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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]]. <ref name="agarwal2005">{{REFjournal |last=Agarwal |first= |init=A |author-link= |last2=Mohta |first2= |init2=A |author2-link= |last3=Anand |first3= |init3=RK |author3-link= |etal=no |title=Preputial retraction in children |trans-title= |language= |journal=J Indian Assoc Pediatr Surg |location= |date=2005-04 |season= |volume=10 |issue=2 |article= |pages=89-91 |url=https://journals.lww.com/jiap/fulltext/2005/10020/preputial_retraction_in_children.5.aspx |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.4103/0971-9261.16468 |accessdate=2024-06-26}}</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

}}</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.

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]].

The first two reasons are normal in childhood and are not pathological in children. <ref name="agarwal2005" /> 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

Non-retractile [[foreskin ]] is the normal, expected, and more usual condition in this age group.<ref name="agawal2005agarwal2005">{{REFjournal |last=Agawal |first=Abhnav |init=A |author-link= |last2=Mohta |first2=Anup |init2=A |author2-link= |last3=Anand |first3=Ritesh K. |init3=RK |author3-link= |etal=no |title=Preputial retraction in children |trans-title= |language= |journal=Journal of Indian Association of Pediatric Surgeons |location= |date=2005 |volume=10 |issue=2 |pages=89-91 |url=http://www.jiaps.com/article.asp?issn=0971-9261;year=2005;volume=10;issue=2;spage=89;epage=91;aulast=Agarwal |quote= |pubmedID= |pubmedCID= |DOI=10.4103/0971-9261.16468 |accessdate=2019-12-09}}</ref> Harmless [[Ballooning ballooning of the foreskin]] may occur in this age group.

[[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

Boys usually 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"/><ref name="Thorvaldsen"/> There is no “right” age for the foreskin to become retractable. 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

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

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.

}}</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

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.