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Urinary and Genital Disorders (Children)

21 month old says penis hurts

03/18/2011

Question:

my son has been telling me his penis is sore and won`t let me touch it to clean it,getting a nappy on him is a battle,he cries and i`m worried that his foreskin is tight or he has kidney infection.he`s in the right size nappies could they be the problem,so worried don`t want him to be in agony and not be able to tell me exactly how he feels.

Answer:

This question is difficult to answer. I assume that your son is uncircumcised. In many boys his age the foreskin can be retracted completely or nearly completely. However, in some boys the tip of the foreskin is tight and/or there are persistent adhesions between the foreskin and head of the penis. In these cases, during an erection the penis can stretch the foreskin, causing discomfort or pain. In some uncircumcised boys an infection can develop under the foreskin, causing pain and requiring antibiotic treatment. Many uncircumcised boys have whitish cheesy material drain out from the tip of the foreskin--this material looks like infection or pus, but is actually physiologic, and is accumulation of epithelial (skin) cells, and is completely normal. I would not worry about a kidney infection, because he would be quite ill with a high fever. It would be worthwhile having him see his pediatrician and have him examined. In boys whose foreskin does not retract, we usually apply a topical corticosteroid cream to the tip of the foreskin or the adhesions 3 times daily for several weeks, and usually the tight foreskin loosens.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University