Phimosis in Infants: What Parents Need to Know

May I ask about infants under 6 months old?

Hello doctor, I have a question about my five-month-old son.
Today, during a diaper change, I noticed that the area around his genitalia had a slight reddish-yellow discoloration, somewhat similar to the color of adult underwear.
When I looked at my son's penis, I found that the glans was completely covered and it seemed like there was no foreskin, as the entire head was enclosed.
There is an opening for urination, but I couldn't see the glans.
Some people have mentioned that this might be phimosis in infants.
Is it normal for infants to have this condition? If he hasn't been circumcised, shouldn't there still be foreskin allowing the glans to be exposed? And if he had been circumcised, there should be skin behind the glans, allowing it to be visible, right? My son hasn't been circumcised, but it currently appears to be a complete covering.
Is this normal for an infant under one year old? Thank you for your response, doctor.

Xiao Le, 30~39 year old female. Ask Date: 2016/04/03

Dr. Li Xinyi reply Urology

If there is no obstruction, circumcision may not be necessary.
This includes your concerns.
It is important to consult a urologist for an examination to confirm this.
When cleaning, do not forcefully retract the foreskin to avoid causing any injuries.

Reply Date: 2016/04/03

More Info

Phimosis in infants is a common condition that many parents may encounter, and it can often lead to confusion and concern. To clarify, phimosis refers to the inability to retract the foreskin (the skin covering the glans or head of the penis) in males. In newborns and infants, this condition is typically physiological, meaning it is a normal part of development.

Understanding Phimosis
1. Normal Development: In most newborns, the foreskin is naturally adhered to the glans, which means that it cannot be retracted. This is a normal condition and is expected to resolve as the child grows. By the age of three, most boys will have a retractable foreskin, but this can vary significantly.

2. Signs of Phimosis: In your case, it sounds like your son has a non-retractable foreskin, which is typical for his age. The yellowish discharge you noticed could be smegma, a natural substance that can accumulate under the foreskin. This is also normal and usually resolves with regular cleaning during diaper changes.

3. When to Seek Help: While phimosis is usually not a cause for concern in infants, you should consult a pediatrician if you notice any of the following:
- Pain or discomfort during urination.

- Signs of infection, such as redness, swelling, or discharge that appears abnormal.

- Difficulty urinating or a change in the urine stream.

4. Treatment Options: In most cases, no treatment is necessary for phimosis in infants. However, if the condition persists as the child grows and causes problems, options may include gentle stretching exercises or, in rare cases, surgical intervention (circumcision) if there are complications.

Parental Guidance
- Do Not Force Retraction: It is crucial not to forcefully retract the foreskin, as this can cause pain and lead to scarring or infection. Instead, allow the foreskin to separate naturally over time.

- Hygiene Practices: Maintain good hygiene by cleaning the area during diaper changes. You can gently wash the external genitalia with mild soap and water, but avoid trying to retract the foreskin.

- Monitoring Development: Keep an eye on your child's development and any changes in the genital area. Regular pediatric check-ups will help ensure that everything is progressing normally.

Conclusion
In summary, phimosis is a normal condition in infants, and your son’s situation appears to be typical for his age. As he grows, his foreskin will likely become more retractable. If you have ongoing concerns or notice any unusual symptoms, do not hesitate to reach out to your pediatrician for further evaluation and guidance. They can provide reassurance and help you understand what to expect as your child develops.

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