Care For The Intact Penis

Simple as 1... 2... 3!

For infants and small children, no special cleaning is necessary! Simply wipe it as you would your finger. Clean from base of the penis, towards the tip of the penis. NEVER retract your sons penis to clean. A boys foreskin usually becomes retractable by the age of 18.

Why shouldn’t I retract to clean?

In the young child, the foreskin is fused to the head of the penis. There is no need to clean under it. 

As a boy grows, the foreskin will gradually (possibly over many years) separate from the head of the penis (also called the glans), so eventually there will be a space underneath. Then the boy will be able to slide back (retract) the foreskin to expose the glans, if desired.


Even once the foreskin has separated, however, it  fits snugly over the glans, keeping foreign matter out. When the boy urinates, the foreskin opening is flushed, keeping the inside of the foreskin clean. (Urine is sterile when it leaves the body.) So there is absolutely no need for a parent or other caregiver to clean under the foreskin of a young child.


The first person to ever retract the foreskin should be the boy himself, not a parent or a doctor. Only he will know when he is comfortable doing this, and he will be less likely to hurt himself than another person would.


Medical Concerns

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Forced retraction of the foreskin causes pain and trauma. It rips the child’s foreskin from his glans and/or tears his foreskin’s opening. Only the boy himself should retract, when he so desires. There should be no manipulation of the foreskin. This includes pulling back to see the urethra - a  common misconception spread in the medical community. That would be the equivalent of trying to see a females vulva - unnecessary and intrusive.


Forced retraction creates raw surfaces on the foreskin and glans, which cause the following problems:


Infection-

There is now an opening through which bacteria can enter the body.


Adhesions-

The two raw surfaces grow together as they heal, often requiring surgery to make foreskin retraction possible later.


Acquired Phimosis-

The foreskin’s narrow opening sometimes tears when the glans is forced through it, forming scar tissue that may prevent it from widening later on its own.


Paraphimosis-

When a child’s foreskin is retracted by force, its (narrow) opening may “get caught” behind his glans, and, like a tourniquet, trap blood in the glans and make it swell. Many physicians recommend circum­cision to “correct” this, but the foreskin can be brought forward without cutting by holding the shaft of the penis and gently pushing the glans into the foreskin. If this doesn’t work, squeezing the glans to reduce swelling should help it slip back inside the foreskin. 

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What is it? 


Yeast infections throughout the body are caused by an overgrowth of candida, a fungus that is usually present in small amounts all over the body. However, moist environments like the mouth, armpits, and genitals make it easier for candida multiply and spread. 


How do I fix it? 


When candida spreads and infects the glans, or head of the penis, boys may experience itching, burning, white and shiny patches or a red rash.  A number of over-the-counter antifungal creams can treat penile yeast infections.


How do i prevent it? 


  • If your son is in diapers, change them as often as possible. Time away from the diaper is the best option. 
  • If you are using cloth diapers, you will want to bleach the diapers to eliminate yeast, as it can survive on cloth. Drying the diapers in the sun will also help eliminate any yeast left over in the cloth. 
  • If your son is potty-trained, encourage him to pat himself dry. 
  • Wash all underwear in hot water and dry them using high heat or put them outside to sun dry.
  • Apply clotrimazole/lotrimin 1% (yes, this is athletes foot cream, but it is an anti-fungal!) topically to speed healing time. If you feel something stronger is needed, or it is not going away/getting better, a doctor can prescribe Nystatin cream.


Note: If you have treated for yeast for 48 hours and there is no improvement, there might be a bacterial infection in addition to yeast and a doctor may need to prescribe an antibiotic. This is rare, but does happen on occasion. Antibiotics themselves often cause yeast by killing the good bacteria in the gut along with the bad, which causes yeast to flourish. If your child (or you) are ever prescribed an antibiotic, it's always good to take an oral probiotic (two hours minimum apart from the antibiotic), and watch for signs of yeast.

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What is it?


A condition in which tight foreskin can't be pulled back over the head of the penis.


Tight foreskin is normal in an intact child. It will go away over time and is not a valid reason to circumcise.

 With advent of newer effective and safe medical and conservative surgical techniques, circumcision is gradually getting outmoded. Parents and doctors should a be made aware of the noninvasive options for pathologic phimosis for better outcomes with minimal or no side-effects. Also differentiating features between physiologic and pathologic phimosis should be part of medical curriculum to minimise erroneous referrals for surgery.


Physiologic Phimosis:

Most phimosis referrals seen in pediatric urology clinics are normal physiologically phimotic foreskins. This means that the foreskin has not yet separated from the glans (head) of the penis. Until puberty has finished, diagnosis of phimosis will be Physiological. 


Pathologic Phimosis:

In older boys and adults, phimosis can be caused by an injury to the foreskin — often due to the foreskin being forcibly retracted before it's ready — or by a bacterial infection of the foreskin or glans. This is called pathologic phimosis, and it can lead to recurring infections, problems while urinating (peeing), and pain during sexual intercourse.