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[[Image:Side by side retraction.png|right|thumb|A human [[penis ]] before and after retraction of the [[foreskin]].]]

Infant boys are born with a non-retractable [[foreskin]]. 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 common normal for the foreskin to be fused to the head of the penis by the [[synechia]], thus rendering it non-retractable. The [[preputial cavity sac]] is sealed by the [[synechia]].<ref name="fleiss-hodges-vanhowe1998">{{REFjournal |last=Taylor |init=JR |author-link=John R. Taylor |last2=Lockwood |init2=AP |author2-link= |last3=Taylor |init3=AJ |title=The prepuce: specialized mucosa of the penis and its loss to circumcision |journal=Brit J Urol |date=1996 |volume=77 |issue= |pages=291-5 |url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.TaylorJR LockwoodAP TaylorAJ 1996.85023.x/full |quote= |pubmedID=8800902 |pubmedCID= |DOI=10.1046/j.1464-410X.1996.85023.x |accessdate=2019-12-02}}</ref> The [[foreskin ]] usually separates from the glans and becomes retractable with increasing age. There is much uncertainty among health care workers about when the foreskin of a boy should become retractable.<ref>{{REFjournal

}}</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.

Normally, developmental non-retractability does not cause any problems, in fact, it is protective of the [[glans penis]] and protects against [[meatal stenosis]]. 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.

Almost all boys are born with the inner [[foreskin ]] mucosa fused with the underlying [[glans penis ]] by the [[synechia]]. Most also have a narrow [[foreskin ]] that cannot retract. Non-retractile foreskin is normal at birth and remains common in the normal range until after puberty (age 18). 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.

* Fusion of the [[foreskin ]] with the [[glans penis]]<ref name="deibart1933">{{REFjournal

* [[Frenulum breve ]] (which is rare and cannot be diagnosed until the previous two reasons have been eliminated).

The first two reasons are normal in childhood and are not pathological in children. The third can be treated conservatively, retaining the [[foreskin]].

Kayaba ''et al''. (1996) reported that before six months of age, no boy had a retractable [[prepuce]]; 16.5 percent of boys aged 3-4 had a fully retractable [[prepuce]].<ref name="kayaba1996">{{REFjournal

}}</ref> Imamura (1997) examined 4521 infants and young boys. He re-ported reported that the [[foreskin ]] is retractile in 3 percent of infants aged one to three months, 19.9 percent of those aged ten to twelve months, and 38.4 percent of three-year-old boys.<ref name="imamura1997">{{REFjournal

}}</ref> Ko ''et al''. (2007) examined 59 newborn Taiwanese boys. Not one had a retractable [[foreskin]].<ref name="ko2007">{{REFjournal

Non-retractile [[foreskin ]] is the normal, expected, and more usual condition in this age group.<ref name="agawal2005">{{REFjournal

}}</ref> [[Ballooning of the foreskin]] may occur in this age group.

[[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="Thorvaldsen">{{REFjournal

Ko ''et al''. (2007) examined 1145 Taiwanese boys aged 7 to 13. Ko ''et al''. reported:

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)

Boys usually are born with a non-retractile foreskin. The [[foreskin ]] gradually becomes retractable over a variable period of time ranging from birth to 18 years or more.<ref name="Øster1968"/><ref name="Thorvaldsen"/> There is no “right” age for the foreskin to become retractable. Non-retractile foreskin does not threaten health in childhood and 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

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 problemsissues, 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>{{REFweb

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.

* Application of topical steroid ointmentto assist the stretching.<ref>{{REFjournal

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 weeksto prevent re-adhesion.

[[Adolescent and adult circumcision| Male circumcision]] is outmoded as a treatment for non-retractile foreskin, but it is still recommended by many [[Issues with American urologists and the practice of male circumcision| urologists]] because of lack of adequate information, and perhaps because of the [[Financial Incentive|profit to the doctor]] associated with circumcision. Nevertheless, [[Adolescent and adult circumcision| circumcision]] should be avoided whenever possible because of [[pain]], [[trauma]], cost,<ref name="Van Howe">{{REFjournal

}}</ref> [[Complication| complications]],<ref name="Van Howe"/> difficult recovery, [[Circumcision scar| permanent injury to the appearance of the penis]], extreme loss of [[Foreskin sensitivity| pleasurable erogenous sensation]],<ref>{{REFjournal

}}</ref> and adverse [[Sexual effects of circumcision| sexual ]] and [[Psychological issues of male circumcision| psychological]] effects.

* [[Forced retractionPenis]]

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]

|publisher=''[[Doctors Opposing Circumcision''(D.O.C.)]]