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Is your son a straight shooter?
Filed under: Toddlers Preschoolers, Development/Milestones: Babies
I have long suspected my youngest son, just barely 2 years-old, to have a small issue when urinating. But it wasn't until this summer when he started to frequently run around in the buff and enjoy the wonders of peeing in the great outdoors that my suspicions were confirmed: he does not shoot straight. Yes, that's right. He pees to the left. Not just a little bit mind you, he pees about 45 degrees off center and to the left. At first I wondered if he was just standing at an odd angle so I actively encouraged the outdoor potty sessions for further micturation observation. After a number of these sessions and extensive thought I have come to the conclusion that he will never be able to hit a target dead on while standing straight.Is this a bad thing for a little fellow to grow up with? Will he be the butt of locker room jokes? Will he cringe at the thought of using bathroom urinals lest another fellow notice his "offness"? According to Dr Julian Shah, who is a Consultant Urologist at the Institute of Urology and Nephrology in London, it could be an issue serious enough to need medical consultation. Urine leaves the penis through the urethra in a spiral pattern, a detail that although I do not at all debate, is one that I did not notice during my observations of my son. If that spiral is interrupted by anything in its path, then the urine stream will be off center. One problem could be hypospadias, meaning the hole for the urethra is in the wrong place and the result being a wonky stream of urine. Hypospadias can be surgically repaired and the stream problem corrected.
The next time we are at the doctor's office I think I will have my son evaluated for hypospadias. Since I have never encountered this problem, I am not sure how debilitating it would be to go through life shooting to the left. If anybody has experienced this issue and has some thoughts, feel free to share them.
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ReaderComments (Page 1 of 1)
9-18-2006 @ 1:53PM
Sharon said...Actually when one of my cousins was very small, he was hospitalized for surgery for his club foot. His roommate in the hospital was in for a surgery for exactly the same thing as your son. I remember my cousin saying "he pees sideways!".
For sure have it checked out - there may be something obstructing that needs to be fixed.
Now, my son has a very small penis. He is 5. His cousin who is the same age is MUCH bigger. Can you believe it - I'm worried. Should I be?
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9-18-2006 @ 2:14PM
mamaloo, the doula said...My son has hypospadius. When he was born, his urethra exited his glans about 5mm below true. There was a tiny dimple where it should have come out at the tip. His foreskin was slightly fused at the top of the glans, but unformed below, so as not to catch the urine when Kieran peed. Kieran had no problem peeing. He never had an infection or a problem with his urine stream being obscured or anything.
The consulting doctor, a pediatric urinary specialist who deals regularly with hypospadius cases, recommended surgery to correct the hypospadius and remove the foreskin. I didn't want the foreskin removed, but the doc claimed it would grow ungainly and cause problems eventually and that it was removed in order to provide native tissue in the reconstruction work where they re-routed the urethra to the tip of the penis.
My son had the surgery just after his first birthday. I can tell you that there is nothing so heartbreaking than hearing your child wake, from a dead sleep, while under the double narcotic effects of morphine and gravol, screaming in total hysteria and pain, because he just peed in his diaper. Just recalling it sound gives me a sensation akin to a panic attack starting. He screamed for a week after surgery after every pee and cried for a further week.
At about 2 years of age, while Kieran was standing naked waiting to have a shower, he peed in the livingroom. I noticed that he peed out the back of his legs, meaning he was shooting about 45 degrees downward instead of straight. I had a closer look at his penis during a diaper change and I'll be damned if not only did the surgery not "take" but it had worsened the positioning of the urethra, trending it further down the underside of the glans.
The doctor had, instead of re-routing the urethra, slit the glans at the urethral opening and sewn it back up, attempting to make a tube that would merely point the pee straight-ways, but not actually re-locate it at the tip of the glans. Obviously, on closer examination, you could see how that slit skin did not fuse.
In a panic I called our pediatrician (who wasn't really our pediatrician, but who had been called in to deal with the hypospadius diagnosis at his birth and who had had a few appointments with us in the the first year postpartum). Her office told me they didn't get a copy of the surgery notes and that the pediatrician had recently broken her neck and would be off work indefinitely. I called our family doctor, explained the situation to the receptionist who said someone would contact me to sort things out. Neither the doctor or her nurse-assistant ever called.
Being that I am furious that the operation was a botch and that I wasn't certain that I even wanted the surgery for what was effectively a minor deformity that had no poor health implications (he could get chicks pregnant, if he one day chose to, he never got infections, his penis and foreskin worked perfectly fine until removed), I have sat on this for the last year, going over and over in my head what I expect to happen. As you can see, stalling is my way of dealing with things that scare and upset me.
Here's my advice: if the penis works, don't mess with it. If your son's urethra does exit at the tip of the glans, he does not get recurring infections and there are no barriers to ejecting sperm: leave it alone and teach your son that no two penises are alike.
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9-18-2006 @ 2:42PM
Michelle said...This is an issue we are just starting to deal with. My son came home from NICU with a hernia. After that was resolved, we noticed he not only has hypospadius, he also has penis adhesions. My mother (a NICU nurse) said she noticed it, and that she was surprised they performed the circ while he was still in NICU, which is what we suspect is the cause of the adhesions.
We have our first appt with a ped urolgist this week regarding the adhesions and surgery will be involved. I am debating trying to have the hypospadius dealt with at the same time. Any advice from those who have "been there, done that" would be most welcome!
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9-18-2006 @ 2:43PM
Summer said...When your son is in jr. high or at any age for that matter, if any boy is caught noticing ANYTHING about another boys penis, well that boys will have much further emotional scarring than your son.
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9-18-2006 @ 3:21PM
MamaChristy said...Just have it looked at. The beautiful thing is that you don't have to do anything if you aren't comportable with it and you can get more than one opinion. It might cost a couple of co-pays to see some doctors, but then you can make an informed decision.
A woman that my husband works with takes her teenaged son to the same pediatric practice that I take my 2-year old to. When her son was very small the doctor at this practice noticed that he had a hypospadius that caused the opening to be abnormally small. For him it wasn't a matter of peeing to the side, but that the smaller hole would cause his bladder to have to push much harder than normal to excrete the urine. This would, over time, cause his bladder to become smaller and harder than normal and giving him difficulty for life. So, the point is, go have it looked at while he is still small and not bothered by his nudity. If you don't like what you hear, then you don't have to do anything.
Mamaloo - I'm so sorry that your son is going through this. I sincerely hope that you are able to find a way to get this corrected. At least that horrid doctor won't be doing this to any other children. Karma, baby!
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9-18-2006 @ 4:07PM
Erin said...Is there any link to circumcision and this affliction? Or to UNcircumcised penises and this? Just curious for my boys.
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9-18-2006 @ 5:13PM
mamaloo, the doula said...I just wanted to add that I defo think you should get the consultation. Absolutely - having the information about exactly what's up with his sideshooter is invaluable. I hope I didn't come off like I was warning you away from diagnostics. I just mean that, if the condition or whatever it is is minor and doesn't impact his urinary or future sexual health, being a sideshooter isn't so bad.
MamaChristy, thank you for your kind words. The entire thing is like one of those silent nightmares for me and my husband and I keep going back over whether we want to correct the situation or leave it and deal with that. The doc who performed the surgery is the head of the pediatric urology department of the local Children's Hospital in a rather famous hospital. He's definitely still practicing. He was not only incompetent in this surgery, but he was a real a$$hole, too. We liked our pediatrician very much, however.
I should probably put a call in to her.
Erin, hypospadius is a birth defect where the urethra exits the body at any other point except the tip of the penis. It is not a side effect of a poorly executed circumcision. In many cases, when the urethra exits on the glans, the body knows enough to grow a foreskin that does not cover the exit hole. Adhesions, of course, are a side effect of circumcision. Some cases of hypospadius involved a urethral opening on the penis shaft or at the base of the penis. It is a glitch in the DNA.
Momcast: http://momcast.blogspot.com
Hamilton Birth Revolution: http://www.hamiltonbirthrevolution.com
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9-20-2006 @ 12:21AM
George said...Our son had the sideways pee, and when he got to be 3-1/2 began to complain that it hurt when he peed. We thought it might be a urinary tract infection, but after working our way up to a consultation with a pediatric urologist, he determined it was an adhesion. He believes that it's becoming more common because pediatricians are doing circumsicions instead of surgeons. A ten minute operation and two weeks of applying Bacitracin to the red spot seem to have cured the angle and the soreness without any psychological damage (except to his father). He still refers kindly to the "penis dentist."
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