Retention Of Urine In Boy

A 12 years old boy came crying along with his mother. On inquiry, the boy showed the swollen end of his penis and inability to pass urine for sometime. His mother told that the boy had faced similar problem since some months back, when the skin of penis was opened, which enabled him to pass urine. He was also advised surgery in the coming winter. Why in winer I do not understand. Somehow people here prefer winter season to undergo surgery. The opening in the prepuce, penile foreskin was not visible and the prepuce seen distended with fluid inside it. It was painful to touch. The opening was seen closed with a flimsy adhesion, after clearing it, collected urine from the under the prepuce came out and the boy got relief. He further was able to pass urine comfortably. A small nodule was felt inside the prepuce. After some blood test the boy was advised a surgery, when the prepuce would be excised, a circumcision. My concern was the nodule inside the prepuce, because the carcinoma penis grows under cover of prepuce. The age factor was going against the diagnosis. So, I thought there could be a papilloma at least.




A circumcision was performed next day under local anesthesia. It was uneventful. It was noticed that there was a rough area in the inner side of the foreskin and it was reddish. It seems due to an inflammatory process following irritation. However the excised specimen was sent for histopathological study. The boy was sent home. I am waiting for the biopsy report. In India people till now, have not accepted circumcision as an aesthetic measure. Muslims take up it as a custom. Now it was in news that a Human Papilloma virus Vaccine has got FDA node for administration in boys. But it has been well documented that a circumcision in the early childhood prevents cancer of penis, as seen in Jews.