Development of retractable foreskin - Revision history

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	}}</ref> The '''development of retractable foreskin''' occurs gradually over a widely-variable number of years.		}}</ref> The '''development of retractable foreskin''' occurs gradually over a widely-variable number of years.

	In the majority of adult men, the [[foreskin]] normally retracts to reveal the [[glans penis\| head of the penis]]. In newborns, it is normal for the foreskin to be fused to the head of the penis by the [[synechia]], thus rendering it non-retractable.<ref name="agarwal2005" /> The [[preputial sac]] is sealed by the [[synechia]].<ref name="fleiss-hodges-vanhowe1998">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> The [[foreskin]] usually separates from the glans and becomes retractable with increasing age.<ref name="agarwal2005" /> There is much uncertainty among health care workers about when the foreskin of a boy should become retractable.<ref>{{REFjournal		In the majority of adult men, the [[foreskin]] normally retracts to reveal the [[glans penis\| head of the penis]]. In newborns, it is normal for the foreskin to be fused to the head of the penis by the [[synechia]], thus rendering it non-retractable.<ref name="agarwal2005" /> The [[preputial sac]] is sealed by the [[synechia]].<ref name="fleiss-hodges-vanhowe1998">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> The [[foreskin]] usually separates from the [[glans]] and becomes retractable with increasing age.<ref name="agarwal2005" /> There is much uncertainty among health care workers about when the [[foreskin]] of a boy should become retractable.<ref>{{REFjournal
	\|last=Simpson		\|last=Simpson
	\|init=ET		\|init=ET
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	\|date=1998-05		\|date=1998-05
	\|accessdate=2019-10-17		\|accessdate=2019-10-17
	}}</ref> The mistaken belief that the foreskin was supposed to be retractable at the time of birth of the infant has led to a characterization of the genitalia of most infant males as defective at birth. This has led to many false diagnoses of [[phimosis]], followed by unnecessary [[circumcision]], when, in fact, the [[foreskin]] is developmentally normal. There is no one correct age for the foreskin to become retractable.<ref name="agarwal2005" />		}}</ref> The mistaken belief that the [[foreskin]] was supposed to be retractable at the time of birth of the infant has led to a characterization of the genitalia of most infant males as defective at birth. This has led to many false diagnoses of [[phimosis]], followed by unnecessary [[circumcision]], when, in fact, the [[foreskin]] is developmentally normal. There is no one correct age for the foreskin to become retractable.<ref name="agarwal2005" />

	Normally, developmental non-retractability does not cause any problems, in fact, it is protective of the [[glans penis]] and protects against [[meatal stenosis]].<ref name="agarwal2005" /> Non-retractability may be deemed pathological if it causes problems, such as difficulty urinating or performing normal sexual functions, but even then, this is rare, and, if the non-retractability itself is not caused by pathological inflammation, it cannot be called "pathological" or "true phimosis." A foreskin that is so narrow it will retract very little or not at all, but is not the result of a pathological inflammation, is accurately termed ''preputial stenosis'' (narrow prepuce), and will respond to treatment including steroid creams, manual [[stretching]], and changing [[masturbation]] habits.		Normally, developmental non-retractability does not cause any problems, in fact, it is protective of the [[glans penis]] and protects against [[meatal stenosis]].<ref name="agarwal2005" /> Non-retractability may be deemed pathological if it causes problems, such as difficulty urinating or performing normal sexual functions, but even then, this is rare, and, if the non-retractability itself is not caused by pathological inflammation, it cannot be called "pathological" or "true phimosis." A [[foreskin]] that is so narrow it will retract very little or not at all, but is not the result of a pathological inflammation, is accurately termed ''preputial stenosis'' (narrow prepuce), and will respond to treatment including steroid creams, manual [[stretching]], and changing [[masturbation]] habits.

	== History ==		== History ==
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	Almost all boys are born with the inner [[foreskin]] mucosa fused with the underlying [[glans penis]] by the [[synechia]].<ref name="agarwal2005" /> Most also have a narrow [[foreskin]] that cannot retract. Non-retractile foreskin is normal at birth and remains in the normal range until after [[puberty]] (age 18).<ref name="agarwal2005" /> The non-retractile [[foreskin]] is nature's way of protecting the young boy from [[meatal stenosis]] and [[infection]] in the [[preputial sac]].		Almost all boys are born with the inner [[foreskin]] mucosa fused with the underlying [[glans penis]] by the [[synechia]].<ref name="agarwal2005" /> Most also have a narrow [[foreskin]] that cannot retract. Non-retractile foreskin is normal at birth and remains in the normal range until after [[puberty]] (age 18).<ref name="agarwal2005" /> The non-retractile [[foreskin]] is nature's way of protecting the young boy from [[meatal stenosis]] and [[infection]] in the [[preputial sac]].

	Some boys develop retractile foreskin earlier, and about 2-4 percent of males have a non-retractile foreskin throughout life. Non-retractile foreskin is not a disease and does not require treatment.		Some boys develop retractile foreskin earlier, and about 2-4 percent of males have a non-retractile foreskin throughout life. Non-retractile [[foreskin]] is not a disease and does not require treatment.

	There are three possible conditions that cause non-retractile foreskin:		There are three possible conditions that cause non-retractile foreskin:
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	Teen boys who still have a non-retractable [[foreskin]] (about 10 percent of boys) should start [[stretching]] exercises to make the foreskin retractable in preparation for adult life.		Teen boys who still have a non-retractable [[foreskin]] (about 10 percent of boys) should start [[stretching]] exercises to make the foreskin retractable in preparation for adult life.

	Occasionally a male reaches adulthood with a non-retractile foreskin. Some men with a non-retractile foreskin happily go through life and father children. Other men, however, may want to make their foreskin retractile.		Occasionally a male reaches adulthood with a non-retractile foreskin. Some men with a non-retractile foreskin happily go through life and father children. Other men, however, may want to make their [[foreskin]] retractile.

	===Fixing a narrow foreskin===		===Fixing a narrow foreskin===
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	According to Agarwal et al. (2005):		According to Agarwal et al. (2005):
	<blockquote>		<blockquote>
	Although circumcision is considered to be a simple procedure devoid of much morbidity, it is associated with many complications like hemorrhage, edema, infection, meatal stenosis, urethral fistulae, unsightly scars, penile curvature, shortness of shaft skin, and partial, or total penile loss. … In view of the various studies including the present one and the versatile use of preputial skin as a graft, it is suggested that circumcision should be avoided as far as possible especially for nonseparation of prepuce in early childhood.<ref name="agarwal2005" />		Although circumcision is considered to be a simple procedure devoid of much morbidity, it is associated with many complications like hemorrhage, edema, infection, meatal stenosis, urethral fistulae, unsightly scars, penile curvature, shortness of shaft skin, and partial, or total penile loss. … In view of the various studies, including the present one, and the versatile use of preputial skin as a graft, it is suggested that circumcision should be avoided as far as possible especially for nonseparation of prepuce in early childhood.<ref name="agarwal2005" />
	</blockquote>		</blockquote>

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	\|accessdate=2020-08-13		\|accessdate=2020-08-13
	\|format=PDF		\|format=PDF
	\|quote=Male circumcision is an outmoded treatment for non-retractile foreskin, but it is still recommended by many urologists because of lack of adequate information and understanding of alternative methods of relief. Nevertheless, circumcision should be avoided because of pain, trauma, cost, complications, difficult recovery, permanent injury to the appearance of the penis, loss of pleasurable erogenous sensation, and impairment of erectile and ejaculatory functions.		\|quote=Male circumcision is an outmoded treatment for non-retractile foreskin, but it is still recommended by many [[urologist\| urologists]] because of lack of adequate information and understanding of alternative methods of relief. Nevertheless, circumcision should be avoided because of pain, trauma, cost, complications, difficult recovery, permanent injury to the appearance of the [[penis]], loss of pleasurable erogenous sensation, and impairment of erectile and ejaculatory functions.
	}}		}}

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	* [[Physiological phimosis]]		* [[Physiological phimosis]]
	* [[Preputioplasty]]		* [[Preputioplasty]]
			* [[Puberty]]
	* [[Stretching]]		* [[Stretching]]
	* [[Synechia]]		* [[Synechia]]

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	The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">Fleiss PM, Hodges FM, Van Howe RS. [https://www.cirp.org/library/disease/STD/fleiss3/ Immunological functions of the human prepuce]. Sex Transm Infect. 1998 Oct;74(5):364-7. doi: 10.1136/sti.74.5.364. PMID: 10195034; PMCID: PMC1758142.</ref> so retraction should be minimized.		The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">Fleiss PM, Hodges FM, Van Howe RS. [https://www.cirp.org/library/disease/STD/fleiss3/ Immunological functions of the human prepuce]. Sex Transm Infect. 1998 Oct;74(5):364-7. doi: 10.1136/sti.74.5.364. PMID: 10195034; PMCID: PMC1758142.</ref> so retraction should be minimized.

	Birley et al. (1993) reported excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a balanitis like inflammation. The use of soap (including body wash, shower gel, and shampoo) should be avoided and emollients should be applied.<ref name="Birley1991">{{REFjournal		Birley et al. (1993) reported excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a [[balanitis]]-like inflammation. The use of soap (including body wash, shower gel, and shampoo) should be avoided and emollients should be applied.<ref name="Birley1991">{{REFjournal
	\|last=Birley		\|last=Birley
	\|init=HDL		\|init=HDL
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	}}</ref> [[Jojoba]] oil has been recommended as an emollient.		}}</ref> [[Jojoba]] oil has been recommended as an emollient.

	The foreskin should be kept in its normal forward position so that the protective functions are operative. Retraction and washing should be minimized.		The [[foreskin]] should be kept in its normal forward position so that the protective functions are operative. Retraction and washing should be minimized.

	== Making the foreskin retractable ==		== Making the foreskin retractable ==

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 == Avoidance of excessive retraction ==
 The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">Fleiss PM, Hodges FM, Van Howe RS. [https://www.cirp.org/library/disease/STD/fleiss3/ Immunological functions of the human prepuce]. Sex Transm Infect. 1998 Oct;74(5):364-7. doi: 10.1136/sti.74.5.364. PMID: 10195034; PMCID: PMC1758142.</ref> so retraction should be minimized.
 == Making the foreskin retractable ==

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	}}</ref>		}}</ref>
	== Avoidance of excessive retraction ==		== Avoidance of excessive retraction ==
	The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">~~{{FleissP HodgesF VanHoweRS~~ 1998}}</ref> so retraction should be minimized.		The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">Fleiss PM, Hodges FM, Van Howe RS. [https://www.cirp.org/library/disease/STD/fleiss3/ Immunological functions of the human prepuce]. Sex Transm Infect. 1998 Oct;74(5):364-7. doi: 10.1136/sti.74.5.364. PMID: 10195034; PMCID: PMC1758142.</ref> so retraction should be minimized.

	== Making the foreskin retractable ==		== Making the foreskin retractable ==

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	}}</ref>		}}</ref>
	== Avoidance of excessive retraction ==		== Avoidance of excessive retraction ==
	The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens, so retraction should be minimized.		The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens,<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> so retraction should be minimized.

	== Making the foreskin retractable ==		== Making the foreskin retractable ==

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	\|quote=		\|quote=
	}}</ref>		}}</ref>
			== Avoidance of excessive retraction ==
			The [[foreskin]] developed by natural selection over an aeon of time to provide survival of the fittest. The presence of the foreskin makes mankind more fit to survive. The foreskin is endowed with [[Immunological and protective function of the foreskin\| immunological and protective functions]] to improve health and well-being. Retraction of the foreskin opens the [[preputial sac]] and allows entry of contaminants and pathogens, so retraction should be minimized.

	== Making the foreskin retractable ==		== Making the foreskin retractable ==

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	== Avoidance of premature retraction ==		== Avoidance of premature retraction ==

	Care-givers and healthcare providers must be careful to avoid [[forced retraction\|premature retraction]] of the foreskin, which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause [[infection]], is likely to generate medico-legal issues, and may cause [[paraphimosis]], with the tight foreskin acting like a tourniquet. The first person to retract the boy’s [[foreskin]] should be the boy himself.<ref name="Wright1994"/> <ref name="agarwal2005" /> <ref>{{REFweb		Care-givers and healthcare providers must be careful to avoid [[forced retraction\|premature retraction]] of the [[foreskin]], which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause [[infection]], is likely to generate medico-legal issues, and may cause [[paraphimosis]], with the tight foreskin acting like a tourniquet. The first person to retract the boy’s [[foreskin]] should be the boy himself.<ref name="Wright1994"/> <ref name="agarwal2005" /> <ref>{{REFweb
	\|url=https://www.doctorsopposingforcibleretraction.org/		\|url=https://www.doctorsopposingforcibleretraction.org/
	\|title=Doctors Opposing Forcible Retraction		\|title=Doctors Opposing Forcible Retraction

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	[[Category:Physiology]]		[[Category:Physiology]]
	[[Category:Parental information]]		[[Category:Parental information]]
			[[Category:Teen]]

	[[Category:From Intactipedia]]		[[Category:From Intactipedia]]

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	The findings reported by Ko et al. are consistent with the findings reported by Øster (1968), by Kayaba et al. (1996), and by Thorvaldsen & Meyhoff (2005).		The findings reported by Ko et al. are consistent with the findings reported by Øster (1968), by Kayaba et al. (1996), and by Thorvaldsen & Meyhoff (2005).
			===Graphic presentation===
			* [https://www.reddit.com/media?url=https%3A%2F%2Fcf.preview.redd.it%2Fmom-of-a-three-year-old-v0-dz6pcmlc11yg1.jpeg%3Fwidth%3D1588%26format%3Dpjpg%26auto%3Dwebp%26s%3Dd36d2c2e751ca6d829144a87f591655fe8fc5b13 Graphs]
	== Discussion ==		== Discussion ==

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	\|accessdate=2025-10-17		\|accessdate=2025-10-17
	}}		}}
	* [https://www.reddit.com/media?url=https%3A%2F%2Fcf.preview.redd.it%2Fmom-of-a-three-year-old-v0-dz6pcmlc11yg1.jpeg%3Fwidth%3D1588%26format%3Dpjpg%26auto%3Dwebp%26s%3Dd36d2c2e751ca6d829144a87f591655fe8fc5b13 Graphs]

	* {{NSFW}} [http://www.circumstitions.com/Works.html How the foreskin works]		* {{NSFW}} [http://www.circumstitions.com/Works.html How the foreskin works]