One of the worries for parents of boys is how to deal with the topic of “wieners”. How should you clean it? When do you need to be careful? Should you pull the foreskin back or not? The uncertainty is understandable, especially given the amount of inaccurate and outdated information out there – the advice given by older generations is often now contradicted by modern medical science. Our pediatric urologist Dr András Kiss PHD is here to help.
What are we talking about, exactly?
For newborn babies, it is normal for the foreskin to provide protection to the head of the penis, which is why it cannot be pulled back. While you mustn’t disturb the foreskin under any circumstances, if there is any kind of problem, it needs to be treated. Possible issues include infections and “ballooning”, when urination is obstructed and the baby’s foreskin expands when he pees.
Adhesion or phimosis?
It is important to know the difference between penile adhesion and phimosis. Penile adhesion occurs when the foreskin and the penis grow together and cannot be pulled apart. This begins in the womb and remains for 80% of babies until around six months, when the foreskin separates from the penis. This is completely natural up until the age of three and parents shouldn’t worry about it.
Phimosis is a different phenomenon. It occurs when the foreskin is thicker than it should be and cannot be pulled back, and therefore requires treatment. In its mild form, it can sometimes be treated using a special cream, while it is necessary to perform an operation in more serious cases. It is important to note, however, that phimosis often eases by the age of three, and it can pass even after this time, so it is important to be patient.
What can a parent do?
For babies younger than a year, it is best not to touch their penis. Once they are older, you can start giving the foreskin some very light “exercise”. The simplest way is to pull the foreskin back during bath time, but only if it can be done without force. You don’t need to worry too much about cleanliness, it’s sufficient to wash it with a bit of water.
A lot of people are not aware of this and cause problems by forcing the foreskin back. This can result in the skin rupturing and becoming sore, and scars will form as the wound heals. During this process, the foreskin can lose its flexibility, and will then be unable to expand.
When should you go to a doctor?
The earliest time you should go to a doctor for assistance with either penile adhesion or phimosis is when your child is three years old. Nowadays, however, the advice is usually to wait until they are four or five years old. If your child’s foreskin has still not separated from the penis by this time, or is very tight, then you should consult a doctor.
It is also important to intervene if inflammation occurs (at any age) between the foreskin and penis. If the foreskin is red, swollen and produces any discharge, it is important to consult a doctor. If this is not treated in time and in the appropriate way, then the inflammation can cause the two to grow together, leading to “pathological phimosis”.
We hope we have been able to reassure any parents that you don’t need to get scared straightaway if you notice any signs that your baby has a tight foreskin. Appropriate care is not as hard as it first seems, and the most important thing is to know when you should take your child to the doctor. If you are unsure, don’t hesitate to ask for help from a pediatric urologist, as treatment by someone who is not a professional can make the situation worse. Dr András Kiss PhD is available to assist our young patients and their parents in our pediatric department.
