Foreskin Issues in Young Boys: When to Seek Help

Prepuce issues

Hello, doctor.

1.
My son is currently two years old, and when I help him wash his penis during bath time, he says it hurts.
What should I do? Should I continue to wash it, and could there be other issues?
2.
How can I determine if a child has phimosis, and at what age is it appropriate to consider circumcision?

Mama, 30~39 year old female. Ask Date: 2008/07/02

Dr. Lai Ronghao reply Urology

It is common for young children to have the foreskin adhered to the glans.
Cleaning by retracting the foreskin can help prevent phimosis in the future.
Surgery is only necessary if there are recurrent balanitis or difficulties in urination caused by the foreskin.
It is recommended to wait until after puberty to have an evaluation at the hospital to determine if surgery is needed.
If you have any questions, you can visit the outpatient clinic of Dr.
Huang Yuan-Hui in the Urology or Pediatric Surgery department for further assessment and treatment.

Reply Date: 2008/07/02

More Info

When it comes to foreskin issues in young boys, it's important to approach the topic with sensitivity and an understanding of normal development. Your concerns about your two-year-old son experiencing pain during washing are valid, and it's crucial to address them appropriately.

1. Pain During Washing: If your son is expressing discomfort or pain when you attempt to retract the foreskin during bathing, it is essential to respect his feelings. At this age, many boys have a naturally tight foreskin that may not retract easily, and forcing it can cause pain and potential injury. The foreskin typically remains attached to the glans (the head of the penis) in young boys and will gradually separate as they grow older. This process can take several years, and it's not uncommon for boys to experience discomfort if the foreskin is forcibly retracted. Therefore, it is advisable to avoid pushing back the foreskin during washing. Instead, you can gently clean the external area with warm water, allowing your son to remain comfortable.

2. Determining Foreskin Issues: As for determining if your child has phimosis (a condition where the foreskin cannot be retracted), it's important to note that many boys will have a non-retractable foreskin until they are around 3 to 5 years old. If, by the age of 5 or 6, the foreskin still cannot be retracted without pain, it may be worth consulting a pediatrician. Signs that may indicate a problem include:
- Persistent pain or discomfort during urination or washing.

- Difficulty urinating due to a tight foreskin.

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

3. When to Consider Circumcision: Circumcision is a surgical procedure that involves the removal of the foreskin. The decision to circumcise should be made based on medical necessity rather than routine practice. In most cases, circumcision is not required unless there are significant issues such as recurrent infections, severe phimosis, or other medical concerns. If you are considering circumcision, it is best to discuss this with a pediatric urologist or your child's pediatrician, who can provide guidance based on your child's specific situation.

In summary, it is essential to approach foreskin care with gentleness and understanding. Avoid forcing retraction during washing, and monitor for any signs of complications. If you have ongoing concerns about your son's foreskin or if he continues to experience pain, seeking advice from a healthcare professional is the best course of action. They can provide tailored recommendations and determine if any further intervention is necessary. Remember, every child develops at their own pace, and many foreskin issues resolve naturally over time.

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