took him to another doctor for second opinion, who examined him and was ready to prescribe him only medicine for the itching. When I told that my pediatrician told he needs circumcision, she again checked him and said, ya that might be required if he is ballooning and referred me to a urologist. I was still hesitant and continued my search on the net and found this article put my mind at ease. How many wrong diagnosis could have been there by doctors? I would appreciate if you can inform when exactly is a circumcision required? My son is only complaining about itching and little pain. There is ballooning in the middle of the penis. He handles his private part very rough and tough(while removing from the pant and putting it back while going urine) I thought this might be the reason for irritation. Please advice when to be concerned for circumcision? Thankyou and once again we appreciate this article that helped many families out there.

    ReplyDelete
    Replies
    1. You may wish to review some more of the articles at the intact care page - http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html A bit of irritation and itching can be normal during this stage in prepuce separation (most common between 3-6 years of age). The best thing to get is Calmoseptine at a local pharmacy near you and put this around the outside of the penis/foreskin. Be sure no one is retracting your son (other than himself if he does so) or messing with his foreskin. It is normal for it to be 'tight' at this point. The Calmoseptine will soothe and heal irritation without interfering with normal pH and healthy microflora of the genitals.

      If there is still itching, there may also be yeast overgrowth. In this case, you would apply Lotrimin (pick this up at any store in the fungal section of the pharmacy) to the outside of the penis/foreskin (again do not retract) and then put Calmoseptine over the Lotrimin. These two together will take care of yeast overgrowth and the redness/irritation.

      Please feel free to email DrMomma.org@gmail.com if you have further questions.

      (To respond to your question as well - there is virtually never a reason for circumcision. Even in cases of true phimosis - when urine cannot exit - a slit can be made in the prepuce to widen things - amputation is not necessary.)

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  67. Thankyou so much for the detailed explanation. I am definitely at ease now. The doctor did prescribe Candid B and Neosporin to be applied. I am in India, so the names of the cream may be different. Thankyou so much.

    ReplyDelete
  68. Candid B is a cream for yeast overgrowth (would be similar to the Lotrimin that you may be able to purchase over the counter in India as well). But Neosporin is a topical antibiotic that shouldn't be used on the genitals -- it would only serve to increase yeast overgrowth and the issue is not likely to be a bacterial issue on the surface of the skin. If it IS bacterial (i.e. staph, strep) then it needs oral antibiotics to treat. More likely this is simple irritation from being manipulated and handled roughly - or from the beginning stages of prepuce separation. You should be able to obtain Calmoseptine in India - it is a worldwide dispersed cream for skin irritations exactly as those you describe. If you cannot find it local to you, we would be happy to send to you. Email DrMomma.org@gmail.com for further assistance.

    ReplyDelete

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