Development of retractable foreskin: Difference between revisions
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== Current view == | == Current view == | ||
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 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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[[File:Kayaba.jpg|left|frame|Percentage of boys with tight ring totally non-retractile foreskin according to Kayaba et al.]]<br clear="all"> | [[File:Kayaba.jpg|left|frame|Percentage of boys with tight ring totally non-retractile foreskin according to Kayaba et al.]]<br clear="all"> | ||
[[Jakob Øster]], a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in [[Denmark]], where [[circumcision]] is rare.<ref name="Øster1968">{{OesterJ 1968}}</ref> Øster (1968) found that the incidence of fusion of the [[foreskin]] with the [[glans penis]] steadily declines with increasing age and foreskin retractability increases with age.<ref name="Øster1968"/> Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5 Kayaba et al. also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42 percent of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9 percent in boys aged 11-15.<ref name="kayaba1996" /> Imamura (1997) reported that 77 percent of boys aged 11-15 had retractile foreskin.<ref name="imamura1997" /> Thorvaldsen & Meyhoff (2005) conducted a survey of 4000 young men in [[Denmark]]. They reported that the mean age of first foreskin retraction is 10.4 years in [[Denmark]].<ref name="thorvaldsen2005">{{REFjournal | [[Jakob Øster]], a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in [[Denmark]], where [[circumcision]] is rare.<ref name="Øster1968">{{OesterJ 1968}}</ref> Øster (1968) found that the incidence of fusion of the [[foreskin]] with the [[glans penis]] steadily declines with increasing age and foreskin retractability increases with age.<ref name="Øster1968"/> Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5 Kayaba et al. also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42 percent of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9 percent in boys aged 11-15.<ref name="kayaba1996" /> Imamura (1997) reported that 77 percent of boys aged 11-15 had retractile foreskin.<ref name="imamura1997"/> Thorvaldsen & Meyhoff (2005) conducted a survey of 4000 young men in [[Denmark]]. They reported that the mean age of first foreskin retraction is 10.4 years in [[Denmark]].<ref name="thorvaldsen2005">{{REFjournal | ||
|last=Thorvaldsen | |last=Thorvaldsen | ||
|init=MA | |init=MA | ||
| Line 259: | Line 259: | ||
|issue=17 | |issue=17 | ||
|pages=1858-1862 | |pages=1858-1862 | ||
|url= | |url=https://www.cirp.org/library/normal/thorvaldsen1/ | ||
|quote= | |quote=The boys themselves retracted the foreskin for the first time at a mean age of 10.4 years. | ||
|pubmedID= | |pubmedID=15929334 | ||
|pubmedCID= | |pubmedCID= | ||
|date=2005-04 | |||
|date=2005 | |||
|accessdate=2019-10-17 | |accessdate=2019-10-17 | ||
}}</ref> Non-retractile foreskin is the more common condition until about 10-11 years of age. | }}</ref> Non-retractile foreskin is the more common condition until about 10-11 years of age. | ||
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Our findings indicate that the degree of preputial retractability increases with age, while the prevalence of unretractable prepuce decreases with age. By the age of 13 years, very few boys (some 0.3%) still had an unretractable prepuce (i.e. type 1 prepuce).<ref name="ko2007" /></blockquote> | Our findings indicate that the degree of preputial retractability increases with age, while the prevalence of unretractable prepuce decreases with age. By the age of 13 years, very few boys (some 0.3%) still had an unretractable prepuce (i.e. type 1 prepuce).<ref name="ko2007" /></blockquote> | ||
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 == | ||
Boys are born with a non-retractile foreskin.<ref name="agarwal2005" /> The [[foreskin]] gradually becomes retractable over a variable period of time ranging from birth to 18 years or more.<ref name="Øster1968 | Boys are born with a non-retractile foreskin.<ref name="agarwal2005" /> The [[foreskin]] gradually becomes retractable over a variable period of time ranging from birth to 18 years or more.<ref name="Øster1968"/> There is no “right” age for the foreskin to become retractable. Thorvaldsen & Meyhoff (2005) reported the mean age of first foreskin retraction was 10.4 years.<ref name="thorvaldsen2005"/> Non-retractile foreskin does not threaten health, so no intervention is necessary. Many boys only develop a retractable foreskin after [[puberty]]. Education of concerned parents usually is the only action required.<ref>{{REFjournal | ||
|last=Spilsbury | |last=Spilsbury | ||
|init=K | |init=K | ||
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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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|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,<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 | |||
|last=Birley | |||
|init=HDL | |||
|author-link= | |||
|last2=Wasker | |||
|init2=MM | |||
|last3=Luzzi | |||
|init3=GA | |||
|etal=yes | |||
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing | |||
|journal=Genitourin Med | |||
|date=1993-10-01 | |||
|volume=69 | |||
|issue=5 | |||
|pages=400-3 | |||
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf | |||
|quote= | |||
|pubmedID=8244363 | |||
|pubmedCID=1195128 | |||
|DOI=10.1136/sti.69.5.400 | |||
|accessdate=2026-05-01 | |||
}}</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. | |||
== Making the foreskin retractable == | == Making the foreskin retractable == | ||
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===Fixing a fused foreskin=== | ===Fixing a fused foreskin=== | ||
In a few cases, the [[Synechia| synechial]] fusion of childhood lingers past puberty. After puberty, the synechial fusion should be about ready to spontaneously release the [[foreskin]] from the [[glans penis]]. One may try gently peeling the [[foreskin]] away from the glans penis by using one's thumbs. It may take one several tries to get it all separated. Do ''not'' force anything and do ''not'' cause cause yourself pain. | In a few cases, the [[Synechia| synechial]] fusion of childhood lingers past [[puberty]]. After [[puberty]], the synechial fusion should be about ready to spontaneously release the [[foreskin]] from the [[glans penis]]. One may try gently peeling the [[foreskin]] away from the glans penis by using one's thumbs. It may take one several tries to get it all separated. Do ''not'' force anything and do ''not'' cause cause yourself pain. | ||
Apply petroleum jelly after separation occurs for about two weeks to prevent re-adhesion. | Apply petroleum jelly after separation occurs for about two weeks to prevent re-adhesion. | ||
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==Adult foreskin== | ==Adult foreskin== | ||
===Should the foreskin retract automatically when the penis becomes erect?=== | ===Should the foreskin retract automatically when the penis becomes erect?=== | ||
It appears that many sex education classes provide incorrect information about automatic foreskin retraction. Not all foreskins retract automatically when [[erection]] occurs. | |||
It depends on the relative length of the [[foreskin]] in relation to the length of the [[penis]]. If the foreskin is shorter than the erect [[penis]], then it will retract automatically on [[erection]]. On the other hand, if the foreskin is longer than the erect penis, then automatic retraction will not occur. This condition is not viewed as a problem. | |||
A very few of the longest foreskins will not stay retracted when manually retracted. Instead, they will spontaneously [[gliding action| glide]] forward when released. This harmless condition is believed to be very rare. | A very few of the longest foreskins will not stay retracted when manually retracted. Instead, they will spontaneously [[gliding action| glide]] forward when released. This harmless condition is believed to be very rare. | ||
[[Longer foreskin is favored]] by many men for both functional and esthetic reasons. | |||
<i>See [[Foreskin#Foreskin_length| Foreskin length]].</i> | <i>See [[Foreskin#Foreskin_length| Foreskin length]].</i> | ||
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* [[Forced retraction]] | * [[Forced retraction]] | ||
* [[Foreskin Care for Boys]] | * [[Foreskin Care for Boys]] | ||
* [[Foreskin comment]] | |||
* [[Foreskin sensitivity]] | * [[Foreskin sensitivity]] | ||
* [[Fusions and adhesions]] | |||
* [[Gliding action]] | * [[Gliding action]] | ||
* [[Penis]] | * [[Penis]] | ||
* [[Phimosis]] | * [[Phimosis]] | ||
* [[Physiological phimosis]] | |||
* [[Preputioplasty]] | * [[Preputioplasty]] | ||
* [[Puberty]] | |||
* [[Stretching]] | * [[Stretching]] | ||
* [[Synechia]] | * [[Synechia]] | ||
* [[Risks and complications]] | * [[Risks and complications]] | ||
* [[The natural foreskin - retraction and frenulum]] | |||
* [[Tissue expansion]] | * [[Tissue expansion]] | ||
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|accessdate=2024-06-21 | |accessdate=2024-06-21 | ||
}} | }} | ||
* {{ | * {{REFweb | ||
|url=https://www.reddit.com/r/uncircumcised_talk/comments/1o8tj14/do_you_remember_what_it_was_like_when_your/ | |||
|title=Do you remember what it was like when your foreskin detached from your glans? What was your reaction? | |||
|last=Anonymous | |||
|publisher=REDDIT | |||
|date=2025-10-16 | |||
|accessdate=2025-10-17 | |||
}} | |||
* {{NSFW}} [http://www.circumstitions.com/Works.html How the foreskin works] | |||
{{REF}} | {{REF}} | ||
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[[Category:Education]] | [[Category:Education]] | ||
[[Category:Foreskinned life]] | |||
[[Category:Penis]] | |||
[[Category:Physiology]] | [[Category:Physiology]] | ||
[[Category:Parental information]] | [[Category:Parental information]] | ||
[[Category:Teen]] | |||
[[Category:From Intactipedia]] | [[Category:From Intactipedia]] | ||