Cognosco

So, we went to a pediatric surgeon yesterday for Dude’s umbilical hernia. The good news is that it’s totally no big deal unless it sticks around until he’s 4 or 5 years old. Did you know that those hernias are measured not by how far it sticks out or how wide it sticks out, but by the actual abdominal hole itself? His is too small to even put a finger into. Did you also know that it is the only type of hernia that is self-repairing? Fascinating.

However, when the surgeon undid his diaper just to check for abdominal tenderness, he said, “Has anyone talked to you about his penis?”

I’m pretty sure that particular conversation starter never goes anywhere good.

When Dude was born, the midwife noticed that his foreskin was “different”. Never having had a male infant, or spent a lot of time inspecting uncircumcised penises, I didn’t know how it was different. He could pee fine, so what did I care? The family doc looked at it and said it’s “within the range of normal”. Which is what I said to the surgeon. He said he begged to differ.

Turns out, the foreskin is no big deal. It is a “hooded” or “incomplete” foreskin. So it doesn’t totally cover the head and there’s basically not a lot of it on the underside. But, as it turns out, this particular foreskin appearance is often associated with something else that the surgeon looked for and discovered right away—hypospadias. Go ahead. Google it. I dare you.

The short version is that his pee hole isn’t where it should be. So, that area at the tip of the penis that looks like a pee hole actually has no hole. His pee hole is at the base of the head on the undersize.

This is not a conversation I ever wanted to have or a topic I ever wanted to blog about.

Now, I had sort of noticed that there was a little dot there when I bathed him, but assumed the family doc would have noticed if something was off. And never having really noticed where he peed from, I didn’t realize we had this hole discrepancy. And deep down, I didn’t want to look at that little dot too closely, because I thought it looked like a pee hole, and then thought, “No. It couldn’t be. The doctor would have noticed.” Had we not went to this surgeon for something unrelated, I probably wouldn’t have realized it until he started standing to pee. I had noticed he sort of peed downward, but didn’t realize why. Apparently, the family doc didn’t actually look under his penis. Or maybe it was still too little to tell the hole was different. But Jesus, there have been other doctors there who have inspected his penis because none of them seem to ever notice that the newborn exam has been done. And yet, none of them noticed. WTF?

So, if it was a more severe form, as in lower on the penis, surgery would be a no-brainer because it would make his penis curve downward severely, give him painful erections, and make his little member dysfunctional. Painful erections are a definite argument in favor of surgery in my opinion. Oh, and he probably wouldn’t be able to pee standing up. I am all about not circumcising, but by god, given the choice, my boy should be able to pee standing up. Because seriously, I could see how that would totally suck for a dude.

However, this is a mild form. So, it’s not likely to make his penis curve. He’s not likely to have painful erections. But he may have to “aim at the ceiling” to properly hit a urinal.

Because it is a “mild” form, surgery is much less risky than for the more severe forms. It is also less necessary. The primarily consequence of no surgery is psychological.

We asked if he would have to be circumcised. The doctor said it makes the surgery easier, especially since they use part of the foreskin to reconstruct the pee hole. And, as his foreskin looks now, he looks neither circumcised nor uncircumcised, doubling the whammy that his penis is “different”. In the moments right after we learned this news before we had recovered enough to wonder if surgery was the decision we would make (surgeons have a sneaky way of making you assume it’s the decision you’ll make), Hubbie said to Dude, “Your mom tried so hard to protect you.” Because I absolutely refused to consider circumcision. And it seemed, at that moment, that this surgery and circumcision were the only option.

Oh, and the doc doesn’t have a circumcision bias. Neither of his sons were circumcised.

I can’t believe I’m writing all this. Too much information, I know.

So how much should the psychological aspect matter? As much as I can be critical of the penis as the central body part in the male psyche, the fact that I have been agonizing over this news like you wouldn’t believe is only a further testament to its importance.

I’ve heard the “psychological” arguments in favor of circumcising, and was able to chalk them up as bullshit because it seemed so easy to explain to a little boy, “that’s what you were born with and we didn’t want to chop it off because it’s barbaric and we love you”. But this seems a little different…

And, I’d like to say I could wait and he could make the decision on his own, but the best time to do the surgery is 6 to 8 months. Which totally makes sense. Less scar tissue. Less memory of the event. Less mobility. Quicker recovery, etc. So, if I don’t do it, will he hate that we left his penis to be so different? If I do the surgery, will he feel like his penis was so “messed up” we had to “fix” it? Will he hate that we didn’t just leave it alone?

So, we’re definitely going to seek a second and possibly third opinion, because that’s what you do. Right? I will say that this doc was actually pretty good about making it clear that this was a decision we should mull over. But he’s a surgeon. His bias is towards surgery.

If I could have one wish at this moment, it would be have a time machine to go to the future and ask him what he wants us to do. Because his father and I are at a loss here.

As M the wise midwife always says, “It’s a parenting decision”. But that doesn’t make it any easier.