Urinary Issues in Children: A Guide for Parents

Pediatric Urological Issues

Dear Sir/Madam,
My son is seven years old and in his final year of kindergarten.
He enjoys sleeping in a prone position, but since he turned six, I have noticed a peculiar phenomenon: while in this sleeping position, his genitalia becomes erect (approximately five centimeters), and he uses both hands to manipulate himself in a manner similar to sexual activity, often resulting in profuse sweating.
This behavior occurs not only during nighttime sleep but also during nap time at school.
Initially, I thought it might be due to a urinary tract infection causing itchiness, but after careful observation, I have determined that this is not the case.
When I asked him why he engages in this behavior, he responded with "involuntary" and "curious."
I would like to inquire about the following:
1.
Is this phenomenon normal and healthy for his age group?
2.
Is this an indication of precocious puberty?
3.
Could this have any adverse physiological or psychological effects in the future?
4.
Would circumcision of an excessively long foreskin help mitigate this behavior?
5.
From a modern medical perspective, is there an issue with his urinary system?
6.
How should parents address this issue? What is the best way to communicate with the child about it?
I would greatly appreciate your guidance on these matters.
Sincerely,
Chen Wenlong

Chen, 40~49 year old female. Ask Date: 2005/04/02

Dr. Weng Wenzhen reply Urology

Hello! Infant and toddler self-stimulation is a normal phenomenon that occurs in both genders and can take various forms.
There is no need to be anxious about it.
If you believe it is inappropriate behavior, you can discuss it with them and consider providing guidance or appropriate consequences.
Thank you for your question!

Reply Date: 2005/04/02

More Info

Understanding urinary issues in children can be a complex and sensitive topic for parents. Your concerns regarding your seven-year-old son’s behavior during sleep and at school are valid and warrant careful consideration. Let’s address your questions one by one.

1. Is this phenomenon normal for his age? Is it healthy?
Yes, it is relatively common for children around this age to explore their bodies and experience curiosity about their genitalia. This behavior can be a part of normal childhood development, where children begin to understand their bodies and may engage in self-exploration. As long as the behavior is not compulsive or causing distress, it is generally considered normal. However, it is essential to ensure that the child understands boundaries and privacy.

2. Is this early maturation?
The behavior you described does not necessarily indicate early sexual maturation. Children can exhibit curiosity about their bodies without it being linked to sexual development. Early maturation typically refers to the onset of secondary sexual characteristics at an unusually young age, which is not the case here based on your description.

3. Could this lead to negative physiological or psychological effects in the future?
If the behavior is addressed appropriately, it is unlikely to lead to negative effects. However, if the child feels shame or is punished for natural curiosity, it could lead to psychological issues such as anxiety or embarrassment related to their body. Open and honest communication about body autonomy and privacy is crucial in helping children develop a healthy relationship with their bodies.

4. Would circumcision help stop this behavior?
Circumcision is a surgical procedure that removes the foreskin from the penis. While it may reduce certain physical sensations, it is not a solution for behavioral curiosity. It is essential to approach the topic of circumcision with caution and to consider the medical and ethical implications. If there are no medical issues related to the foreskin, circumcision may not be necessary.

5. From a modern medical perspective, is there a problem with his urinary system?
Based on your description, there does not appear to be any immediate concern regarding his urinary system. The behaviors you mentioned do not indicate a urinary tract infection or other medical issues. However, if you notice any signs of pain, discomfort, or unusual urinary patterns, it would be wise to consult a pediatrician for further evaluation.

6. How should parents approach this issue? How can they communicate with their child?
It is essential to create a safe and open environment for discussion. Parents should approach the topic with sensitivity, using age-appropriate language. You might say something like, "It's normal to be curious about your body, but it's important to do that in private." Encourage your child to ask questions and express their feelings. Reinforce the idea of privacy and respect for their own body and others.

In conclusion, while your son’s behavior may seem concerning, it is often a normal part of childhood development. The key is to foster an environment of understanding and communication. If you have ongoing concerns or if the behavior escalates, consider consulting a pediatrician or child psychologist who can provide guidance tailored to your child's needs.

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