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Child Having Pain During Urination. Noticed Red Shaft. Not Circumcision Done. What To Do?

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Posted on Mon, 3 Jun 2013
Question: Hi. My two year old is uncircumsised. He recently has been pain when he is peeing. His shaft is red. He was at times tightening up as if he was going to poop when he needs to pee the last couple of days. Couple of nights ago he peed through the diaper and woke up crying. My husband changed him but he was crying for a good half hour before he went back to bed. We thought it was because he was woken and peed a lot because he ate too much watermelon. We did not notice the red shaft yet. The following day he was holding his croch and I asked him what's wrong and he said hurt but was not in pain at that moment because he went and played . The following night he was restless in his sleep. My mom then who takes care of him noticed when he woke up that he peed through his diaper. He was cranky the whole morning . He also expressed to her that he hurt. So I asked her to give him a bath. She noticed that his shaft was red.
Being that my child has a history of urinary issues- at a month old he gave himself sepsis . He had strep b in blood and was hospitalized. Caught in time and treated. It was discovered after many tests that he had urinary reflux level 4 on both sides . The urologist put him on profalaxis for the year. At the end of the year he completely overcame it. He has told us to do a yearly checkup which we did last month. At first the results came back as uti but since we did bag ourselves and all other tests came back normal the ped redid it and it came back normal. So then I took him to an after hours ped clinic when i got home to do a urinary test. Since I know it takes two days for culture to come back and knew couldn't get to ped till weekend. At first the tried to XXXXXXX him. Screeched in pain . There was no urine. Then we did it via bag. When he finally peed he was crying going hurt. She said analysis was normal with some red blood cells that are prob from XXXXXXX But his analysis in past always would come back normal and told her to make sure culture is sent . Later that evening he woke up screeching in pain. Had not peed. Gave Tylenol because I know catheter prob aggravated it more. After falling a sleep I noticed this morning his diaper was went but didn't pee through diaper.
I'm concerned due to his history. How can I also help him with pain. He is a G6pd baby as well so I'm also limited to medications I can us
XXXXXX
doctor
Answered by Dr. Vaishalee Punj (1 hour later)
Hi

Thanks for posting your query on XXXXXXX

It seems that your baby has developed a hematoma after insertion of catheter. It will take a few weeks to settle down. Till then we need to take care of the pain. Since this condition is completely curable you should just wait and watch and follow the treating doctor's instructions.

Since he has a history of G6PD Deficiency, we need to avoid NSAIDS (pain-killers) in general. We can try topical application of lidocaine 1% cream. Brufen and ketorolac can be tried though they come in the category of NSAIDS. You will need a prescription for ketorolac.

Let me know if I can assist you further.

Take care

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj (31 minutes later)
Hi
Thank you for your answer , especially about what I can use.
Makes sense that the catheter aggravated it, but it was also red prior. What could that be from? Also the fact that he tightens up to avoid peeing worries me because that is why he had reflux and then the sepsis . The urologist said he outgrew his level 4 reflux b/c he would most likely would tighten when he would pee and then push back his pee. If in the event he does have a uti - how likely is he to get sepsis again due to tightening? Also clinic said to use Vaseline on area. Is that ok . I'd rather get cream.
Thank you
XXXXXX
doctor
Answered by Dr. Vaishalee Punj (7 minutes later)
Hi again

It resulted from trauma from the process of inserting the catheter.It will get better but the worry is that this may result in some urinary retention if the urine outflow is getting blocked. A UTI is always a possibility with reflux and retention of urine. A repeat urinalysis can rule it out. Antibiotics will be needed only if tests show UTI.

It is worthwhile to get in contact with the physician performing his ultrasounds and see if he can also prescribe another ultrasound to assess for retention.

You can try vaseline but it will not be effective for pain. It may be beneficial for the itching due to the swelling.

Dr Vaishalee
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 3262 Questions

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Child Having Pain During Urination. Noticed Red Shaft. Not Circumcision Done. What To Do?

Hi

Thanks for posting your query on XXXXXXX

It seems that your baby has developed a hematoma after insertion of catheter. It will take a few weeks to settle down. Till then we need to take care of the pain. Since this condition is completely curable you should just wait and watch and follow the treating doctor's instructions.

Since he has a history of G6PD Deficiency, we need to avoid NSAIDS (pain-killers) in general. We can try topical application of lidocaine 1% cream. Brufen and ketorolac can be tried though they come in the category of NSAIDS. You will need a prescription for ketorolac.

Let me know if I can assist you further.

Take care

Dr Vaishalee