Thursday, December 1, 2011

Premature and Forced Retraction of the Foreskin

I wanted to point something out that seems to be missing in the conversations about intact boys and their penile care.

The bonding membrane between the foreskin and the glans (synechia, or preputial lamina) needs to naturally separate before the foreskin can retract. Retraction prior to this time is "forced" and causes many issues like infection, tearing, bleeding, adhesions, scarring, phimosis; not to mention the boy having anxiety or worse in regard to his penis.

What I've seen from some is that they feel hygiene is still so important that whenever this finally occurs it's ok retract and rinse.
Here's the thing: the ridged band (elastic tissue that makes the opening of the foreskin narrow, yet can still open for the glans) needs time to mature as well. Just because the synechia is released, doesn't mean the ridged band is ready to be constantly expanded. Children's bodies grow in a pretty sporadic way, and all the parts as they're growing change in size relative to each other. Ya know, they have big ears, then grow into them... The foreskin and penis can go through this too. At some stages, the foreskin is tighter, and sometimes it's looser. So what this means is that by "premature" retraction you still risk over stretching the ridged band which can still cause minute scarring and possible later phimosis without even knowing it. If the boy is instructed to retract rather than finding it out himself (which personally I think is a little sad, because he's being denied a 'personal discovery') then he may cause himself to get paraphimosis: where the foreskin is gets stuck in the retracted position, which can be painful, or even cut off blood supply. He may start retracting when his foreskin is looser, and because he was instructed, do it when it's tighter, as opposed to only doing it when nature tells him to. Puberty takes care of the penis with a lot of hormones, which help in penile development and skin elasticity, and the urge to "stretch" the foreskin pretty regularly.

Until puberty there is REALLY nothing going on under the foreskin that needs to be dealt with. If you instruct your child (like you would with a girl) to wash hands after touching the bum or mouth, and before touching the genitals or mouth, the rest should take care of itself. Cut down on sugar and soaps if there's irritation and deal with a problem IF it comes up. Trust nature =) ~ there is such a thing as too much prevention. 

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