Difference between revisions of "Care of intact, foreskinned boys"

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<youtube>rpN13irwvGk</youtube>
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'''{{FULLPAGENAME}}''' provides parents with basic information on the care of [[intact]] boys.
 +
 
 +
Newborn [[intact]] boys are easier to care for than [[circumcised]] boys because intact boys do not have an open surgical wound,<ref>{{REFweb
 +
|url=https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Caring-For-Your-Sons-Penis.aspx
 +
|title=How to Care for Your Baby's Penis
 +
|publisher=American Academy of Pediatrics
 +
|date=2021-08-02
 +
|accessdate=2024-08-18
 +
}}</ref> <ref name="milos2022-08-08">{{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-circumcised-vs-uncircumcised-babies-how-do-you-care-for-one-or-the-other/
 +
|title=Ask Marilyn – Circumcised vs Uncircumcised Babies: How Do You Care for One or the Other?
 +
|last=Milos
 +
|first=
 +
|init=MF
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-08-08
 +
|accessdate=2024-10-24
 +
}}</ref> and because [[intact]], non-traumatized boys are easier to [[Breastfeeding| breastfeed]]. [[Foreskinned]] boys are likely to enjoy better health because of the [[immunological and protective function of the foreskin]].
 +
 
 +
The [[foreskin]] has the duty of protecting the [[glans penis]] and [[meatus]] from physical [[trauma]] and [[infection]], so boys are born with a [[foreskin]] that does not retract.<ref name="agarwal2005">{{REFjournal
 +
|last=Agarwal
 +
|first=
 +
|init=A
 +
|author-link=
 +
|last2=Mohta
 +
|first2=
 +
|init2=A
 +
|author2-link=
 +
|last3=Anand
 +
|first3=
 +
|init3=RK
 +
|author3-link=
 +
|etal=no
 +
|title=Preputial retraction in children
 +
|trans-title=
 +
|language=
 +
|journal=J Indian Assoc Pediatr Surg
 +
|location=
 +
|date=2005-04
 +
|season=
 +
|volume=10
 +
|issue=2
 +
|article=
 +
  |pages=89-91
 +
|url=https://journals.lww.com/jiap/fulltext/2005/10020/preputial_retraction_in_children.5.aspx
 +
|archived=
 +
|quote=
 +
|pubmedID=
 +
|pubmedCID=
 +
|DOI=10.4103/0971-9261.16468
 +
|accessdate=2024-06-26
 +
}}</ref> There are two reasons that the foreskin of infant boys does not retract:
 +
* The tip of the foreskin is too narrow to pass over the [[glans penis]].
 +
* The inner layer of foreskin is fused with the underlying glans penis by a [[synechia]].
 +
 
 +
These developmental conditions are normal and expected in infancy and childhood.
 +
 
 +
[[Forced foreskin retraction]] is harmful and must be avoided.
 +
==Introduction==
 +
After many decades of excision of the [[foreskin]] at birth, American and Canadian healthcare providers lost the knowledge of how to care for the normal, [[intact]], [[foreskinned]] boy's [[penis]].<ref name="bollinger2007">{{REFjournal
 +
|last=Bollinger
 +
|init=D
 +
|author-link=Dan Bollinger
 +
|title=The Penis-Care Information Gap: Preventing Improper Care of Intact Boys
 +
|url=https://www.academia.edu/6394928/The_Penis_Care_Information_Gap_Preventing_Improper_Care_of_Intact_Boys?email_work_card=thumbnail&li=0
 +
|journal=Thymos The Journal of Boyhood Studies
 +
|date=2007
 +
|season=fall
 +
|volume=1
 +
|issue=2
 +
|pages=205-19
 +
|format=PDF
 +
|accessdate=2024-11-07
 +
}}</ref> Therefore, it has been necessary to establish an educational program for both parents and physicians on the normal care of the [[intact]] [[penis]].<ref name="bollinger2007" />
 +
 
 +
Parents of [[intact]] boys in the [[United States]] have an additional responsibility of protecting their [[intact]], [[foreskinned]] son from harmful, painful [[Forced foreskin retraction| premature forcible foreskin retraction]] (PFFR) by ignorant doctors and nurses.<ref>{{REFweb
 +
|url=https://www.doctorsopposingcircumcision.org/for-parents/help-with-forcible-foreskin-retraction/
 +
|title=Wrongful Foreskin Retraction
 +
|last=Anonymous
 +
|first=
 +
|init=
 +
|author-link=
 +
|publisher=Doctors Opposing Circumcision
 +
|date=1916
 +
|accessdate=2024-06-27
 +
}}</ref>
 +
 
 +
==Discussion==
 +
The human [[foreskin]] is nature's protection against injury and [[infection]] of the [[penis]]. Since it has [[Immunological and protective function of the foreskin| protective and immunological functions]] that work best when the [[foreskin]] is left alone, only the outside of the [[foreskin]] should be washed as one washes a finger. Bubble bath can be irritating to a child's foreskin so it is best to avoid bubble bath products in the bath water.<ref name="milos2022-03-07">{{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-bath-time-turns-a-boys-foreskin-red/
 +
|title=Ask Marilyn – Bath Time Turns a Boy’s Foreskin Red
 +
|last=Milos
 +
|first=
 +
|init=MF
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-03-07
 +
|accessdate=2024-10-24
 +
}}</ref>
  
The [[preputial mucosa]] of the [[foreskin]] is fused with the [[glans]] penis by the [[synechia]] in infancy and childhood so the foreskin cannot be retracted. No attempt to retract the foreskin should be made. Forcible retraction is harmful. Wright (1994) advises that the first person to retract the boy’s foreskin should be the boy himself.<ref name="Wright1994">{{REFjournal
+
The [[preputial mucosa]] of the [[foreskin]] is fused with the [[glans penis]] by the [[synechia]] in infancy and childhood so the [[foreskin]] cannot be retracted. No attempt to retract the foreskin should be made. Forcible retraction is traumatic and painful. Wright (1994) advised that the first person to retract the boy’s [[foreskin]] should be the boy himself.<ref name="Wright1994">{{REFjournal
 
  |last=Wright
 
  |last=Wright
  |first=J.E.
+
  |init=JE
 
  |title=Further to the "Further Fate of the Foreskin"
 
  |title=Further to the "Further Fate of the Foreskin"
 
  |journal=Med J Aust
 
  |journal=Med J Aust
Line 18: Line 117:
 
}}</ref>
 
}}</ref>
  
Thorvaldsen & Meyhoff (2005) conducted a survey of 4,000 boys in Denmark. They report that the mean age of first [[foreskin]] retraction is 10.4 years in Denmark.<ref name="Thorvaldsen-meyhoff2005">{{REFjournal
+
Thorvaldsen & Meyhoff (2005) conducted a survey of 4,000 boys in [[Denmark]] where most boys are [[intact]]. They reported that the mean age of first [[foreskin]] retraction is 10.4 years in [[Denmark]].<ref name="Thorvaldsen-meyhoff2005">{{REFjournal
 
  |last=Thorvaldsen
 
  |last=Thorvaldsen
  |first=M.A.
+
  |init=MA
 
  |last2=Meyhoff
 
  |last2=Meyhoff
  |first2=H.
+
  |init2=H
 
  |title=Patologisk eller fysiologisk fimose?
 
  |title=Patologisk eller fysiologisk fimose?
 
  |trans-title=Pathological or physiological phimosis?
 
  |trans-title=Pathological or physiological phimosis?
Line 37: Line 136:
 
  |date=2005
 
  |date=2005
 
  |accessdate=2019-11-14
 
  |accessdate=2019-11-14
 +
}}</ref> [[Jakob Øster| Øster]] (1968) reported that some boys will not develop retractable [[foreskin]] until after puberty.<ref name="Øster1968">{{OesterJ 1968}}</ref>
 +
 +
==Behavior of young intact boys==
 +
Parents observe that many young, [[intact]] boys will pull and tug on their [[foreskin]]. Some parents express concern that the boy may be hurting himself, however that is not the case. The boy would not do that if it caused him pain.<ref>{{REFweb
 +
|url=https://www.kidshealth.org.nz/how-care-your-childs-foreskin
 +
|title=How To Care For Your Child's Foreskin
 +
|publisher=KidsHealth of New Zealand
 +
|date=2020-06-04
 +
|accessdate=2023-01-25
 
}}</ref>
 
}}</ref>
 +
The foreskin has many [[Meissner's corpuscles]],<ref name="winkleman1956">{{REFjournal
 +
|last=Winkelmann
 +
|first=
 +
|init=RK
 +
|author-link=
 +
|etal=no
 +
|title=The cutaneous innervation of human newborn prepuce
 +
|trans-title=
 +
|language=
 +
|journal=J Invest Dermatol
 +
|location=
 +
|date=1956-01
 +
|volume=26
 +
|issue=1
 +
|article=
 +
|page=
 +
|pages=53-67
 +
|url=https://www.jidonline.org/article/S0022-202X(15)48804-9/pdf
 +
|archived=
 +
|quote=
 +
|pubmedID=13295637
 +
|pubmedCID=
 +
|DOI=10.1038/jid.1956.5
 +
|doi=
 +
|format=PDF
 +
|accessdate=2023-07-12
 +
}}</ref> which are specialized nerves that sense motion and [[stretching]] as pleasurable. Such behavior is normal and parents need not be concerned.
 +
 +
Intact, [[foreskinned]] boys should give their (usually non-retractile) [[foreskin]] a gentle tug away from their body to get the wrinkles out prior to [[urination]], so that the [[urine]] flows out in a smooth stream.
 +
 +
==Spontaneous disintegration of the synechia==
 +
The inner foreskin is fused from birth with the [[glans penis]] by a [[synechia]]. The synechia spontaneously disintegrates to release the foreskin.<ref name="deibart1933">{{REFjournal
 +
|last=Deibart
 +
|init=GA
 +
|title=The separation of the prepuce in the human penis
 +
|journal=Anat Rec
 +
|date=1933-11
 +
|volume=57
 +
|issue=
 +
|pages=387-99
 +
|url=http://www.cirp.org/library/anatomy/deibert/
 +
|quote=
 +
|pubmedID=
 +
|pubmedCID=
 +
|DOI=https://doi.org/10.1002/ar.1090570409
 +
|accessdate=2023-08-16
 +
}}</ref> The disintegration usually occurs in childhood but will persist into adolescence in a few cases.
 +
 +
When a young boy urinates, the [[foreskin]] may [[Ballooning of the foreskin| balloon]] slightly and the pressure will tend to lift the [[foreskin]] away from the [[glans penis]].<ref name="milos2022-03-21">{{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-let-the-balloon-go/
 +
|title=Ask Marilyn – Let the Balloon Go!
 +
|last=Milos
 +
|first=
 +
|init=MF
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-03-21
 +
|accessdate=2024-10-24
 +
}}</ref>
 +
 +
Some [[intact]] boys will report pain when they urinate during the period in which separation is occurring.<ref name="milos2022-09-26">{{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-kiddo-is-having-painful-erections/
 +
|title=Ask Marilyn—Kiddo Is Having Painful Erections
 +
|last=Milos
 +
|first=
 +
|init=MF
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-09-26
 +
|accessdate=2024-10-24
 +
}}</ref> The condition is temporary and will end when separation is complete.<ref>{{REFweb
 +
|url=https://www.rch.org.au/kidsinfo/fact_sheets/penis_and_foreskin_care/#foreskin-separation
 +
|title=Foreskin separation
 +
|last=
 +
|first=
 +
|init=
 +
|publisher=The Royal Children's Hospital Melbourne
 +
|date=2018-02
 +
|accessdate=2023-08-15
 +
}}</ref> It does not require a visit to a doctor or any kind of care.
 +
 +
==Mayo Clinic information should be rejected==
 +
Mayo Clinic provides information on the care of [[foreskinned]] boys. This advice is ''not'' recommended. The language indicates Midwestern [[bias]] against [[intact]] boys, a lack of understanding of the [[Immunological and protective function of the foreskin| immmunological and protective functions]], and lack of current information on [[Development of retractable foreskin| development of foreskin retraction]].
 +
==Care at daycare centers==
 +
Parents must ''not'' assume that the staff of a daycare facility know how to care for [[intact]], [[foreskinned]] boys. In America it is most likely that the staff of a daycare center will not know the proper care of [[foreskinned]] boys,<ref>{{REFweb
 +
|url=https://intactamerica.org/the-daycare-risk-for-intact-uncircumcised-babies-and-boys-forcible-foreskin-retraction/
 +
|title=The Daycare Risk for Intact, Uncircumcised Babies and Boys: Forcible Foreskin Retraction
 +
|last=Ashford
 +
|first=Jeannie
 +
|init=
 +
|author-link=
 +
|publisher=Intact America
 +
|date=2024-09-12
 +
|accessdate=2024-09-13
 +
}}</ref> which may place your [[foreskinned]] son at risk of [[forced foreskin retraction]].
  
 +
==Video==
 +
<br>
 +
<youtube>rpN13irwvGk</youtube>
 +
<br>
 +
<youtube>?v=dqexM8uqDes&list=PLAWLXIFlrYdr0cuWb81Qy155NqXh0bnnP&index=3</youtube>
 
{{SEEALSO}}
 
{{SEEALSO}}
* [[Retraction of the foreskin]]
+
* [[Ballooning of the foreskin]]
 +
* [[Catheterization of intact boys]]
 +
* [[Development of retractable foreskin]]
 +
* [[Lists of foreskin-friendly and intact-friendly physicians]]
 +
* [[DoNoHarm.report]]
 +
* [[Forced foreskin retraction]]
 +
* [[Immunological and protective function of the foreskin]]
 +
* [[Intact-friendly]]
 +
* [[Meatal stenosis]]
 +
* [[Protection of intact newborns in hospital]]
 
* [[Synechia]]
 
* [[Synechia]]
 +
* [[Intact versus Circumcised Baby Care]]
  
 
{{LINKS}}
 
{{LINKS}}
 +
* {{REFdocument
 +
|title=When Your Baby Boy is Not Circumcised
 +
|url=https://pool.intactiwiki.org/w/images/1982-02_Wallerstein-WhenYourBabyBoyIsNotCircumcised.pdf
 +
|language=English
 +
|last=Wallerstein
 +
|first=Edward
 +
|author-link=Edward Wallerstein
 +
|publisher=Pennypress
 +
|location=Seattle
 +
|format=Four-page pamphlet
 +
|date=1982-02
 +
|accessdate=2021-05-30
 +
}}
 
* {{REFweb
 
* {{REFweb
  |url=http://www.gaamerica.org/symposia/first/fleiss.html
+
  |url=http://www.nocirc.org/symposia/first/fleiss.html
 
  |title=Care of the intact male
 
  |title=Care of the intact male
 
  |trans-title=
 
  |trans-title=
Line 55: Line 286:
 
  |website=
 
  |website=
 
  |date=1989-03
 
  |date=1989-03
  |accessdate=2019-12-20
+
  |accessdate=2021-10-05
 
  |format=
 
  |format=
 
  |quote=Leave the penis of the newborn infant alone.  
 
  |quote=Leave the penis of the newborn infant alone.  
Line 62: Line 293:
 
  |last=Simpson
 
  |last=Simpson
 
  |first=Errol T.
 
  |first=Errol T.
 +
|init=ET
 
  |author-link=
 
  |author-link=
 
  |last2=Baraclough
 
  |last2=Baraclough
 
  |first2=Phillip
 
  |first2=Phillip
 +
|init2=P
 
  |author2-link=
 
  |author2-link=
 
  |etal=no
 
  |etal=no
Line 77: Line 310:
 
  |pages=381-3
 
  |pages=381-3
 
  |url=http://www.cirp.org/library/hygiene/simpson1/
 
  |url=http://www.cirp.org/library/hygiene/simpson1/
  |quote=
+
  |quote=Minor foreskin related complaints are very common in the first few years of life. Most of these can be managed with advice and reassurance, or with medical treatment alone. Circumcision is very rarely indicated in young boys, particularly under the age of 5 years.
 
  |pubmedID=9613002
 
  |pubmedID=9613002
 
  |pubmedCID=
 
  |pubmedCID=
Line 86: Line 319:
 
  |url=http://www.nocirc.org/publish/4pam.pdf
 
  |url=http://www.nocirc.org/publish/4pam.pdf
 
  |title=Answers To Your Questions About Your Young Son's Intact Penis
 
  |title=Answers To Your Questions About Your Young Son's Intact Penis
|trans-title=
 
|language=
 
 
  |last=Milos
 
  |last=Milos
 
  |first=Marilyn
 
  |first=Marilyn
  |author-link=
+
  |author-link=Marilyn Fayre Milos
 
  |publisher=
 
  |publisher=
 
  |website=NOCIRC
 
  |website=NOCIRC
Line 101: Line 332:
 
  |url=http://www.nocirc.org/publish/6pam.pdf
 
  |url=http://www.nocirc.org/publish/6pam.pdf
 
  |title=Answers To Your Questions About Premature (Forcible) Retraction of Your Young Son's Foreskin
 
  |title=Answers To Your Questions About Premature (Forcible) Retraction of Your Young Son's Foreskin
|trans-title=
 
|language=
 
 
  |last=Milos
 
  |last=Milos
 
  |first=Marilyn
 
  |first=Marilyn
  |author-link=
+
  |author-link=Marilyn Fayre Milos
 
  |publisher=
 
  |publisher=
 
  |website=NOCIRC
 
  |website=NOCIRC
Line 112: Line 341:
 
  |format=
 
  |format=
 
  |quote=
 
  |quote=
 +
}}
 +
* {{REFjournal
 +
|last=Bollinger
 +
|init=D
 +
|author-link=
 +
|url=https://www.academia.edu/6394928/The_Penis_Care_Information_Gap_Preventing_Improper_Care_of_Intact_Boys?
 +
|title=The Penis-Care Information Gap: Preventing Improper Care of Intact Boys
 +
|journal=The Journal of Boyhood Studies
 +
|date=2007
 +
|season=Fall
 +
|volume=1
 +
|issue=2
 +
|pages=205-19
 +
|accessdate=2023-05-25
 +
}}
 +
* {{REFweb
 +
|url=http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html
 +
|title=How to Care for Your Intact Son
 +
|last=
 +
|first=
 +
|init=
 +
|author-link=
 +
|publisher=Peaceful Parenting
 +
|date=
 +
|format=PDF
 +
|accessdate=2024-09-17
 
}}
 
}}
 
* {{REFdocument
 
* {{REFdocument
Line 119: Line 374:
 
  |last=
 
  |last=
 
  |first=
 
  |first=
  |publisher=''Doctors Opposing Circumcision''
+
  |publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
 
  |format=PDF
 
  |format=PDF
 
  |date=2016-07
 
  |date=2016-07
 
  |accessdate=2019-11-08
 
  |accessdate=2019-11-08
 +
}}
 +
* {{REFdocument
 +
|title=Intact care guide for parents and caregivers
 +
|url=https://intactamerica.org/wp-content/uploads/2024/03/Intact-Care-Guide.factsheet.pdf
 +
|contribution=
 +
|last=Anonymous
 +
|first=
 +
|publisher=Intact America
 +
|format=PDF
 +
|date=2018
 +
|accessdate=2024-10-12
 
}}
 
}}
 
* {{REFweb
 
* {{REFweb
 
  |url=//www.yourwholebaby.org/basic-intact-care
 
  |url=//www.yourwholebaby.org/basic-intact-care
 
  |title=https:Basic Care (Intact Penis)
 
  |title=https:Basic Care (Intact Penis)
|trans-title=
 
|language=
 
|last=
 
|first=
 
|author-link=
 
 
  |publisher=Your Whole Baby
 
  |publisher=Your Whole Baby
 
  |website=
 
  |website=
Line 138: Line 399:
 
  |format=
 
  |format=
 
  |quote=
 
  |quote=
 +
}}
 +
* {{REFweb
 +
|url=https://www.yourwholebaby.org/smegma/
 +
|title=Smegma Pearls
 +
|publisher=Your Whole Baby
 +
|date=
 +
|accessdate=2024-08-24
 
}}
 
}}
 
* {{REFweb
 
* {{REFweb
 
  |url=https://www.rch.org.au/clinicalguide/guideline_index/The_penis_and_foreskin/
 
  |url=https://www.rch.org.au/clinicalguide/guideline_index/The_penis_and_foreskin/
 
  |title=The penis and foreskin
 
  |title=The penis and foreskin
|trans-title=
 
|language=
 
|last=
 
|first=
 
|author-link=
 
 
  |publisher=The Royal Children's Hospital of Melbourne
 
  |publisher=The Royal Children's Hospital of Melbourne
 
  |website=
 
  |website=
Line 153: Line 416:
 
  |format=
 
  |format=
 
  |quote=
 
  |quote=
 +
}}
 +
* {{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-bath-time-turns-a-boys-foreskin-red/
 +
|title=Ask Marilyn – Bath Time Turns a Boy’s Foreskin Red
 +
|last=Milos
 +
|first=Marilyn
 +
|init=
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-03-07
 +
|accessdate=2024-06-21
 +
}}
 +
* {{REFweb
 +
|url=https://intactamerica.org/ask-marilyn-circumcised-vs-uncircumcised-babies-how-do-you-care-for-one-or-the-other/
 +
|title=Ask Marilyn – Circumcised vs Uncircumcised Babies: How Do You Care for One or the Other?
 +
|last=Milos
 +
|first=Marilyn
 +
|init=
 +
|author-link=Marilyn Fayre Milos
 +
|publisher=Intact America
 +
|date=2022-08-08
 +
|accessdate=2024-06-21
 +
}}
 +
* {{REFweb
 +
|url=https://www.yourwholebody.org/teens
 +
|title=I’m an intact teen. What do I need to know?
 +
|last=
 +
|first=
 +
|init=
 +
|publisher=Your Whole Body
 +
|date=
 +
|accessdate=2023-04-16
 +
}}
 +
* {{REFweb
 +
|url=https://www.yourwholebaby.org/smegma/
 +
|title=Smegma Pearls
 +
|last=
 +
|first=
 +
|init=
 +
|author-link=
 +
|publisher=Your Whole Body
 +
|date=
 +
|accessdate=2024-08-24
 +
}}
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* {{REFweb
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|url=https://intactamerica.org/intact-penis-care/
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|title=Intact Penis Care: Embracing Natural Well-being
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|first=Connor
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|author-link=Connor Judson Garrett
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|publisher=Intact America
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Latest revision as of 18:19, 7 November 2024

Care of intact, foreskinned boys provides parents with basic information on the care of intact boys.

Newborn intact boys are easier to care for than circumcised boys because intact boys do not have an open surgical wound,[1] [2] and because intact, non-traumatized boys are easier to breastfeed. Foreskinned boys are likely to enjoy better health because of the immunological and protective function of the foreskin.

The foreskin has the duty of protecting the glans penis and meatus from physical trauma and infection, so boys are born with a foreskin that does not retract.[3] There are two reasons that the foreskin of infant boys does not retract:

  • The tip of the foreskin is too narrow to pass over the glans penis.
  • The inner layer of foreskin is fused with the underlying glans penis by a synechia.

These developmental conditions are normal and expected in infancy and childhood.

Forced foreskin retraction is harmful and must be avoided.

Introduction

After many decades of excision of the foreskin at birth, American and Canadian healthcare providers lost the knowledge of how to care for the normal, intact, foreskinned boy's penis.[4] Therefore, it has been necessary to establish an educational program for both parents and physicians on the normal care of the intact penis.[4]

Parents of intact boys in the United States have an additional responsibility of protecting their intact, foreskinned son from harmful, painful premature forcible foreskin retraction (PFFR) by ignorant doctors and nurses.[5]

Discussion

The human foreskin is nature's protection against injury and infection of the penis. Since it has protective and immunological functions that work best when the foreskin is left alone, only the outside of the foreskin should be washed as one washes a finger. Bubble bath can be irritating to a child's foreskin so it is best to avoid bubble bath products in the bath water.[6]

The preputial mucosa of the foreskin is fused with the glans penis by the synechia in infancy and childhood so the foreskin cannot be retracted. No attempt to retract the foreskin should be made. Forcible retraction is traumatic and painful. Wright (1994) advised that the first person to retract the boy’s foreskin should be the boy himself.[7]

Thorvaldsen & Meyhoff (2005) conducted a survey of 4,000 boys in Denmark where most boys are intact. They reported that the mean age of first foreskin retraction is 10.4 years in Denmark.[8] Øster (1968) reported that some boys will not develop retractable foreskin until after puberty.[9]

Behavior of young intact boys

Parents observe that many young, intact boys will pull and tug on their foreskin. Some parents express concern that the boy may be hurting himself, however that is not the case. The boy would not do that if it caused him pain.[10] The foreskin has many Meissner's corpuscles,[11] which are specialized nerves that sense motion and stretching as pleasurable. Such behavior is normal and parents need not be concerned.

Intact, foreskinned boys should give their (usually non-retractile) foreskin a gentle tug away from their body to get the wrinkles out prior to urination, so that the urine flows out in a smooth stream.

Spontaneous disintegration of the synechia

The inner foreskin is fused from birth with the glans penis by a synechia. The synechia spontaneously disintegrates to release the foreskin.[12] The disintegration usually occurs in childhood but will persist into adolescence in a few cases.

When a young boy urinates, the foreskin may balloon slightly and the pressure will tend to lift the foreskin away from the glans penis.[13]

Some intact boys will report pain when they urinate during the period in which separation is occurring.[14] The condition is temporary and will end when separation is complete.[15] It does not require a visit to a doctor or any kind of care.

Mayo Clinic information should be rejected

Mayo Clinic provides information on the care of foreskinned boys. This advice is not recommended. The language indicates Midwestern bias against intact boys, a lack of understanding of the immmunological and protective functions, and lack of current information on development of foreskin retraction.

Care at daycare centers

Parents must not assume that the staff of a daycare facility know how to care for intact, foreskinned boys. In America it is most likely that the staff of a daycare center will not know the proper care of foreskinned boys,[16] which may place your foreskinned son at risk of forced foreskin retraction.

Video



See also

External links

References

  1. REFweb (2 August 2021). How to Care for Your Baby's Penis, American Academy of Pediatrics. Retrieved 18 August 2024.
  2. REFweb Milos MF (8 August 2022). Ask Marilyn – Circumcised vs Uncircumcised Babies: How Do You Care for One or the Other?, Intact America. Retrieved 24 October 2024.
  3. REFjournal Agarwal A, Mohta A, Anand RK. Preputial retraction in children. J Indian Assoc Pediatr Surg. April 2005; 10(2): 89-91. DOI. Retrieved 26 June 2024.
  4. a b REFjournal Bollinger D. The Penis-Care Information Gap: Preventing Improper Care of Intact Boys PDF. Thymos The Journal of Boyhood Studies. 2007 (fall); 1(2): 205-19. Retrieved 7 November 2024.
  5. REFweb Anonymous (1916). Wrongful Foreskin Retraction, Doctors Opposing Circumcision. Retrieved 27 June 2024.
  6. REFweb Milos MF (7 March 2022). Ask Marilyn – Bath Time Turns a Boy’s Foreskin Red, Intact America. Retrieved 24 October 2024.
  7. REFjournal Wright JE. Further to the "Further Fate of the Foreskin". Med J Aust. 7 February 1994; 160: 134-135. PMID. Retrieved 17 October 2019.
  8. REFjournal Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? [Pathological or physiological phimosis?] (Danish). Ugeskr Læger. 2005; 167(17): 1858-1862. Retrieved 14 November 2019.
  9. REFjournal Øster J. Further Fate of the Foreskin: Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys PDF. Arch Dis Child. 1968; 43(228): 200-3. PMID. PMC. DOI. Retrieved 18 June 2024.
  10. REFweb (4 June 2020). How To Care For Your Child's Foreskin, KidsHealth of New Zealand. Retrieved 25 January 2023.
  11. REFjournal Winkelmann RK. The cutaneous innervation of human newborn prepuce PDF. J Invest Dermatol. January 1956; 26(1): 53-67. PMID. DOI. Retrieved 12 July 2023.
  12. REFjournal Deibart GA. The separation of the prepuce in the human penis. Anat Rec. November 1933; 57: 387-99. DOI. Retrieved 16 August 2023.
  13. REFweb Milos MF (21 March 2022). Ask Marilyn – Let the Balloon Go!, Intact America. Retrieved 24 October 2024.
  14. REFweb Milos MF (26 September 2022). Ask Marilyn—Kiddo Is Having Painful Erections, Intact America. Retrieved 24 October 2024.
  15. REFweb (February 2018). Foreskin separation, The Royal Children's Hospital Melbourne. Retrieved 15 August 2023.
  16. REFweb Ashford, Jeannie (12 September 2024). The Daycare Risk for Intact, Uncircumcised Babies and Boys: Forcible Foreskin Retraction, Intact America. Retrieved 13 September 2024.