Penis Surgery for my 6 mo old ds! Anyone familiar w/ webbed or concealed penis? - Sybermoms Parenting Forum
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post #1 of 21 (permalink) Old 03-20-2003, 08:43 AM Thread Starter
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Penis Surgery for my 6 mo old ds! Anyone familiar w/ webbed or concealed penis?

This is stemming from the UTI he was diagnosed with last month. My son saw a Pediatric Urologist and was told that he will need surgery for his penis, ASAP. It appears that he has a web or concealed penis. This means that the penis is webbed to the scrotum. My son will have to get the skin de-tached and also be circ'd so that the foreskin can be used for the base of the penis. I am very upset; I am so against circumcision and just want to make sure that this surgery is absolutely necessary. The surgery is already set up for 4/11; my son will go under general anesthesia for the hour long procedure. If my son does not have this surgery, I was told that he would then be unable to have "normal" erections. Does anyone know anything about this condition??
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post #2 of 21 (permalink) Old 03-20-2003, 08:50 AM
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Ask Nursing Chick she is or was an urology nurse. Sorry about your son.
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post #3 of 21 (permalink) Old 03-20-2003, 12:45 PM
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No experience with that here. Just wanted to wish you luck.
post #4 of 21 (permalink) Old 03-20-2003, 01:47 PM
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I would second the suggestion to ask nursingchick. I'm sorry he's having to go through such trauma. I recently had to take my 2 yo ds to the emergency room for penile issues. Luckily he didn't have to go through surgery or be circumsized. I feel for you and I hope you get some answers. I would get a second opinion before going through with surgery though!! Best of luck to you!
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post #5 of 21 (permalink) Old 03-20-2003, 01:48 PM
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I thought this was discussed on the ME recently... Click here to enlarge You could do a search.

Anyway, what I was going to suggest is getting a second (and perhaps third) opinion. Also, get as much information about the condition and the corrective surgery as you possibly can.

Why does it need to be done ASAP? Having erections that aren't 'normal' is hardly a concern at 6 months old! (Not a jab at you, I'm just a bit surprised by the doctor's thinking...).

Perhaps the operation could be rescheduled so you have more time to research/decide?

Another thought, er, question - is the UTI related? Or recurring? Just thinking if there was a connection then the doctor may want the surgery done ASAP because of the UTI...

Take care.
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post #6 of 21 (permalink) Old 03-20-2003, 03:18 PM
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I don't know much about this, but my understanding is that 6 months is the standard age for this surgery. It is a good thing you didn't have him circed as a newborn because that can make the repair much harder! I'd also get another opinion.
post #7 of 21 (permalink) Old 03-20-2003, 03:37 PM
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There were some links posted in the ME thread that might be helpful to you. It really sounds as if surgery would be helpful, but circumcision would make things worse. I'd get more opnions if I were you.

My son had a big surgery to his penis when he was 14 months old. If I can be of any help, let me know. Sometimes hearing how other kids make out it is helpful.
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post #8 of 21 (permalink) Old 03-20-2003, 03:43 PM
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I googled my ass off and didn't find the reason for the circ but that is the standard treatment. I couldnt even find a site that said this is NOT the right thing to do. Sorry did you pm nursingchick?
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post #9 of 21 (permalink) Old 03-20-2003, 04:11 PM
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Are they doing a circ so they can use the skin to graft to the bottom of his penis when they take away the webbing? Also, is he having this done because it causes UTIs, or it will cause serious sexual dysfunction, or mainly cosmetic?

I'm sorry your son has to go through this. I would suggest a second opinion, and have the person thoroughly explain why everything has to be done.
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post #10 of 21 (permalink) Old 03-20-2003, 06:11 PM Thread Starter
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Yes, I did PM Nursingchick and am anxiously awaiting her reply.

The reason the Urologist wanted to do the procedure "ASAP" is because the recovery would be easier on a baby who is not yet crawling or walking. I do think I am canceling the procedure for now until I can gather more information.

The foreskin will be used to help reconstruct the shaft of the penis. I am having a really hard time picturing it though; I also did several searches on Google and found very vague information. If my son does not have this procedure, he will be unable to have normal erections. Also, it would be difficult to urinate standing up.

kwl; you are so right. I am so fortunate we did not try to have him circ'd at birth. What a nightmare that would have been!

Thank you for all of your replies. I have an appt. with another Pediatric Urologist at Hershey Medical Center next week. I will keep you all posted!
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post #11 of 21 (permalink) Old 03-20-2003, 07:39 PM
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Please do! I am glad you have a second opinion already set up, andhope you can get some completer answers. It's good you want to wait to find out more about the procedure before surgery, it does sound complex.
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post #12 of 21 (permalink) Old 03-20-2003, 09:51 PM
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Why would he have difficulty urinating standing up?

I only found a few (like 3) links about webbed penis, but they all said circumcision makes the condition worse. They all 3 also said circumcision is the biggest cause of the problem to begin with.
Will your insurance pay for more opinions? Was it a pediatric urologist you saw or a regular urologist?
When my son was diagnosed with hypospadias and chordee, we went to different doctors at other clinics. It really made me feel more confident in making a decision to have more than 1 doctor come to the same conclusion.

I know it's scary to think about your baby having surgery. But you will make the right decision. A month won't make that much difference as far as your son is concerned, but it can give you a lot of time to look at options.

Good luck.
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post #13 of 21 (permalink) Old 03-20-2003, 10:12 PM
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You might already know this site, but if not, it has some discussion about penis problems, and a lot of links to other sites that might be helpful.

Warning- it is mostly about adult penises- not in a perverted way, but not in a quiet way either. There are some pictures as well.
But it is a good site.

http://www.geocities.com/HotSprings/5571/problems.html
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post #14 of 21 (permalink) Old 03-21-2003, 12:39 PM
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His penis is attached to his testicles in such a way that he won't be able to have a normal erection and you're considering not having surgery to correct it? Haven't you seen him have an erection? Try leaving him diaperless with a towel and waterproof pad under him at night and seeing his nocturnal erections--my ds woke up with one as an infant, as I often discovered changing his morning diapers. If he can't have a normal erection, get the surgery done while he's a baby. Circumcision sounds like the least of his worries.
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post #15 of 21 (permalink) Old 03-21-2003, 02:15 PM
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Actually, Sour, I disagree with you. Circumcision might be the biggest of his worries if the information I have been reading is correct. You think she should just run off and have the first surgeon she can find perform surgeyr on her child's penis?
She's looking at all her options. That's the smart thing to do.
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post #16 of 21 (permalink) Old 03-21-2003, 05:02 PM
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Click here to enlarge with MHM
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post #17 of 21 (permalink) Old 03-21-2003, 06:22 PM
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I have nothing to add, just wanted to wish you luck. Sorry that your DS has to go through this Click here to enlarge

I'm doing it because she asked but I really do her.
FMT
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post #18 of 21 (permalink) Old 03-22-2003, 01:40 PM
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I think there is some confusion regarding circumcision here...from what I've read NEWBORN circumcision is contraindicated for babies with webbed penis because then there wouldn't be any foreskin left for the repair later. I'm not sure that what they do during repair is technically circumcision or not, but it does use the foreskin to repair the penis after separating it from the testicles.

Hence, it is a damn good thing that Phishgal doesn't believe in neonatal circumcision!

I've got two uncircumcized boys, I fought long and hard with their respective daddies to keep them that way. I totally understand Phishgal's reluctance to have her son circumcized now. But, I don't think either she or anyone here is suggesting her son not have the surgery, but given the very senstive nature of this particular body part, caution and second opinions are well advised!
post #19 of 21 (permalink) Old 03-22-2003, 08:01 PM
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The links I posted on the ME said circumcision a spart of corrective surgery led to another set of problems and advised against it.
It's possible those sites simply had anti-circumcision leanings to begin with.

Phish- is th eopening on your son's penis in the correct place? At the end of his penis?
I'm seeing in some links that webbed penis is sometimes associated with hypospadias, and I'm wondering if that's a concern with your son?
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post #20 of 21 (permalink) Old 03-22-2003, 08:28 PM
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Some of the info. I've found.
There is a lot of conflicting info out there!

Quote:
Webbed and buried penis

Webbed penis is a common congenital abnormality in which a web or fold of scrotal skin obscures the penoscrotal angle. If the physician performing circumcision does not recognize the condition, the penis may become buried in a tentlike fold of skin. Recircumcision to remove the excess skin makes the situation worse by drawing hair-bearing scrotal skin onto the penis.
http://www.emedicine.com/PED/topic2798.htm


This one isn't saying not to circ., but doesn't seem concerned that the child was circed at birth- makes it sound as if surgery can proceed without the foreskin needing to be used as part of the repair.

Quote:
Question: At two weeks of age, my son was circumsized. The result didn't look right so at 3 weeks I asked my pediatrician for an opinion. She thought it needed to be redone and sent me to a pediatric urologist. The urologist told me that my son had two issues. One was that the left testicle was swollen and about 4 times larger than the right. He felt that this would resolve itself over time.
The second issue was what he called a "webbed penis." The skin from the testicles appears to be webbed to the penis. He believes this will require surgical repair when my son is 6 months old, and he wants to re-evaluate him at 3 months. Can you tell me about this condition and what its medical term is? Also, his penis now appears to be slanting to the left. Is this part of the same condition?

Answer: The abnormality of a webbed penis or penis palme is really fairly common in a pediatric urologist's practice. Hydroceles are common. The correction at age 6 months is quite correct, as the amount of growth needed for a good repair is at about that age. If the hydrocele does not go away on its own, it should be repaired at the time of the penile surgery. The scrotum should be made as normal as possible, by fixing undescended testes or hydroceles, and then correcting the penile abnormality.
http://www.coloradohealthsite.org/ch...?Symptoms?1249


This one mentions circumcision as part of the repair, but doesn't say the foreskin is used in the repair.

Quote:
CASE 3: WEBBED PENIS
A 12-day-old was referred to the department of pediatric urology for circumcision. A penile abnormality had been noted on the initial newborn assessment. Physical examination revealed an uncircumcised phallus with a nonretractable foreskin and signi ficant penoscrotal webbing. Circumcision was attempted by his primary physician, but the webbing was extensive enough to prevent placement of the Gomco clamp.

The patient was observed for 6 months, but there was no change. The abnormality was subsequently repaired. Surgery consisted of circumcision followed by degloving of the penis, lysis of abnormal connective tissue bands, and removal of excess skin and subcutaneous fascial tissue. The procedure was finished with longitudinal closure and approximation of the shaft and coronal skin such that the penis extended appropriately. Several follow-up visits revealed good healing, with a normally positioned and extended penis.
http://www.cirp.org/library/complications/bergeson/



Just a note from me- hypospadias, which is what my son had, is sometimes repaired by using the foreskin as part of the reconstructive repair. However, that is generally only in severe cases. In milder cases, which are what is most common and what my son had, the foreskin is not used.
My son had a pretty extensive surgery to close an existing opening. create a new opening, remove a hooded foreskin which was causing torsion of the penis, and his penis was degloved and bands of chordee removed, and then the penis skin was reattached. It was a lot of repair. But his foreskin was not used for reconstruction.

It is possible circumcision is necessary to repair your son's penis- obviously I don't know. But in meeting with pediatric urologists and researching my son's options, I did find that urologists seem to be very, very pro-circ. in general. Over and over I ran across urologists saying circumcision was necessary so the child wouldn't have psychological problems about being "different".
I thin it's excellent you aren't just acepting as fact one doctor saying your son needs ot be circumcised. Obviously any surgery to the penis is likely to damage some tissue and/or nerves, so there's no point in adding to the surgery unnecessarily.
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