[echaos]

I have a question about uncircumcised penises.

As you can imagine, neither Hilary nor I have much experience with penises in general.

I'm an only child, she has 2 older step brothers, neither of have boy cousins and any babysitting we did was either with girls or circumcised boys.

So my question is this....

Liam is three and daytime toilet trained. He is not circumcised. We do not pull back his foreskin for cleaning. But his foreskin is always pink/red. Is this normal? It doesn't "look" sore, nor does he complain about it.... it just doesn't look "right" (whatever that means!)

So any thoughts and ideas would be great. I meant to ask our Dr. last time we were in, but of course I forgot!

[Javalita]

Do you mean it is red/pink at the little opening or just the top or all of it? I just noticed that my son's uncircumcized penis is a little pink just inside the little opening, but nowhere else. I think at his age (15mos) maybe the foreskin is naturally pulling back a bit more than it used to. I was going to ask at the Dr. in the next week or so.

I've been loading the desitin on it for now.

Can't help you much I'm afraid, but wanted to answer and give you some details. I think maybe you should ask the Dr. - can't hurt.

[Lovebug]

Hey Gals...

I'm a mom to an uncirced boy and a wife to an uncirced man...(tmi???). Lol. DS is 21 months old. Basically, in care for him, the ped recommended pulling the foreskin back once a day and cleaning it. Apply vaseline...not desitin, around it trying to not cover the part where the urine would come out. DS's is a little pink, too...certainly it's natural color. Ask the ped for further advice or to check. This is just what we've done and he is perfectly perfect! Lol.

--Renee

[redhedded]

Renee, Did the foreskin retract on it's own first or did your ped recommend you do it? I certainly hope not.

[tobeafamily]

Andy,

At this age, you don't need to worry so much about cleanliness under the foreskin as long as he's bathing regularly, there's no discharge, the penis isn't swollen, tender or there's bleeding.

Foreskins actually should NOT be forcibly retracted, and they won't fully retract until age 5 or so. Our ped was very clear on this - if we did retract, do so very gently.

Urine is sterile when it leaves the body. The principal cause of infection in an uncircumcised penis is smegma getting trapped under the skin - something that his body won't make and excrete until he's older. Infants and toddlers (not potty trained) are at higher risk of infection if their diapers are not changed regularly and/or they don't get regular washing.

Here's some information from the American Academy of Pediatrics that may help:

http://www.medem.com/MedLB/article_d...&sub_ca t=108

HTH

Regina

[kelleymac]

Guys, this is an issue close to my heart (so to speak). Our ped recommended NOT retracting Jonah's foreskin once a day as suggested by some peds. Six weeks ago, we took Jonah to urgent care for a terrible infection that was the result of an adhesion. When the doctor at urgent care retracted the foreskin, the infection literally shot from his penis.

I have never been angrier at a doctor as I am at our original pediatrician. If I had it to do over again, I would retract his foreskin once a day in the bath to keep it clean and prevent such an adhesion.

Please talk with your pediatrician about this and about the concern of adhesion. Jonah is doing great now, but it was a painful and unnecessary thing for him to go through.

Kelley

edited to add: what tipped us off about the problem is that his penis became red at the tip and then slightly swollen.

[shoeshopping]

If he is 3 yrs. old and NOT complaining about it, then I would just watch it...or ask him.

If it is red and looks unhealthy or perhaps looks uneven in color, then I would call the doctor just so s/he can do a looksee.

both of my sons are circumsized...but one can never not know too much about uncircumsized penises. I have heard it is an unnecessary procedure and being uncircumsized is rather beneficial in adult life.

[[coughs discreetly]]

[redhedded]

taken from the Australian Family Physician

Normal foreskin anatomy
At birth, the inner layer of the prepuce is firmly adherent to the glans and is unable to be retracted at all. These adhesions are formed early in foetal development and serve to protect the developing glans.3 Separation of these adhesions occurs slowly over the next few years and there is great variability in the timing of this event. It has been classically stated that the foreskin should be fully retractable by the age of three years. However, this can occur as early as the first few months in some boys and not until 9 or 10 years in others.4 Almost all the perceived foreskin problems in young boys relate to the existence of subpreputial adhesion.

Common foreskin related complaints
Phimosis
The term phimosis is broadly regarded as describing a foreskin that is unable to retract. However, it is very important to distinguish between true pathologic phimosis from the normal anatomic situation where the infantile adhesions have not yet separated. In the latter situation, the tip of the foreskin is supple and unscarred and is likely to retract normally and fully in time (Figure 1).

True pathologic phimosis occurs when fibrosis, induration and scarring occur in the tip of the foreskin usually secondary to inflammation or trauma (Figure 2). Phimosis may also be due to lichen sclerosus et atrophicus.5 6

Ballooning
Ballooning refers to the swelling of the subpreputial area as urine becomes temporarily trapped under the foreskin during micturition. This probably occurs as a result of the stream being diverted by the adhesions. This phenomenon is not pathologic, usually causes no distress or discomfort to the boy and generally requires no treatment.

Smegma collections
Smegma is a creamy yellow sebaceous material that is secreted by the glans and often accumulates in clumps under the foreskin. These are often mistaken for cysts or pus collections, but require no treatment and will release once the foreskin retracts naturally.

Balanitis
Mild inflammatory changes with redness and some discomfort are often encountered in young boys, particularly while still in nappies, as a result of ammonical dermatitis (Figure 3). True balanitis or posthitis is usually staphylococcal in origin and responds well to simple cleaning and appropriate oral antibiotics.

Management
Normal foreskin
No attempt should be made to retract a foreskin in a child unless significant separation of the subpreputial adhesions has occurred. Failure to observe this basic rule may result in tearing with subsequent fibrosis and consequent true phimosis. However, once the foreskin is able to be retracted, this should be performed every time bathing occurs and the penis cleaned as part of normal male hygiene.

Penile cancer and sexually transmitted diseases have been reported as occurring more commonly in uncircumcised adults.7,8 However, it seems illogical in the extreme to advocate circumcision to prevent these afflictions. Penile hygiene and safe sex education are likely to be far more effective in this pursuit.

Mild redness of the foreskin requires only cleaning., while significant ammonical dermatitis may require some form of barrier cream.

Ballooning and smegma collection require no treatment, unless they are responsible for specific symptoms.

Andy, if you are concerned about the redness, see your pediatrician. However, if he/she tells you to retract it forcefully without current complications present, I would run and never see him again. The foreskin naturally retracts on it's own then normal cleaning is required.

[qs mom]

My son came home at almost 3 years old. He foreskin was already retracted. I don't know if it was natural or forced.

My ped stated since it was retracted, the only thing he needed was a daily washing.

He is olive complected, so his penis isn't very pink, but it is just a little bit.

His penis becomes irritated by bubble bath. The color seems darker pinkish. That is the only way to tell. He really doesn't complain about it. But he will hold his urine a bit longer than usual - that is another story.

Could it be a little irritation from bubble bath, scented soap, etc?

And of course, if you want, call your ped. You should never, ever feel that you can't/shouldn't call your doc.

In fact, just a story, for your entertainment - my son put his little hand on the front seat. I put the seat down for him to get into the backseat. Well, I crunched his little fingers in the mechanism. He cried like mad. I called the doc, I explained what happened, the skin was kind of torn up. I rushed him in - the put neosporine and a bandaid on and sent us on our way.

Just a little overreaction!

[mommieof2cuties]

Originally Posted by kelleymac

Guys, this is an issue close to my heart (so to speak). Our ped recommended NOT retracting Jonah's foreskin once a day as suggested by some peds. Six weeks ago, we took Jonah to urgent care for a terrible infection that was the result of an adhesion. When the doctor at urgent care retracted the foreskin, the infection literally shot from his penis.

I have never been angrier at a doctor as I am at our original pediatrician. If I had it to do over again, I would retract his foreskin once a day in the bath to keep it clean and prevent such an adhesion.

Please talk with your pediatrician about this and about the concern of adhesion. Jonah is doing great now, but it was a painful and unnecessary thing for him to go through.

Kelley

edited to add: what tipped us off about the problem is that his penis became red at the tip and then slightly swollen.

Dear Kelley:

So sorry your little one had to go through this. I hope he is better soon.

God Bless,
Summer

[LisaCA]

I just wanted to say i'm finding this discussion fascinating. I grew up one of three sisters, and I've never dated an uncircumcised guy, and never babysat an uncircumcised boy. so when we adopt again I'm convinced we'll have a boy just because that's the way the universe works (I hate doing hair, i have none myself, and i have dd who has miles of lovely hair for me to do ). since we don't plan to circumcise any child, this is the kind of info I need.

dh comes from a family of all boys but mom, everyone circumcised. he's learned a lot about little girls the past year or so.

anyway, thanks for starting the thread, andy and thanks for everyone posting the info. I'm learning tons...

lisa