Concerns About Child's Urethral Inflammation and Foreskin Issues

Q: Concerns About Child's Urethral Inflammation and Foreskin Issues

Xiao Min： Hello, when the foreskin cannot retract, there is often a buildup of smegma at the junction of the foreskin and the glans, which appears as a white substance hidden beneath the foreskin, resembling a tumor. <br>You can improve local hygiene; by cleaning the smegma, the

Question

Hello Doctor: Around late May, I noticed a small protrusion on my son's glans (it looks like a small blister but also resembles a small piece of flesh).
The doctor mentioned it was a mild urethritis and would resolve on its own.
However, last week while bathing my son, I noticed that I could no longer retract his foreskin (it was possible before).
It feels like it is stuck, and I can vaguely see the previous protrusion at the urethral opening.
I am concerned that it may have enlarged, preventing the retraction of his foreskin.
Thank you, Doctor, for your help!

Xiao Min, 20~29 year old female. Ask Date: 2007/06/13

Dr. Xu Weikai reply Urology

Xiao Min: Hello, when the foreskin cannot retract, there is often a buildup of smegma at the junction of the foreskin and the glans, which appears as a white substance hidden beneath the foreskin, resembling a tumor.
You can improve local hygiene; by cleaning the smegma, the "tumor" will naturally disappear.
During bathing, it is recommended to gently push the foreskin downwards with a bit of force to gradually widen the opening.
After some time, the foreskin may retract naturally, making cleaning easier and preventing the occurrence of the "tumor" you mentioned.
If you still have concerns, you can consult a urologist.
This is a response from Dr.
Hsu Wei-Kai, Director of Urology at Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2007/06/13

More Info

It sounds like you are experiencing a concerning situation with your son's urethral inflammation and foreskin issues. Based on your description, it seems that your son has developed a small protrusion on the glans (the head of the penis) that was initially diagnosed as a mild urethral inflammation. The fact that you are now unable to retract the foreskin as you previously could is indeed a concern that warrants further evaluation.

In young children, it is not uncommon for the foreskin to be non-retractable due to natural adhesions between the foreskin and the glans. However, if there has been a change in the ability to retract the foreskin, especially if it was previously retractable, this could indicate a few potential issues. One possibility is that the inflammation has led to swelling or scarring, which could make retraction difficult. Another possibility is that the protrusion you mentioned has increased in size, potentially causing a blockage or further irritation.

Given that the protrusion was previously noted and is now visible again, it is essential to have this evaluated by a pediatric urologist or a pediatrician with experience in this area. They can perform a physical examination to assess the protrusion and determine if it is indeed related to the urethral inflammation or if there are other underlying issues, such as a condition called phimosis (where the foreskin cannot be retracted over the glans) or a possible infection.

In terms of treatment, if the inflammation is mild and the protrusion is not causing significant discomfort or urinary issues, your doctor may recommend a watchful waiting approach, as many cases resolve on their own. However, if there is significant swelling, pain, or if your son is experiencing difficulty urinating, more immediate intervention may be necessary. This could include topical treatments, such as corticosteroids, to reduce inflammation, or in some cases, a minor surgical procedure to address any adhesions or to remove the protrusion if it is deemed necessary.

It is also important to maintain good hygiene in the area, ensuring that your son is not forced to retract the foreskin if it is not easily done, as this can lead to further irritation or injury. Gentle cleaning during baths is usually sufficient, and any signs of infection, such as redness, increased swelling, or discharge, should prompt a visit to the doctor.

In summary, while it is possible that the protrusion and the inability to retract the foreskin are related to the initial inflammation, it is crucial to seek medical advice for a thorough evaluation. Early intervention can help prevent complications and ensure your son's comfort and health. Please consider scheduling an appointment with a healthcare provider who can provide a detailed assessment and appropriate management options.

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