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Old 10-04-2016, 04:59 AM
 
36 posts, read 20,612 times
Reputation: 35

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Quote:
Originally Posted by aus1ander View Post
A thorough pediatrician sounds like a creep? When you get formal training in pediatrics and understand the standards of care, check back. I bet you'll be calling your internist a creep for checking your testicles and doing a rectal exam when you're 50. Lazy/rushed doctors will skip it because its uncomfortable. Good doctors will do their job and deliver high quality care.

Its fairly standard practice in pediatrics to ensure a child is progressing normally through puberty and assigning a Tanner stage to both boys and girls. Pediatricians that don't at least look in the underwear area are not being thorough. Counseling on hygiene is an essential part of counseling at that age, whether its teeth brushing, deodorant, or foreskin care (particularly checking for phimosis). I do agree with a previous poster that it would be more appropriate for the patient to retract their foreskin for the doctor instead of the doctor doing it themselves, as a phimotic foreskin can be painful to retract.

A gynecologic exam is for girls, not boys. And as previously stated, the standard of care for girls (to my knowledge--any pediatricians here can correct me) is to not perform a pelvic exam until they are sexually active or 21. Those guidelines have been changing over time, as it was routine to do paps on sexually active teens when I was in training which doesn't really happen anymore. Since HPV vaccination is now readily available, paps might become increasing irrelevant.

So checking up on boys at that age is okay (normal), but checking up on girls at the same age is just not necessary.

Yeah, makes perfect sense.

I thought girls matured / developed faster than boys?

 
Old 10-04-2016, 06:42 AM
 
906 posts, read 1,183,419 times
Reputation: 1046
Quote:
Originally Posted by maccabees View Post
So checking up on boys at that age is okay (normal), but checking up on girls at the same age is just not necessary.

Yeah, makes perfect sense.

I thought girls matured / developed faster than boys?
Boys and girls are different. Boys have external parts that can have obvious pathology through most ages. Girls have internal parts that are difficult/painful to examine and unlikely to have pathology until they are older. Makes sense to me to skip pelvic exams until they are necessary. A good pediatrician will still visually inspect externally both boys and girls.
 
Old 10-06-2016, 12:50 PM
 
3,421 posts, read 3,310,627 times
Reputation: 8754
Quote:
Originally Posted by megamom82 View Post
My son (11) has always had his privates parts checked by our pediatrician at his yearly check-up. At the end of a check-up, she'll take a quick look down the front of his boxers to see if hair has sprouted, then have him pull them down to his ankles and she checks for a hernia and pulls back his foreskin to make sure he's keeping it clean and it isn't too tight.

I've never had any problem with this, but I recently talked to my sister and she was shocked. She said her daughter (who's 14) never gets her privates looked at.

Is it normal for doctors to be checking all this? How much does your kids' pediatrician check?
Standard of care is to check boys at every well child visit (checkup) for the appearance and degree of advancement of pubertal hair, to check testicular size for signs of puberty and staging of puberty, to palpate the testes for lumps (which could be testicular cancer) or for not being descended, and to check for hernias. If the boy is uncircumcised, to very, very gently check to see if the foreskin is loose enough to be gently and easily retracted for cleaning - and if this hasn't happened by mid to late puberty, to offer treatment for a non-retractible foreskin. All of this should take only a few seconds, unless the testes are not descended. If the pediatrician is not doing this, get another pediatrician. Cancer is worse than embarrassment.

For females, the standard of care is really, with the child in the parent's lap, or lying on an exam table, to part the labia and pull slightly (apply anterior traction) on them to check the introitus for signs of infection, disease, or abuse. But I have to admit that a very quick look at the mons for signs of pubertal hair and pubertal staging is much more common, once the child is more than a few years old, so as not to emotionally traumatize the child. But every pediatrician is trained in the full screening, and should be doing it, as part of an annual checkup.

I will never forget how I had a mother tell me that her childhood pediatrician had done a full internal vaginal exam on her every year starting from the age of about 12, performed with the mother standing by her side. The woman had no medical condition that would have made this necessary. The poor woman said it had been like being raped, year after year, with her mother standing there holding her hand. I had trouble believing her, but really, she had no reason to lie about it. Many years later, other now-adult patients, both male and female, made similar accusations of inappropriately invasive, intrusive, and extensive examinations of their genitalia by this physician, who died shortly after the accusations came out - and I realized it all had probably been true.
 
Old 10-06-2016, 05:19 PM
 
Location: FLG/PHX/MKE
7,289 posts, read 12,942,664 times
Reputation: 11529
The OP hasn't been back to contribute to this thread in quite some time...
 
Old 10-11-2016, 07:57 PM
 
7 posts, read 13,339 times
Reputation: 23
Quote:
Originally Posted by 43north87west View Post
The OP hasn't been back to contribute to this thread in quite some time...
My bad, I've been busy.
 
Old 11-21-2016, 12:02 PM
 
1,809 posts, read 2,434,604 times
Reputation: 1488
Quote:
Originally Posted by maccabees View Post
Ahh, the it's okay, I'm a doctor excuse. The new job for Pedophiles.
I mean, I guess my answer is that if you are very, very concerned about what a doctor can do while you are sitting there watching him or her do it, then you should be equally concerned about what a friend/relative can do behind closed doors.

People seem to have this idea that the only people worthy of arousing suspicion are strangers. The reality is that if your child is going to be abused in any way, it is exponentially more likely to occur from somebody that they know well and spend time with in private.
 
Old 11-23-2016, 01:16 PM
 
Location: Geneva, IL
12,976 posts, read 11,850,099 times
Reputation: 14681
Quote:
Originally Posted by srsmn View Post
I mean, I guess my answer is that if you are very, very concerned about what a doctor can do while you are sitting there watching him or her do it, then you should be equally concerned about what a friend/relative can do behind closed doors.

People seem to have this idea that the only people worthy of arousing suspicion are strangers. The reality is that if your child is going to be abused in any way, it is exponentially more likely to occur from somebody that they know well and spend time with in private.

Despite this fact being repeated over and over and over and over on this forum, some people just don't hear it, or maybe they choose not to hear it.
 
Old Yesterday, 04:04 PM
 
1 posts, read 18 times
Reputation: 10
just get naked
 
Old Today, 06:33 AM
 
Location: Pikeville, Ky.
13,472 posts, read 21,255,245 times
Reputation: 17697
thread is closed
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