Swollen Glans in Newborns: Causes and Concerns

Swelling of the infant's glans penis?

Hello Dr.
Lee: My baby had redness and swelling of the glans at birth.
A few days later, the redness subsided, but the tip of the glans is still enlarged and appears larger than that of other infants.
However, urination is normal.
What could this symptom be?

A-Hong, 0~9 year old female. Ask Date: 2012/10/22

Dr. Li Yilun reply Urology

Possible conditions include the presence of smegma under the foreskin in newborns.
The foreskin is an anatomical structure that extends from the coronal sulcus at the back of the glans penis, covering the glans itself.
The foreskin is characterized by its looseness and good elasticity, providing sufficient expansion space for the penile shaft.
Generally, newborns and infants are unable to retract the foreskin, which is a normal phenomenon.
However, by the age of 3 to 4 years, about 60% of children can easily retract it, while only a small percentage may need to grow a bit older for easier retraction.
If the foreskin remains non-retractable after puberty, it is considered complete phimosis, which may require surgical intervention.
The foreskin serves to protect the glans.
Since humans began wearing clothing, the foreskin may seem redundant.
However, it still holds significant value; retaining it is not necessarily more harmful than beneficial.
For instance, modern infants are often diapered until they are two or three years old for easier care.
Without the protective foreskin, the urethral opening may frequently rub against the diaper, potentially causing scarring and narrowing of the urethra due to friction.
If a newborn is found to have a hypospadias, the foreskin can be utilized for urethral reconstruction surgery.
When the foreskin is not easily retractable, smegma can accumulate between the foreskin and the glans, sometimes forming pearl-like structures.
This smegma does not affect health, and it is not advisable to forcefully retract the foreskin for cleaning, as doing so can be painful and may result in scarring from injury.
Circumcision is often indicated when a child reaches school age but still cannot easily retract the foreskin, especially if ballooning occurs during urination, if the foreskin is too tight to clean properly leading to recurrent urethritis, or if the foreskin adheres to the glans and cannot be retracted.
These conditions should be discussed with a physician.
Each patient's situation is different, and it is essential to explain that a simple description cannot determine the condition.
Therefore, it is emphasized that if symptoms do not improve or worsen, it is advisable to seek professional medical consultation and examination to avoid delaying treatment.
Physicians often need to take a medical history, perform visual and physical examinations, and conduct tests to confirm the diagnosis and treatment plan.

Reply Date: 2012/10/22

More Info

Swollen glans in newborns can be a concerning observation for new parents, and it's important to understand the potential causes and implications. In your case, the initial redness followed by persistent swelling of the glans (the head of the penis) can be attributed to several factors, most of which are benign and self-limiting.

One common cause of swelling in the glans of newborns is a condition known as "physiological phimosis." This is a normal developmental stage where the foreskin is not yet fully retractable, leading to a buildup of smegma (a combination of dead skin cells and oils) under the foreskin. This can cause temporary swelling and redness, especially if there is any irritation or friction. As the child grows, the foreskin typically becomes more retractable, and the swelling usually resolves on its own.

Another potential cause could be a mild infection or irritation, which can occur due to various reasons, including diaper rash or exposure to irritants in soaps or wipes. If the swelling is accompanied by discharge, a foul odor, or if the baby seems to be in discomfort, it may indicate an infection that requires medical attention.

In some cases, the swelling could be related to a condition known as "balanitis," which is inflammation of the glans. This can occur due to poor hygiene, infections, or irritants. If balanitis is suspected, it is important to maintain good hygiene and consult a pediatrician for appropriate treatment, which may include topical medications.

Given that your baby is urinating normally and there are no other concerning symptoms, it is likely that the swelling is not a serious issue. However, it is always best to consult with a pediatrician for a thorough examination to rule out any underlying conditions. They can provide guidance on proper hygiene practices and monitor the situation to ensure that it resolves appropriately.

In summary, swollen glans in newborns can be caused by physiological phimosis, irritation, or mild infections. While it is often benign, it is essential to monitor the situation and consult a healthcare professional if you have any concerns or if the symptoms change. Regular check-ups with your pediatrician can help ensure your baby's health and address any questions you may have as a new parent.

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