Care of intact, foreskinned boys

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

The foreskin has the duty of protecting the glans penis and meatus, so boys are born with a foreskin that does not retract. 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.

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. Therefore, it has been necessary to establish an educational program for both parents and physicians on the normal care of the intact penis.

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.

Discussion

The intact foreskin 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.

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.

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. Øster (1968) reported that some boys will not develop retractable foreskin until after puberty.

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. The foreskin has many Meissner's corpuscles, 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. 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.

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

Not recommended

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

See also

• Ballooning of the foreskin
• DoNoHarm.report
• Forced foreskin retraction
• Immunological and protective function of the foreskin
• Intact-friendly
• Development of retractable foreskin
• Meatal stenosis
• Protection of intact newborns in hospital
• Synechia
• Intact versus Circumcised Baby Care

External links

• Wallerstein, Edward: When Your Baby Boy is Not Circumcised (Four-page pamphlet), Pennypress (Seattle). (February 1982). Retrieved 30 May 2021.
• Fleiss, Paul M. (March 1989). Care of the intact male, NOCIRC. Retrieved 5 October 2021.
  Quote: Leave the penis of the newborn infant alone.
• Simpson ET, Baraclough P. The management of the paediatric foreskin. Aust Fam Physician. 1998; 27(5): 381-3. PMID.
  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.
• Milos, Marilyn (September 2007). Answers To Your Questions About Your Young Son's Intact Penis, NOCIRC. Retrieved 8 December 2019.
• Milos, Marilyn (September 2007). Answers To Your Questions About Premature (Forcible) Retraction of Your Young Son's Foreskin, NOCIRC. Retrieved 8 December 2019.
• Bollinger D. The Penis-Care Information Gap: Preventing Improper Care of Intact Boys. The Journal of Boyhood Studies. 2007 (Fall); 1(2): 205-19. Retrieved 25 May 2023.
• (2018). Intact care guide for parents and caregivers., Intact America. Retrieved 29 December 2022.
• Care of the Intact (Not Circumcised) Penis in the Young Child , Doctors Opposing Circumcision (D.O.C.). (July 2016). Retrieved 8 November 2019.
• https:Basic Care (Intact Penis), Your Whole Baby. Retrieved 8 December 2019.
• (July 2018). The penis and foreskin, The Royal Children's Hospital of Melbourne. Retrieved 23 December 2019.
• I’m an intact teen. What do I need to know?, Your Whole Body. Retrieved 16 April 2023.
• Garrett, Connor (9 March 2024). Intact Penis Care: Embracing Natural Well-being, Intact America. Retrieved 10 March 2024.