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Child with fever. Diagnosed with CRP, typhoid, Urine infection. Given citralka, corimite. Thin pinhole on penis. Cause?

Feb 2013
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Hello, My son is now 16 months old. On 26th April 2013, he had fever and we consulted our doctor. He diagnosed him with CRP, typhoid test from blood sample and confirmed he has typhoid. He is now treated for 6 days and the temperature is now stable.

2 weeks back before Doctor has diagnosed him for typhoid, he had some urine infection and fever. He cried with pain while passing urine.... As per Doctors prescription we used Citralka, CORIMITE, GRAMOGIL, CEFIME for 5 days. After that he has no problem with the urine infection or fever.

The main problem or concern is now his foreskin on his penis. He has a thin pinhole on foreskin to pass the urine. We think he has this problem by birth, but not sure. The front foreskin on his penis usually expands like a small bubble while passing urine. We thought its normal because as the baby grows the skin also expands and will be able to pass the urine comfortably. When we expand his foreskin on penis we see some white stuff at the pinhole sometimes. We cleaned it every time after passing urine as per doctor's suggestion. Since 6 days, when he passes urine, the foreskin on his penis expands more. The expansion is now happnening at the foreskin as well as at his right side foreskin. We are really concerned about him for his problem. Doctor suggested for Sunthi or for a temporary widening of the foreskin. He is 16 months old and we are really afraid of that Sunthi operation.

Please suggest any other way of rectifying his problem.
Please advice how much time Sunthi operation takes for a 16 months baby, should he be admitted in hospital, how long we have to stay in the hospital for that operation, how much cost it will be?
Posted Wed, 22 May 2013 in Child Health
Answered by Dr. E Venkata Ramana 22 minutes later

Thank you for your query on Healthcare Magic.

I went through the history of your child and I can understand your concern.

The narrowing of hole of foreskin of the penis is called phimosis and it will cause obstruction to urine flow.

This obstruction to urine flow leads to balloon like swelling of foreskin while passing urine.

Phimosis is a reason for repeated urinary tract infections and if not corrected surgically, the repeated urinary infections will cause damage to kidneys over a time.

Phimosis can be corrected surgically by circumcision which is know as 'Sunthi'.

If the opening is reasonably good, it can be managed by applying a prescribed steroid cream locally, but if the opening is like a pinhole the best option is to go for Sunthi operation.

Sunthi operation is a minor procedure and usually done under anesthesia for child cooperation. Usually this procedure can be completed within an hour.

He needs admission and hospital stay will be around 1 to 2 days and after this you can follow up on outpatient basis.

The cost for Sunthi operation may vary from one center to the other and the treating surgeon will give you the exact estimate of cost for the procedure.

Hope I have answered your query, if you have any clarification please let me know.

Above answer was peer-reviewed by
Follow-up: Child with fever. Diagnosed with CRP, typhoid, Urine infection. Given citralka, corimite. Thin pinhole on penis. Cause? 34 minutes later
Thanks Doctor for your prompt reply.

I have attached 2 images of the penis of my son while passing urine. You can see how the foreskin expands while passing urine.

Could you please tell us what are the causes of this foreskin expansion? Is this due to urine infection? Does the white mucus has part in this expansion?
He only has the front foreskin expansion earlier, which might be normal in most of the kids.

Answered by Dr. E Venkata Ramana 1 hour later

Thank you for getting back.

I went through the images you sent along with this query.

The cause of expansion while passing urine is the back pressure created by the urine while passing through a narrow hole. It is called ballooning effect.

This expansion is a result of scarring of the foreskin at hole which gradually becoming narrower since infancy.

Repeated fibrosis and scarring will lead to narrowing of the hole of foreskin.

White mucus is called smegma and it is due to accumulation inside the undersurface of foreskin due to presence of narrow opening.

Because of progressing narrowing of the hole, the expansion (ballooning) is extending to back because of increased pressure.

Hope I have answered your concerns, if you have any query please write back to me.

Above answer was peer-reviewed by
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