Care of intact, foreskinned boys

From IntactiWiki
Jump to navigation Jump to search

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

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.[1] Therefore, it has been necessary to establish an educational program for both parents and physicians on the normal care of the intact penis.[1]

Sadly, many health care providers promote harmful infant circumcision because they profit from it's performance. 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.[2]

Intact America (2024) provides a comprehensive guidance for parents to aid in the protection of their intact sons from harm in America's heath care establishments.[3]

Infant penile anatomy

When boys are born, the preputial sac is sealed shut by a synechia called the balanopreputial lamina,[4] so it cannot be infected. The preputial sac will remain closed for a variable number of years and the foreskin cannot be retracted without severe injury and pain.

The preputial sac is lined with mucosa as is appropriate for an internal organ where moisture is present.[5] Urine and other sources of moisture are not harmful to it.

Newborn intact boys are easier to care for than circumcised boys because intact boys do not have an open surgical wound,[6] [7] 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.[8] 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.[9] 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. The foreskin must cover the meatus to protect it from the ammonia which forms in wet diapers.[10] If the foreskin does not cover and protect the meatus, then the ammonia will likely attack the meatus and cause meatitis and meatal stenosis.

Forced foreskin retraction is harmful and must be avoided.

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.[11]

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.[12]

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.[13] Øster (1968) reported that some boys will not develop retractable foreskin until after puberty.[14]

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.[15] The foreskin has many Meissner's corpuscles,[16] 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.[4] 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.[17]

Some intact boys will report pain when they urinate during the period in which separation is occurring.[18] The condition is temporary and will end when separation is complete.[19] 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,[20] which may place your foreskinned son at risk of forced foreskin retraction.

Video



See also

External links

References

  1. 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.
  2. REFweb Anonymous (1916). Wrongful Foreskin Retraction, Doctors Opposing Circumcision. Retrieved 27 June 2024.
  3. REFweb Kristel, Alissa (23 December 2024). Where Circumcision Advocates Strike: Protecting Intact Boys From Harm, Intact America. Retrieved 23 December 2024.
  4. a b REFjournal Deibart GA. The separation of the prepuce in the human penis. Anat Rec. 1933; 57: 387-99. DOI. Retrieved 23 May 2023.
  5. REFjournal Cold CJ, Taylor JR. The prepuce. BJU Int. January 1999; 83, Suppl. 1: 34-44. PMID. DOI. Retrieved 8 July 2021.
  6. REFweb (2 August 2021). How to Care for Your Baby's Penis, American Academy of Pediatrics. Retrieved 18 August 2024.
  7. 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.
  8. REFjournal Fleiss PM, Hodges FM, Van Howe RS. Immunological functions of the human prepuce PDF. Sex Trans Inf. October 1998; 74(5): 364-7. PMID. PMC. DOI. Retrieved 23 December 2024.
  9. 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.
  10. REFjournal Brennemann J. The Ulcerated Meatus in the Circumcised Child. Am J Dis Child. 1921; 21: 28-47. Retrieved 1 January 2025.
    Quote: An ulcerated meatus in the circumcised child only is a frequent symptom.
  11. REFweb Milos MF (7 March 2022). Ask Marilyn – Bath Time Turns a Boy’s Foreskin Red, Intact America. Retrieved 24 October 2024.
  12. 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.
  13. 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.
  14. 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.
  15. REFweb (4 June 2020). How To Care For Your Child's Foreskin, KidsHealth of New Zealand. Retrieved 25 January 2023.
  16. 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.
  17. REFweb Milos MF (21 March 2022). Ask Marilyn – Let the Balloon Go!, Intact America. Retrieved 24 October 2024.
  18. REFweb Milos MF (26 September 2022). Ask Marilyn—Kiddo Is Having Painful Erections, Intact America. Retrieved 24 October 2024.
  19. REFweb (February 2018). Foreskin separation, The Royal Children's Hospital Melbourne. Retrieved 15 August 2023.
  20. REFweb Ashford, Jeannie (12 September 2024). The Daycare Risk for Intact, Uncircumcised Babies and Boys: Forcible Foreskin Retraction, Intact America. Retrieved 13 September 2024.