Friday, January 08, 2010

The Phony Phimosis Diagnosis

By Jennifer Coias




I'm writing this article because this is probably one of the most frequent misconceptions that I encounter. It seems that everyone knows of a child or man who 'had' to be circumcised due to a tight foreskin, also known as phimosis. When people hear these stories, most of them do not question the validity of the diagnosis and treatment and simply accept it as, "What had to be done". Could it really be that so many men were designed with such a flaw or is this really just an epidemic of misdiagnosis courtesy of widely foreskin-ignorant medical professionals?

In this article, I will give an overview of the development of the intact male and explain why the diagnosis of phimosis in children and teens is entirely phony. Additionally, I will outline what is true phimosis, its proper treatment, and why our doctors are so confused.

Development of the Prepuce ('foreskin' in males/'hood' in females):

During infancy the prepuce is tightly fused to the glans (head) of the penis. The tissue itself is fibrous and dense at this age, as it is composed of a whorl of muscle fibers. The opening of the prepuce acts like a sphincter and only releases to allow urine to pass. This design serves very important functions:

-It protects the developing penis from feces, bacteria and other harmful pathogens. This is especially important during the diaper-wearing years when a baby is continually exposed to his/her own feces (e-coli and other harmful bacteria/viruses).

-It protects the developing glans and keeps them from becoming desensitized and keratinized.

-It protects against urinary tract infections.

As a child grows, the foreskin will separate from the glans. This can take many years for some boys and for other boys, it seems to happen all at once. During or after the separation process, there may be some shedding of dead skin cells in the form of smegma (please note that women and girls also have smegma). This shedding of dead cells aids in separation since it helps the foreskin differentiate itself from the glans. There is no need to try to clean smegma from underneath a child's foreskin. It will slowly work itself out via the narrow opening. Once a child's foreskin is completely differentiated from the glans this is not an indication that retraction is possible.

Retraction is a separate function that is designed specifically for intercourse and masturbation. Retraction enables the foreskin to glide smoothly over the glans of the penis. This gliding stimulates nerve endings in both the foreskin and the glans. In order for retraction to occur, the foreskin must have separated from the glans and the opening of the foreskin must have widened to allow it to slip back over the glans. How does the foreskin opening widen? Throughout childhood and adolescence, there is a release of hormones. As hormone levels rise, the fiber-dense tissue of the prepuce is replaced with a more elastic tissue. A boy will begin to explore his genitals as he grows and as time passes, the elastic tissue will allow the opening of the foreskin to widen. This can happen at any age but it is not common in young boys. In fact, only 50% of boys are retractable by age ten. The other 50% usually become retractable between age ten and the completion of puberty.

So why all the fuss about retraction? Well, many parents fear that if a boy can not retract, he will get infections. This fear probably stems primarily from misinformation given to them by their doctors and their own fears about lack of hygiene. First, parents must know that there is absolutely no need to clean under a boy's foreskin. As mentioned above, the smegma produced by a boy is merely a shedding of dead skin cells. It is not harmful will not harbor bacteria. Trying to clean under a prepubescent boy's foreskin is the equivalent to trying to wash out a girl's vagina. It is entirely unnecessary and, in fact, harmful. Premature retraction introduces harmful pathogens, disturbs the natural flora, creates scar tissue, damages the intricate structures and can lead to long-term complications. Second, parents must know that retraction of the foreskin is not a necessary function in boyhood. Retraction is specifically designed for sexual relations. The only function a boy's penis needs to perform during childhood is urination. In other words, if a boy can urinate, then his penis is doing exactly what it needs to do.

The Phony Diagnosis:

When a doctor diagnoses a boy with phimosis it is because he/she does not understand the normal development of the prepuce. First, in order to diagnose this condition, the doctor would have had to either try to retract the foreskin or encourage the boy to try to retract his foreskin. This is a huge "no, no" for the reasons described above. Second, there is no expiration date on developing a retractable foreskin. Each boy is individual as to when the separation and widening processes have completed. Just as each girl will begin menstruation in her own time, each boy will experience retraction in his own time. Since hormones play an important role in changing the composition of the tissue of the prepuce, it is not abnormal if the process isn't complete until the finish of puberty. Once an adolescent's foreskin is retractable he can easily retract his foreskin in the shower, rinse with water, and replace his foreskin over the glans. Most men do this naturally during normal manipulation of their genitals while showering. In the case that a boy becomes retractable before puberty, there is no need for him to rinse under his foreskin, unless he so chooses. In the case that an adolescent is not retractable, there is still no need to worry about cleaning under the foreskin. Remember, it is not abnormal for retraction to take until the end of puberty.

True Phimosis:

True phimosis is when a post-pubescent man is unable to retract his foreskin or becomes unable to retract his foreskin and he feels discomfort during sexual activity. A small percentage of men (and women) have prepuces that never retract. This can be a normal variation, so long as it does not impede sexual activity. If it does impede sexual activity then a man should seek conservative treatment. 90% of men with this rare condition can correct the problem with the application of a steroidal cream and stretching exercises. The steroidal cream mimics the effects of puberty hormones and allows the skin to become more elastic. A man usually applies the cream several times a day and uses manual stretching exercises while he showers. Men should be wary of any doctor who recommends circumcision prior to trying a more conservative treatment.

Confused/Ignorant Doctors:

So why are most our nations doctors confused or ignorant as to the normal development of the prepuce? This question has a few answers. First, if we look at the AAP (American Academy of Pediatrics) recommendations, it wasn't until the 1990s that the AAP finally warned against the harms of forcible retraction and outlined the development of the foreskin in the intact boy. Prior to this AAP's warning, it was widely believed that parents needed to retract their intact sons for 'cleaning'. As you can imagine, this lead to many complications for intact boys and resulted in many otherwise unnecessary circumcisions. Second, there was a preliminary study of about 300 boys to determine the average age of the development of a retractable foreskin. This study concluded that most boys will become retractable by age three. This out-dated study set an expiration date in the minds of the medical professionals. A follow up study of thousands of boys concluded that, in fact, only 50% of boys are retractable by age ten. Many doctors, unaware of the most recent study, still operate under the misinformation of the preliminary study. Third, the development of the prepuce is not taught in medical schools. There is no discussion of how the prepuce is structured, how it changes throughout childhood and its protective and sensory functions. Essentially, the only thing medical students learn is how to amputate the foreskin. Some medical students may learn about the condition of phimosis but they are not informed that this only applies to adult men, as children's foreskins are designed to be tight. Fact is, the US medical profession has cut off so many foreskins over the past century that the doctors rarely if ever saw an intact boy and have lost the base of knowledge of diagnosis and treatment. Now, professionals are operating in a vacuum of information or even worse, in an environment of false information. As the nation's circumcision rates have fallen dramatically, intact boys everywhere are suffering the consequences of a widely foreskin-ignorant medical profession. Each year thousands of intact boys between ages two and up are circumcised unnecessarily at the hands of misinformed care providers. Educating parents, doctors and future doctors is an essential step to correcting this problem.


If you would like more information about this topic, please review the following resources.

AAP Guidelines For the Care and Development of the Intact Male


Development of a Retractable Foreskin in a Child/Adolescent


Avoiding Circumcision after the Neonatal Period

Dangers of Forcible Retraction


Protect Your Intact Son, Expert Medical Advice

Answers to Your Questions About Your Intact Son


read more of Jennifer Coias' work here:
The Nuts & Bolts of HIV in the U.S.A. and Why Circumcision Won't Protect Men


more on protecting your intact son:

Only Clean What is Seen: Reversing the Epidemic of Forced Retraction

UTI/Medical Tests: Don't Retract

Doctors Opposing Circumcision Statement on Forced Retraction

How the foreskin protects from UTIs

Raising Intact Sons

Ask the Experts: Forced Retraction

Forced Retraction: Now what?

AAP statement on intact/retraction

Functions of the Foreskin

100 comments:

  1. Just yesterday, a mother told me this was her reasoning for circumcising her son. I'm so glad you posted this. I didn't know if what she said was fact or not. How sad.

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  2. Amazing post. I have dealt with this issue in 1997 when an ignorant nurse told me that my almost one year old intact son would need surgery. I ignored her and my son is perfectly fine and still intact today!

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  3. Do you know about a condition called "imperforate hymen?"

    This is a condition about as rare as phimosis, where a girl is born without an opening in her hymen. It needs to be surgically corrected to allow for the menstrual flow, and/or if a groom is having trouble performing his duties on his wedding night.

    By the phimosis/circumcision logic, we'd have to surgically alter all little girls so that they would "never have this problem."

    That doctors use a perfectly normal condition of a child's penis to indicate circumcision is such a tragic travesty.

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  4. We went through hell with our first pediatrician for my son. I tried to provide her with information about forskin care and development after she, to my horror, tried to retract his forskin. She was quite defensive about my attempt to provide her with information and said, "No this is how we check the penis..." while attempting to retract it again after I specifically told her that I did not want her to do that. We never went back to her. Thank you for posting this...it is upsetting how little info is out there on this.

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    Replies
    1. I fired my son's first pediatrician for the same exact reason. I think I shrieked when she tried retracting his foreskin.

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    2. You should expose this person as she is free to continue her practice without reprimand or further education. It's nuts.

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  5. wow Joseph that's REALLY interesting. There is also a problem with the medical 'professionals'. They forget everything they have learned in school and of course, they don't know the things they SHOULD have learned in school. For example. In my Anatomy & Physiology texts, none of the male images have a foreskin, neither it is mentioned in the books. How can they know something that it is not even taught in schools?

    Also, there is something called Anatomy and Physiology Variation. Quoting: "Someone who thinks that all human bodies are the same would make a very confused medical student or an incompetent surgeon" and also, "failure to consider such variation leads to medical mistakes".

    Interesting.

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    1. In my A&P class I took last semester, our teacher told us that circumcision is absolutely necessary to prevent infections & penile cancer. I sat there, shaking my head in disbelief, knowing I have a perfectly normal, intact son. All my attempts at correcting her information were quickly put down. Sad, very very sad.

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  6. thank you for this post. my son is 7 and intact but i was becoming concerned that his foreskin was not retracting. i had no idea that it took until puberty to do so. i have read a quite a few baby/child books over the years and this is the first time i have ever read this information. thank you peaceful parenting.

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  7. I am an intact man and have been reading intactivist material since 1983. This post is the most thorough and eloquent discussion of the maturation of the normal foreskin I have EVER read. Americans have been bizarrely ignorant about this tender topic.

    And a woman wrote it. Time and time again, I sit at the feet of women to learn more about the tip of my penis. Maybe the George Wald (Nobel 1967) was right: the foreskin is inherently feminine.

    In the absence of balanitis and such, there is no need to retract until he begins his sex life, usually during his college years.

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  8. Apparently for a lot of "men" it becomes retracted for the first time the first time they have intercourse. Sounds an awful lot like a hymen in that regard too, no?

    My husband has a non-retractile foreskin -one that has never been retractable. It used to be that a dorsal slit was recommended (10 years ago) but he wasn't interested.

    I learned that that's just the way his penis is and he's fine with it. I'm not 100% convinced that he wouldn't have less problems if he tried stretching (he sometimes complains of soreness after sex). But again, his body, his choice.

    I know someone that is an adult and tongue tied, her tongue barely gets over her teeth. So she can't french kiss, or stick her tongue out, or make "raspberry noises". But she's happy the way she is.

    I think part of the fear of phimosis rises from the fact that sometimes its caused by bacterial or fungal infections, and the fungal infections can be serious and left untreated lead to amputations (double yikes in circ'd men if they need skin removed!)

    However appendicitis is dangerous if left untreated, so is lung cancer and yet I don't see anyone prophylactically removing appendixes anymore and they don't cut lungs out willy-nilly either (they used to for TB/consumption).

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  9. Joseph,

    WONDERFUL analogy! Thank you so much for posting that.

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  10. Extremely eye opening and informative post. Well written and should be distributed to anyone purporting to know anything about the penis. Thank you peaceful parenting!

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  11. I'd love to see information posted on what to do if your intact son gets a swollen/infected/sore penis. Because it does happen. And it can be rather alarming for the parents.
    Thanks!

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  12. Lee -

    Here are several other articles pertaining to various topics of intact care. In most cases, the best thing to do for a swollen/sore penis on a baby/child is to soak in warm water (no soap) and allow the body to mend itself. Usually this occurs as a result of the normal separation process of the prepuce from the glans and is nothing to mess with or worry about.

    Infections of the prepuce are very rare if it is not forcibly retracted at birth or in infancy (which would be similar to forcibly tearing back your fingernail from your finger - it would certainly cause irritation/pain/scarring/possible infection). See additional resources on the epidemic of forced retraction in the U.S. today.

    If anyone has other questions outside the realm of these articles, we'd be happy to address them specifically. You can email us peacefulparents@gmail.com or we invite you to contact Doctors Opposing Circumcision (http://www.doctorsopposingcircumcision.org/ - they have a great board of physicians who are well informed on the prepuce and intact care) or contact http://www.nocirc.org/ for the same quality help and support.


    Raising Intact Sons:
    http://www.drmomma.org/2009/11/raising-intact-sons.html


    Basic Care of the Intact Child:
    http://www.drmomma.org/2010/01/basic-care-of-intact-child.html


    Protect Your Intact Son:
    http://www.drmomma.org/2009/08/protect-your-uncircumcised-son-expert.html


    Painful Urination During Prepuce Separation
    http://www.drmomma.org/2010/01/painful-urination-during-prepuce.html


    Questions Regarding Normal Separation of the Prepuce
    http://www.drmomma.org/2010/01/common-questions-regarding-normal.html


    Only Clean What is Seen: Reversing the Epidemic of Forced Retraction:
    http://www.drmomma.org/2009/09/only-clean-what-is-seen-reversing.html


    The Functions of the Foreskin:
    http://www.drmomma.org/2009/09/functions-of-foreskin-purposes-of.html


    Medical Testing: Do Not Retract:
    http://www.drmomma.org/2009/09/uti-testing-on-boys-do-not-retract.html


    How the Foreskin Protects Against UTI:
    http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html


    Forced Retraction? Now What?
    http://www.drmomma.org/2009/12/forced-retraction-what-now.html


    Doctors Opposing Circumcision Statement for Physicians and Nurses on Forced Retraction: http://www.doctorsopposingcircumcision.org/info/info-forcedretraction.html


    Forced Retraction: Ask the Experts
    http://www.drmomma.org/2009/09/ask-experts-forced-foreskin-retraction.html


    National Organization of Circumcision Information Resource Centers Publication on care of the intact penis:
    http://www.nocirc.org/publish/4pam.pdf

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  13. I remember when my brother was a kid- my parents were told his foreskin had to retract, and they should try to force it when he had a bath... not fun for my brother, and (I don't know details) he had a lot of painful problems when he reached puberty. This information on normal development should have been available a long time ago, and it should be more widely available now.

    My parents couldn't research the topic on the internet- they just trusted the doctor. Thank you for posting all of this information to help those of us who might need to question our kids' doctor some day!

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  14. This is powerful information; thank you so much for sharing.This says a lot about all those boys that "have to" get circumcised later on because there are "problems." The more I learn the less and less faith I have in our "healthcare" system. I mean, doctors do not study nutrition in medical school! HELLO?! You have to be freaking kidding me! Health and nutrition always have been and always will be intrinsically linked. They are also taught to treat birth as a "condition" and an emergency rather than a natural, normal, safe and healthy process. And apparently they aren't taught squat about the foreskin. More and more reason that people need to make sure that they are educated and well informed!

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  15. I suffered from a severe case imaginable of phimosis for 25 years, and I was eventually cured. What's my secret? I'll give you a clue: It's sure as hell not surgery! Weeks of stretching, penile exercises, topical cream and frequent masturbation made my once-deformed manhood into a fully-operational uncircumcised powerhouse!

    I'm living proof of the possible safe, humane methods of tending tight foreskin.

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  16. My 3 year old was diagnosed with this at age 2. He was retracted numerous times, and I was given the cream from the time he was 1. I was told that if he wasn't fully retractable by age 3 he never would be. Fortunately I had done my own research, stopped retracting him, (something I never felt comfortable with anyway), and said NO to circumcision. I will no longer be seeing that surgeon. Funnily enough, I asked our GP about it and he said he was fine!

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  17. could you share the reference for the updated study that showed only about 50% of boys were retractible by age 10? our son's pediatrician told us today that she thought he has phimosis (he's 4) and i'd love to be able to show the article to her.
    thank you! your post is very reassuring!

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  18. BubbasMama -

    The latest study is out of Holland and shows the average age of retraction to be 10 1/2 years (which means some retract sooner, some later). I've misplaced this citation, but hopefully will locate it soon.

    DOC reports that the average age "for natural foreskin retraction without pain or trauma is 10.4 years."

    http://www.doctorsopposingcircumcision.org/info/info-forcedretraction.html

    --

    One 1996 study in Japan showed 63% of boys retract by age 15 (37% AFTER the age of 15 - or after puberty).

    JOURNAL OF UROLOGY, Volume 156 Number 5: Pages 1813-1815, November 1996.

    You can read the text here: http://www.cirp.org/library/normal/kayaba/

    --

    Notes Pediatrics, a reference text by Rudolph and Hoffman: "The prepuce, [or] foreskin, is normally not retractile at birth. The ventral surface of the foreskin is naturally fused to the glans of the penis. At age 6 years, 80 percent of boys still do not have a fully retractile foreskin. By age 17 years, however, 97 to 99 percent of uncircumcised males have a fully retractile foreskin. Natural separation between the glans and the ventral surface of the foreskin occurs with the secretion of skin oils and desquamation of epithelial cells, [or] smegma.”

    --

    Additional information on the phony phimosis diagnosis and normal retraction ages/studies: http://www.cirp.org/library/normal/

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  19. THANK YOU SO MUCH for the references! we are actually getting a new pediatrician, as i just discovered that she tried to retract my son's penis at age 3 -- without asking or saying that was what she was doing -- and then at age 4. We are going to find a much more intact-knowledgable doc and not subject our little guys to this kind of treatment :(

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  20. My 4 y.o. was diagnosed with phimosis and I went to two more doctors until I found one who said that the diagnosis was wrong. I'm glad I trusted my gut that the ped was incorrect but it's sad that professionals are giving false diagnosis and think it's correct! My son is lucky I'm smart enough to know better. Doc #2 said he'd need a circumcision by age 5 if he wasn't fully retracted. I said to him, "My older son (6) looks exactly the same. His reply, "Then they'll both need the procedure." OVER MY DEAD BODY!

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  21. It's sad when parents need to know more about such things than doctors who went to school at least four years if not more. I dont think I can ever get over it.

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  22. Thanks so much for the great info! We chose to leave our son intact but knew virtually nothing of how the prepuce develops or that "condition" you discussed.

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  23. Thank you for posting this. A nurse prescribed my 9 year old son steroid cream for "phimosis", just two days ago. His skin is not retracting because he was not circumcised. She said that if it does not come down in 2 months he will need to be circumcised. I have felt uneasy about both the cream and the potential circumcision since we left the dr office. After reading this I will be putting the cream away and we will not be going back to that dr. I would like nature to take it's course. Thanks again.

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    1. Thank you for posting your comment. I have a 10 1/2 year old and just a few days ago we were scheduled for surgery, not knowing much about phimosis I was hesitant on going through with the surgery so I decided on a second opinion. The doctor prescriped a steroid cream to see how things went and also informed us that he has scarred tissue but ultimately left the decision up to us. I am still uneasy about every aspect to this topic but would like to know if you as parents have any suggestions and have things gotten better with your son

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    2. 10.5 is the average age for retraction to occur, so your son is still too young to be diagnosed with phimosis. Half of boys will not have retracted by that age. I would do nothing especially if he is not having any issues or discomfort, and if it is still not able to retract in several more years, then I would opt for stretching and/or steroid cream. My husband is a doctor, and the steroid cream is successful in 85% of the cases. He was able to save an adult patient from circumcision by prescribing the cream. Urologists are very quick to find a problem where none exists.

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  24. Our urologist did not try to force retract my son. But they did try to gently push him back to see how far it could go. They could not see the opening and she gave me steroid cream to use 2 times a day for 30 days. She said urine was trapped in there because when she pulled it back a drop came out and she said he was a prime candidate for infection. she then said we need to pull him back gently, not force anything, and wipe him every time he pees to release the trapped urine.
    I am confused. She was not forcing him to be retracted but she was not saying clean what is seen either.
    Does the urine need to be dried out each time? Can urine be trapped in there and lead to infection because it's then a moist environment? She liked it to wearing wet underwear soaked in pee all day- that it would be irritated..

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    1. She may be correct, but the logic is dubious. The inside of my mouth has been wet for years.

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  25. Anonymous- Urine is sterile, so there is no need to do anything =) Only clean what is seen!

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  26. This make me sad because when my brother was a teen, he had to have circumcision because of true phimosis. As far as I know the urologist who performed the mutilation never once suggested steroid cream and stretching. And if I was an intactivist back then, he would have known better

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  27. Every day we hear from someone whose doctor told them their son's penis was "too big for his foreskin." People, this just DOES NOT happen... Don't believe it. If a physician tells you this, and wants to cut it off, take your baby and run the other way.

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  28. I am a male of 64 years of age and still in tact. I have two other younger brothers who are also not circumcised. I thank the Lord and my parents every time I masterbate or have sex that I am not circumcised. Nor can I believe that those who are circumcised are as sensitive as I am on the penis. I also can't believe, with all the access to information on the internet, that there are doctors out there that would recommend circumcision without exhausting all other means of retracting an 'unretractable foreskin'!! Please no mutilation of baby boys (or girls for that matter). Let them decide for themselves. I have had other men my age and younger who have said that they wished their parents had left them intact and let them decide for themselves to be or not to be!!

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  29. both my sons are intact, but the younger son has had 2 instances where his penis was retracted and "stuck"! ie. he couldn't get it back in. This happened without a doctor or I trying to retract it. We took him to th ER, because it was ballooning up more and more...they labeled this phimosis. My doctor told us if it continued to happen we should get him circumcized, which of course we haven't. But it was very painful for him and I wonder why this would happen naturally?

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  30. Thank you for all this info! I am a male whose parents left me uncircumcised... but when my penis was not retracted by age 9 or 10 I was prescribed a cream of some kind which I would dutifully apply to the glans which was showing at the time. I was encouraged to retract the foreskin as far as it would go... by the time I was 14 or so and interested in masturbation, I had a too-tight frenulum which would pull the glans down as I pulled the foreskin back. If I had the wisdom, I would have left it alone! As it happened, I was recommended a "frenuloplasty" I believe it was, which I had when I was 15. I count my blessings that I still have the bulk of my foreskin intact, but I could do without the scar and the little left over piece of skin coming out under my urethra, an artifact from the surgery. Thank you again for the good info!

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  31. My son is now just a few months away from being 3 years old. He has cried during the night and day on and off about his penis hurting. When I check him, he has an erection. This crying and complaining of pain stopped for many months but just started happening again. The first time around his doctor said he was fine, probably natural separation. This time the crying is really awful and he seems to be in a lot of pain. After about a week, I took him to his current doctor which is in a different state, so a new doctor. He was diagnosed with Phimosis and referred to a urologist this week. My question is, how do you know what to do when your child is hurting and complains of regular pain? No problems with urination that we are aware of nor infections. I hate to ignore his pain and do nothing but I also don't want to circumcise him now. I'd hate to put him through that.

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    1. Biomom, I highly recommend you research the term "precocious puberty" and there is a page on google that says something about precocious puberty in the victorian era, I was reading it literally ten minutes before this. It is about abnormally young occurences of all/some the features of puberty. There was a specific case I was reading, a 3 year old boy, who would cry in the night and his mother would wake up and he would have an erection and appeared to he in some sort of pain. Eventually she discovered stains on the sheets and learned it was related to nocturnal emissions the boy was having. I don't know about erections in children but my understanding without researching it is they aren't common, and if you are coming across him crying and it is usually accompanied by an erection this could be the case. Medically it seems to be no big deal, but as he grows you may see he develops muscles and pubic/armpit hair sooner than you would expect.

      Try and distinguish when the pain is happening. If it is accompanied by erections, etc. Im trying to think when my foreskin retracted, Im inlcined to believe I was much younger than people are saying on here, 7 or maybe 8. I mean, it didnt retract, but I could retract is as I willed. I wouldn't be surprised if the increased frequency of (non sexual) erections that comes with the early stages of puberty plays a large part in natural seperation of the foreskin, seeing as the glans expand and all. I think when bathing him in warm water you should gently move the foreskin around to. Manual massage (sort of like 'stretching techniques' mentionede)
      is undoubtedly beneficial, as it will help promote natural seperation and isn't a big deal unless your trying to force the retraction.

      Everyone keeps stating such high numbers, and retraction like it's some singular process. I dunno when the hell it retracted.. but from a young age I could pull back my foreskin, and I would 50/50 do it when I urinated and from my toddler years I remember my other telling me to pull back my foreskin and clean around that area when I bathed. So I think as A kid I initiated the retraction myself at my own rate, and I couldn't see a better way to have it. Im sure if it couldnt retract I didn't force myself into pain, and like I said earlier attempting to pull it back/massage/stretching is surely beneficial in promotion natural seperation.

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  32. I'm 16 years old and i'm going through this now, I haven't told my parents, i thought it would be better to just wait it out, but is that possible?

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  33. Amy - it happens because it can be tight & cause blood to get trapped. You can most times fix it at home if you catch it early by simply compressing the glans gently but firmly - as it needs to reduce in size to slip back through the way it slipped out. It likely will be uncomfortable or even slightly painful momentarily, but once you slip it through, all pain is gone. You can also use a TINY bit of lubricant (not so much so that you can't compress the tissue, just to help it slip back through). It happens "naturally" just like other things happen naturally. You can naturally just like a good friend dislocated her jaw while yawning, or an old high school boyfriend & I were walking & he managed to break a bone in his foot through normal steps - no trips, just suddenly let out a shriek of pain. Sometimes things just behave in ways they shouldn't unfortunately. He can certainly be treated with a topical steroid in order to loosen that ridge if in fact it has now occurred more than once in order to prevent future happenings. My friend has been told it was a fluke & could happen again & there is no way to avoid that & likewise my ex was told it happens, it's rare, but there is no way to avoid it or to predict it.

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  34. Anon 16 yr old - If your foreskin is not retractable then of course it is possible to wait it out. Like other posters have said, it isn't even truly phimosis until after it has been retractable & then becomes unretractable OR if you are past puberty. At 16 you aren't past puberty yet. I borrowed this from a previous post in case you missed it: "One 1996 study in Japan showed 63% of boys retract by age 15 (37% AFTER the age of 15 - or after puberty)." So no need to worry if you can't retract yet - you likely will fairly soon. :)

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  35. Anonymous 16 year old, you should contact Ron Low at TLC Tugger. He manufactures devices that help circumcised men to regrow their foreskin, and he can also help people such as yourself.

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  36. Our 4-year-old son has had continuing infections under his foreskin, which has only a tiny wrinkle of an opening -- to the point where when he wees his foreskin can balloon out a bit. It is not adhered to his penis at all -- it will move around but is unable to retract over his glans because of the teeny opening. We live in a country where circumcision is very rare, but are seeing a specialist at the end of the month and are worried about what he'll recommend. Do Dr.s ever just make a tiny cut to widen the hole? And why do these infections continue to happen, if it's normal for his foreskin to not retract? He is potty trained, has one bath a day...

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  37. Isn't there some sort of stretching that can be done for teenagers? Like for restoration?

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  38. Steve - yes absolutely! A legitimate case of tight foreskin can be helped with foreskin stretching exercises.

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  39. I was circumcised at the age of 5 because of phimosis. It was completely unncessary as proper foreskin care would have avoided this. I think the doctor just didn't know what he was doing and my parents, ignorantly followed what he said. Yes, it can be stretched. Just google phimosis.

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  40. At this point I feel like parents need to understand that for babies and children "proper foreskin care" should almost be referred to as "foreskin neglect" - You do NOTHING to it. Ignore that it is there. The end.

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    1. See now I think this may be absolutely wrong. There is nothing wrong with *attempting* to manipulate the foreskin. It should not be painful and really should aid and promote natural separation. I have both a penis and foreskin so I speak form years of experience here. As I said to someone above, I remember my mom, like a mother would ingrain 'clean behind your ears' to a child, telling me to clean under my foreskin. I don't ever remember having any problems. I always attempted to clean myself as best I could Im sure. And as far as I remember, from a very young age I have been able to full retract my foreskin with comfort and ease, and it usually is more prone to being retracted when I was erect. Reading through all this, I actually think it is MORE beneficial to attempt gentle manual retraction or a massage like stretching/ cleaning process semi regularly. It seems to be how I handled it as a kid, and after reading on this topic for the last half hour, I seem to have had one of the easiest times with my foreskin ever, same with my brother. No tightness, naturally retracts for the most part when erect, etc. It seems if your young boy is tight/attached by 9 or 10 it might be beneficial to start taking this actions. I certainly know I would never want to have had to discover the retraction of foreskin in my teens?! Retracting it has been as normal as urination or breathing for as long as I remember

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  41. BioMom my nephew was recently going through the same thing (age 6) and he was simply retracting naturally. It hurt him but once his skin retracted (ON IT'S OWN) he is fine.

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  42. I know someone who chose to leave her son intact and then, when he was around 5 months old, she noticed he was fussing a bit when he peed. She happened to see him pee one day when she changed his diaper and saw that he was ballooning. She took him to his doctor and to a urologist and was told that he "has a condition where his 'pee-hole' is too small and urine can't escape fast enough" (her words)...she was also told he'd need to be circumcised. I'm not sure if she actually did have him circumcised when she said she was going to (at around 6-7 months old), but I think she did. She was also told that usually this problem isn't discovered until around age 5.

    She was very upset and actually said that anyone who said circumcision was unnecessary in this day and age could [expletive] off, because apparently it is sometimes. She also went on about how upset she was that, what would have been a quick and simple procedure, would now be so much worse for her baby.

    I wish I'd known about this then so I could have asked her to read and get a second opinion. Especially since she ended up getting another mom I know extremely worried about her own intact toddler (who, luckily, is still intact to this day)

    My son (2 1/2) balloons now and has for somewhere around a year, he thinks it's hilarious. I'm so glad no one has ever tried to retract him or tell me he had something wrong with him :) I'm also glad I know about this now and can be ready to correct anyone who tries to tell me my boy has phimosis and needs to be cut.

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    1. Maybe the baby was fussing because he HAD to go, not because he was going and it hurt. I use elimination communication with my second child (now 6 months old) and he balloons sometimes in the morning from the forceful full bladder. Babies are aware they need to go to the bathroom, and cry or use other communication to try and get their caregivers to help them potty. My baby cries if I ignore (or don't notice) his signs he needs to go. If I take him, he goes in the potty and then he's fine. I remember thinking my oldest had a UTI b/c he cried then peed. He didn't have one, and now I know its probably b/c I wasn't "pottying" him. Who wants to pee their pants (or diaper)?

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  43. Baron - I'm pleased that you're happy with your results, but I wouldn't call a penis with a non-retractable foreskin 'deformed'.

    I've had a number of lovers, some circumcised, some not, and all those intact were retractable bar my fiance.

    I used to worry that I'd hurt him or tear him being that it was tight, but after 2 1/2 years of loving I realise he enjoys it just the way it is - and so do I. If he wanted to stretch it, I'd support him to do so, but his penis is beautiful just as it is.

    Sometimes, when it's erect and I'm performing oral or have it between my breasts, I can see the tip of his glans and it's incredibly erotic. It won't retract past the coronal ridge when erect and he doesn't retract to clean, and it's perfectly fresh and perfectly functional.

    I have no idea, and neither does he, whether it's a natural variation or a result of forced retraction, but he has no obvious scarring. Vulvae come in many shapes and forms and not all clitoral hoods retract. If we can celebrate the natural differences in women's genitalia, we can surely celebrate the differences in men's too, right?

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  44. I am 20 now, I can retract my penis when I was 15yrs or less but one day after masturbation I removed some yellow thing which lied under foreskin and cleaned fully... I have no knowledge of foreskin and its function those days but now my skin is tight couldnt retract but still I get semen and masturbation is possible... How to handle this?. Please help me..

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  45. Could you please cite your sources for the "True Phimosis" section? Thanks.

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  46. this is one of the best articles I have ever read. My first son was cut :( He got an infection because I cleaned him TOO often. I was so happy when my second child was a daughter haha. My Third was another son...I wouldn't cut him. The doctor told me to retract his foreskin and clean it at bath time. When he was 3 yrs old his skin was so tight it split open. He came to me covered in blood and said mommy my penis is broken. I still would not cut him and were able to treat it naturally. I have had two more boys since (5 kiddos 4 boys). I have left my last two boys completely alone and have had NO issues what so ever! This information was soooo wonderful thank you!!

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  47. Hi,

    Thanks for your well-written info. For who knows what reasons, my parents had my 4skin removed when I was 2 and 1/2 years old. I hated it. They did not do that good of a job on me (too much skin removed, as in peeled banana) and they butchered my brother's first son. He had to take his week-old son in for "corrective surgery." To fix something that should never have been done in the first place. He said "NO!!" to his other two boys. I felt 2-screw-ups in the same family were enough, so when my son was born, I also said "NO!!" Then the fun began. It seemed that almost everyone felt that all boys should be circumcised. Doctors, Family. and neighbours and friends. OMG! It was awful. But I stood my ground. Also I did not want anyone messing with it. I said to all, "His 4skin is just fine."

    It was mostly released by the time he was 4 years-old. But final seperation did not occur until he was 10. But he has never had any problems.

    But his care-givers also indicated that he should be cut. I ignored them and if they pushed too hard, then I found another care-giver. We put him in pre-school when he was 3 & 1/2. That was number 6.

    One of his care-givers had 5 children. 4 boys and I girl. The girl kept her 4skin. The first boy looked like a peeled banana (like me) The 2nd got an infection at his pee opening. It ate holes in his glans. They filled in, but it is a marbled look. That might be fine in ice cream, but not too good on a penis. The 3rd boy they could not stop the bleeding after the circumcision so they had to give this 4-day-old baby blood. On the last child he screamed and screamed and screamed and puked. He choked on his puke and had to be resusated. All this in one family. Fortunately she had her tubes tied, so no more children to be hacked up.

    I asked her if she was going to have herself and her daughter circumcised. She said "No. We are keeping our 4skins, but on boys they are coming off."

    On a good note I have a niece who has 3 boys and a girl. I convinced her not to have a circumcision done on her first boy and she convinced herself on the other 2 boys.

    I am so glad that the rate of "cutting" has dropped considerably. My intact son and I have been to a naked people resort a few times and one time, there were a couple of dozen kids and all the boys except one retained their 4skins. I was so glad to see that. When I was 11, I took swim lessons at the YMCA and we all swam naked. Out of about 20 kids, only about 2 had their 4skins. Same in jr. high and high school P.E. Back in the early 60s it was chop. Chop. Now it is leave it alone. Finally!!

    My mom said that there was this military doctor that she and my dad knew and he was always trying to get any of the guys that had 4skins to have them removed. He said that after the circumcision was done the guy would be "out-of-action" for several days. So maybe it would be a good idea to have my son circumcised so that he would not "remember" it when he was older. I asked if the being "out-of-action" for a circumcision was worse than a bullet in the gut. She just shrugged.

    Best wishes,
    Bill Bristol
    bbb444@hotmail.com

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  48. My 24 year old son is happily intact. I am so glad I had friends and others who supported me, including my OB/Ped. He was an old Mormon Dr (with lots of practice as you might guess)who greeted my decision with a happy smile and a 'Good! I wish more mothers felt the same way' My current husband is cut and quite upset about it. He is considering restoration and I am thrilled!

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  49. is it obvious if the penis of a toddler has been forcibly retracted? my 19-month-old son has a foreskin that is similar to the one pictured above, but there's a lot more skin at the tip and at times i am able to see the pink tip of his penis as the hole is large enough to allow that. i know my husband did try and pull it back at one point (he didn't know that he wasn't supposed to do that) but he said he didn't pull it back far so i'm wondering if that did any damage.

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  50. Sorry to be pedantic, but I think articles on penile care don't need to be gender neutral...
    "-It protects the developing penis from feces, bacteria and other harmful pathogens. This is especially important during the diaper-wearing years when a baby is continually exposed to his/her own feces (e-coli and other harmful bacteria/viruses)."

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    1. The second sentence there refers to all babies (male and female) who are exposed to fecal mater and as a result have an increased risk of infection. It is not merely pertaining to boys in that instance.

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  51. My son's foreskin didn't retract until he was 12.5 years old when the masturbation fairy came to visit... So never fear, retraction happens when it happens.

    "The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom." - H. L. Tan, MD

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  52. I have a questions but I'm not sure where to turn. A couple of weeks ago my uncircumcised son was diagnosed with balanitis, an inflammation of the foreskin and head of the penis. The urologist told us that he has "tight" foreskin and gave us steroid ointment to put on him for 6 weeks...then we go back again to discuss further options. I'm assuming this is circumcision if there isn't much change in the foreskin. All of the research I've done says it's normal for foreskin to still be tight...my son is only 2. He is our first, and my husband is circumcised so we have no idea how he should look at this point. Is this steroid cream something we should be doing or are we jumping the gun here?

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  53. So glad I read this post. Couple of days ago took our 2 and 1/2 year old (uncircumcised) to the ER because he stopped urinating for 17 hours and he was screaming in pain that his penis hurt. His crying began early in the morning and he usually soils one diaper in the middle of the night. When he couldn't use the potty in the morning because of the pain, I called his pediatric office and they scheduled us to come in right away. The ped saw him and was concerned that his penis looked swollen from the tip and that it looked tighter than usual. So she sent us to the ER.

    As we waited in the ER, another 3 hrs passed with no urine but he cried and screamed everytime he tried to go. Finally, they gave us a room and just as I'm setting my things downs my sons cries the hardest he has ever, but with that came a large amount of urine in his diaper.

    So by this time he hasn't wanted to drink or eat so they gave him IV and an antibiotic called Keflex. ER ped said an infection had formed due to trapped urine. Sent us home him Keflex to be administered 3x a day for seven days. Diagnosed him with phimosis.

    Its been four days and the swelling of the tip is completely gone and he is urinating just fine. We have an appt with his regular ped in three days so she can follow-up. My husband and I are completely against circumcision but wonder what will need to be done if he continues to have these painful infections (this was his first). If anyone has had experience with infections due to urine being trapped please let me know.

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  54. roger desmoulinsMay 27, 2012 7:03 PM

    This post is an example of why Jennifer Coias is one of finest intactivists around. However I do want to comment on the following sentence:

    "A small percentage of men (and women) have prepuces that never retract."

    This sentence is true of men. To be male and unretratractable after age 18 or so is unusual, but usually responds well to a course of steroid ointment applied to the tip twice a day for 1-3 months. There are men who are unretractable lifelong, yet who reproduce without difficulty and enjoy marital intercourse. A few such men have commented above.

    But to be female and unretractable lifelong is fairly common, completely normal, and usually does not have any adverse effects on sexual pleasure or functionality. The glans of the clitoris is usually too sensitive to enjoy direct contact. For many women, foreplay and masturbation involve massaging the clitoris while it is completely encased in the clitoral hood and even the labia majora. The only advantage of having a glans clitoris that can be "peeled" is that a woman for whom this is the case can understand the sexual value of the moving male foreskin better than men circumcised in infancy.

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  55. Thanks for this wonderful article. I would also like to add that this movement against circumcision was gaining steam until recently when doctors began telling parents that the presence of the foreskin can increase the chances of contracting STD's due to the nature of the cells in the foreskin.

    This is very misleading since lifestyle choices are completely ignored. It is also worth noting that a german court recently handed down a decision in essence calling the circumcision of a child an assault. According to the court, the child has rights that even the parent can't absolve and the decision to circumcise should be left to the individual when they are of sound age.

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  56. A week ago, we discovered that my 19 months old son's penis was slightly swollen. I was sure that it wasn't an infection as he had no fever. My worry was that something from a dirty diaper had stuck around the opening but my son, since a doctor tried to forcibly retract him back in March during his well check, doesn't let us near his penis. I gave him a bath, and after that, since my husband was worried, we drove to a clinic to have him checked. Him and his brother like their father are intact. And that was the first thing I said to the nurse when we arrived at the clinic. The woman stared at me like I was speaking Greek. I had to explain he'd not been circumcised, and she proceeded to stare at me as if I'd just said that I'd eaten a cat.

    The doctor who saw my boy, told me that he didn't have a big enough opening, and proceeded to ask me if I'd retracted him or if I'd been told that I had to retract him. I stared at him in disbelief, because after all this was a male doctor. I told him that since he's intact, I don't need to retract him. He proceeded to tell me that I was creating a problem for him when he grows up. That retraction is the ONLY way that his skin will get loose and that if I didn't continue to do that, he would have to be circumcised.

    I told the doctor, what the English doctor that used to care for my eldest back in England told me; Would you retract a dog or cat?

    Doctor ignored me and proceeded to give me a pamphlet about phimosis and told me that I would probably need to see a specialist to deal with that opening. I told him, maybe he needs to refresh his paediatrics course because you don't retract babies nor infants, and the hole can't be bigger, since he's 19 months old.

    I've printed out most of the information on this site and on others, so when I have to return in November for the Well Check, I can give that to the doctors and make sure that they don't try and retract my poor boy.

    It's appalling how little information "doctors" and "paediatricians" have about intact boys and the correct care. Especially when it's all written down in the AAP's site.

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    1. I've had the exact same thought, that if cats and dogs don't need it, neither do people! Good for you for speaking up.

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  57. Thank you for an excellent article. The amount of information on the Web about this subject is growing and it is amazing how much easier it is to find useful information like this now than before. It is so true that many health professionals are ignorant about the subject.

    Just to illustrate that, someone I know went to the doctor to get a diagnosis and all the doctor suggested was to to take tests for STI! My friend didn't give up but asked for a second opinion. The second doctor obviously knew something about phimosis and they prescribed Hydrocortisone and gentle stretching.

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  58. Thank-you so much for writing this. A few days ago I took my 5-year-old son to the doctor for a possible UTI (negative) and as part of the exam the dr. "stretched" his foreskin and recommended I do the same and apply antibiotic cream regularly. She has told me this every time I have taken him in, and I have ignored her, but this time she stretched the foreskin so much I could see his little penis underneath and I am left with a sick feeling in my stomach that I did not protect my child enough. He told me that it hurt when she did this. I tried to talk to her on the phone about it and she got angry at me. My husband is intact, told me that his foreskin did not retract until he was 11 or so, so I always figured my son's will naturally when he gets to be around the same age. Now the doctor tell me that my son's foreskin it too tight, but instinct tells me that it should be tight to protect him against infection. This is the first article I've read that describes exactly how I feel in my gut. So thank-you.

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  59. I am someone who has experienced phimosis. I have now cured myself. I believe most phimosis in teenage boys is caused by damage from masturbation.

    Pressure of the hand during masturbation can damage the 3 delicate inside chambers of the penis. Consequently they do not fill up with blood properly and they lose their spongy structure. The inflated spongy structure is what provides the 'give' to retract the foreskin.

    The fact that the spongy chambers are damaged also means that they do not inflate properly. They are deflated. Consequently they do not expand the skin. If the penis was undamaged the 3 chambers would be constantly pressing outwards against the skin.

    Thirdly, too much masturbation - especially with certain techniques - such as rubbing the erect penis through clothes can cause scar tissue on the foreskin. Scar tissue is less elastic than non scarred tissue.

    Please see my blogpost for more detailed explanation of my theory:
    http://uktightforeskin.blogspot.co.uk/

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  60. Wow, my son must be an early retractor. He is 2 1/2. It first retracted when he was having an erection when I was wiping him. I was changing his diaper. That was anywhere from 6 months to a year ago? not sure. I think closer to a year ago. Anyway, I wasn't trying to retract it; it just happened. It freaked me out frankly and I was afraid I hurt him. Around when it first happened he occasionally would complain that his penis hurt (from an erection) and the tip of the foreskin once was a tiny bit red and irritated. I think there was even a tiny blood spot on his diaper. But I didn't take him in to the doctor. He was fine. I didn't try to retract it. I think it was just from normal erections and him playing with it. I tend not to overreact and take them in for every little thing.

    Even before then he would play with his package all the time. Since then he has discovered on his own what fun it is to retract it while on the potty (at first) when he was having an erection. Now he plays with it all the time ( when naked) and says his penis is playing hide and seek. he retracts it quite easily on his own.

    I also get the impression from these comments that alot of boys don't have erections until right before puberty. How can that be? My son has involuntary erections all the time. they are not sexual. He's only 2 1/2. Even just the usual morning erection should be commonplace. Is it not in prepubescent boys? My son has been having erections from practically day 1.

    Maybe (just a theory) if boys do not play with themselves, i.e. pulling on it, getting an erection, etc. then it wouldn't retract until they start to masturbate. If they play with themselves it pulls apart and retracts, hence the redness and soreness and blood spot. In other words there is some sort of membrane holding the foreskin onto the glans preventing retraction. Kinda sorta similar to how if girls are very active, their hymen disappears or gets broken from a fall.

    Anyway, this is my theory. My husband has no idea because he is circumcised. Traumatic birth, mother somewhat unresponsive (his twin died), doctors in Israel automatically did it without permission. His 2 brothers are intact. But she questioned why we didn't because of course all she hears in the news is that you should circumcise.

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    1. We have four boys and they've all come to retract at different times in life - and it did not seem to correlate with how much/how little they 'played with' things. One retracted early, like your son, and the others were closer to the ages of 7, 10 and a young teen (so we were told - never actually saw him retract, and this is okay). Boys are variable and there is a wide range of normal - so at 2 a boy may be normal, and at 12 he may be normal - and everything in between. :) But no one should 'fear' a secure foreskin because, as you mention, when hormones kick things into gear and boys start doing more with their penis, everything tends to loosen up.

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    2. thanks, Mark.

      This is my first son. He has 2 older sisters. So I have not dealt with this before.

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  61. I would rather have a non-retracting foreskin as an adult male than to have been forcefully cut as an infant as I was.

    When will arrogant doctors and ignorant parents accept that many men are upset about having had our genitalia mutilated in the name of "cleanliness" immediately following birth when we had no say in it.

    Thank you for this article :)

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  62. This is all fine and well. But when happens when your 4 year old DOES get an infection underneath the foreskin and you have a doctor telling you to put iodine and cream underneath there with a sterile q-tip?

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    1. Find a different doctor - one who knows how to properly treat the foreskin. http://www.drmomma.org/2013/02/hands-off-my-foreskin-dr-martin.html

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    2. I was going to say the same - infections are so, so rare when the foreskin is left alone in the first place. Usually it is an ill-informed doctor (or PA or nurse) telling a parent there is an infection, when really, it is irritation that can easily be cleared with a little TLC, clean water, fresh air, and no messing.

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    3. What would do if your daughter got an infection and some idiot told you to put iodine and cream under her foreskin with a q-tip you would hopefully take your child and run don't walk for the nearest exit and ASAP find a real doctor!

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    4. Good point (last Anon)! The things people suggest we do to boys would cause anyone to RUN away with their daughter if it was suggested to do to her... American horrors.

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  63. Wish my parents would have been told this when I "had" to be circumcised at 10 years of age. Mine was a very aggressive circumcision taking most of my penile shaft skin resulting in a lifetime of painful tight erections, tearing and bleeding. I'm now 51 and have never had a normal, satisfying sexual relationship.

    David

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  64. Thanks for this post Jennifer! I was so worried about my 4 year old. When he was 1.5 years old, a pediatrician who was seeing him for the first time, forced the foreskin down and caused him pain with some blood. He didn't ask for our permission to do this (I would've told him no), he just went ahead and did it.

    We were constantly worried about our boy because his official pediatrician tried to force the foreskin down on each visit, she couldn't even get near, probably on response of what happened with the other doctor. He was actually aggressive with the idea of anyone going close to his genitals.

    Some weeks ago, on our regular visit to the pediatrician, she again tried to force the foreskin down, asking us to hold his arms and legs in despite of all the crying, luckily she was gentle but the diagnosis was not: "He needs urgent circumcision" she said.

    I'm glad I found this post, and thank you with all my heart! It all makes sense. I will forward this post to our doctor, friends and family.

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    1. You may want to read this item by Dr. Winkler if you haven't already:

      http://www.drmomma.org/2013/02/hands-off-my-foreskin-dr-martin.html

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  65. Ok, so after chatting a bit with my brother, who has 4 kids, he suggested to search for the other end of the sphere, so I found this: http://www.circinfo.net/index.html:

    "Circumcision of males represents a "surgical vaccine" against a wide variety of infections, adverse medical conditions and potentially fatal diseases over their lifetime, and also protects their sexual partners. In experienced hands, this common, inexpensive, simple procedure is very safe, and can be pain-free. Although it can be performed at any age, the ideal time is infancy. The benefits vastly outweigh risks.

    The public health benefits are enormous, and include protection from urinary tract infections, that are common over the lifetime and often cause permanent kidney damage in babies, inferior genital hygiene, smegma, sexually transmitted HIV, oncogenic types of human papillomavirus, genital herpes, syphilis and chancroid, penile cancer, and possibly prostate cancer, phimosis, paraphimosis, thrush, and inflammatory skin conditions such as balanitis and balanoposthitis. In women circumcision of the male partner provides substantial protection from cervical cancer, genital herpes, bacterial vaginosis (formerly termed "gardnerella"), possibly Chlamydia (that can cause pelvic inflammatory disease, infertility, and ectopic pregnancy), and other infections.

    Circumcision has socio-sexual benefits and reduces sexual problems with age and diabetes. It has no adverse effect on penile sensitivity, erectile function, or sensation during sexual arousal and is reported to enhance the sexual experience for men. Most women prefer the circumcised penis for appearance, hygiene, lower infection risk and sexual activity. At least half of all uncircumcised males will develop one or more problems over their lifetime caused by their foreskin, and many will suffer and die as a result. The benefits exceed the risks by over 100 to 1, and if the level of suffering and fatalities are taken into account in men and their sexual partners the benefit is orders of magnitude higher than this. Given the convincing epidemiological evidence and biological support, routine circumcision should be highly recommended by all health professionals and access facilitated by the health systems of every country."

    So now I'm stuck again!

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    1. Dandabass - the site that your brother gave you (or that you stumbled upon) is Brian Morris' site. Please look into who he is - a well known pro-cutting man with a circumfetish (i.e. one who obtains sexual excitement from genital cutting). He always misrepresents research, misquotes others, and is not respected in academia on this subject.

      See: http://www.drmomma.org/2009/11/brian-morris-his-circumfetish-push-to.html

      And Google 'Circumfetish'

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    2. circinfo.net is not a reliable source of circumcision information, it is run by a pro-circumcision advocate. You can't even find the functions of the foreskin listed on that website.

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  66. Hi my two month old son cries alot before n after passing urine.shw him to pedi.n my ped.said dat he has phimosis prob.u shul consult wth surgn may b u hv to do circumsn. Plz help me is der any other solution.??

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    1. Anon - please see these articles for further information about what is likely happening, and also email SavingSons@gmail.com or visit their FB page: www.FB.com/SavingOurSons for further help.

      Painful Urination: http://www.drmomma.org/2010/01/painful-urination-during-prepuce.html

      Ballooning: http://www.drmomma.org/2011/06/ballooning-in-intact-child.html

      Protect Your Intact Son: When Doctor Says 'Circumcise' http://www.drmomma.org/2009/08/protect-your-uncircumcised-son-expert.html

      Additional information on intact care - especially if your little boy is being retracted by *anyone* - this could be causing these problems - http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html

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  67. Hi. I am so worried that my son will need to be circumcised. Here is why. I have a 9 yr old intact boy who has a bad bladder infection. So bad, that his foreskin has fused and is not retractable anymore (he could retract it before). It also balloons quite badly when he pees. Took him to hospital and he is being treated with fucidin (antibiotic) cream and antibiotics (cephalex). He is on a wait list for a urologist. When my son was bathing tonight he told me he thinks his foreskin is getting tighter. I asked to see it and saw that there is just a tiny opening now. What should I do? I fear that the only treatment option I will be given is to circumcise.

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  68. My 7yo was at least semi retractable for a while, but it seems to have mostly closed up now. he has had a couple of minor infections (or so we were told & treaked) he was diagnosed with phimosis (it does look like there may me a bit of scarring) and we have been applying an ointment, but now I'm thinking about stopping, but I'm concerned that it will get worse again if we do and any damage we may have cause in treatment before I learned more. I would appreciate some help.

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    1. My son is pretty much in the same situation as yours. Do you know what caused the scarring? And is the cream working? My son just started betamethasone to treat his tight foreskin. My comment is above yours. I would like to hear more about your experience. Thanks.

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  69. I'm pissed! My doctor knew damn well I didn't want my son to be circumcised and told me it needed to be done due to a tight foreskin. I had it done on my son believing his word and now I can never take it back. I'm so ashamed. =(

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  70. Hope .. Doctors need to be given an Intact Care Agreement to sign before delivery, stipulating that they will not attempt retraction, and that attempts by any health care provider to retract will result in legal action.

    Also ... men who have had their foreskin amputated can restore. A restored foreskin can never equal the original, but it's better than nothing. Thousands of men are doing it. See: http://www.norm.org/ and http://www.restoringforeskin.org/

    Also, one bit of advice not given is to NEVER bathe infants, boys or girls, in bubble bath suds. Indeed, it's better to bathe them in a shower than in soapy water, as soap bubbles get into every nook and cranny, where they tend to kill the good, protective strains of bacteria which reside there. That's what causes UTI's ... not the foreskin.

    Finally, men who haven't achieved normal foreskin retraction may go here to discover how to "stretch" a tight foreskin to allow retraction ...

    http://www.network54.com/Forum/244184

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  71. Hi, We have a 15 month old who was told he has phimosis, he has been developing a split in the foreskin where the skin is tight, so they recommended the steroid cream for 6 weeks, and then potentially to circumcise him. How long can we safely wait to see if it retracts on its own? Luckily, he doesnt have pain when peeing, but the cut on his penis is worrisome for us, and we dont want to make it worse to the point where he has an infection etc. Help!! Advice needed on this, should we wait it out and try to gently retract it in the bath daily (as doctor suggested!) , get the surgery or wait it out, and for how long if we do? Thanks so very much!

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    1. Stop retracting ASAP, and find a new doctor! Please check this list for one near you:
      http://www.drmomma.org/2007/01/foreskin-friendly-physicians.html

      Retraction is a sexual function, and you don't need to worry about it AT ALL, especially in an infant. If he is still unable to retract his foreskin when he is post puberty and/or over age 18, then it will be something he can seek medical attention for on his own. I recommend using calmoseptine on the split in his foreskin.You can find it in pharmacy stores, and if they don't have it in stock they can order it for you. Calmoseptine does not interfere with the genitals' natural pH balance, and it is a wonderfully soothing, healing cream that is safe to use all around the genitals of babies.

      Please read more of the article above, as well as this one I will link here. Your son does not have phimosis, and almost certainly does not need to be circumcised.
      Protect Your Intact Son: Medical Advice for Parents When Your Doctor Says to Circumcise
      http://www.drmomma.org/2009/08/protect-your-uncircumcised-son-expert.html

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  72. I would always get multiple opinions before consenting to surgery. When you say cut, do you mean it's actually bleeding? If it is, the steroid cream should help. Or is it more that the opening extends up the foreskin a little. That's perfectly normal and you don't need to do anything. At his age, he generally shouldn't be retractable and it shouldn't be forced. I think your doctor us trying to put a premature age limit to when he should be retractable. Look through the foreskin friendly doctors link above and see if there's one in your area. Remember the more you "mess" with it (trying to retact) the more likely he will get an infection.

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  73. When a doctor diagnoses a boy with phimosis it is because he/she does not understand the normal development of the prepuce. First, in order to diagnose this condition, the doctor would have had to either try to retract the foreskin or encourage the boy to try to retract his foreskin. This is a huge "no, no" for the reasons described above. Second, there is no expiration date on developing a retractable foreskin. Each boy is individual as to when the separation and widening processes have completed. Just as each girl will begin menstruation in her own time, each boy will experience retraction in his own time. Since hormones play an important role in changing the composition of the tissue of the prepuce, it is not abnormal if the process isn't complete until the finish of puberty. Once an adolescent's foreskin is retractable he can easily retract his foreskin in the shower, rinse with water, and replace his foreskin over the glans. Most men do this naturally during normal manipulation of their genitals while showering. In the case that a boy becomes retractable before puberty, there is no need for him to rinse under his foreskin, unless he so chooses. In the case that an adolescent is not retractable, there is still no need to worry about cleaning under the foreskin. Remember, it is not abnormal for retraction to take until the end of puberty.

    Personally, I would give it time, continue to use the steroid cream and after that maybe use coconut oil to prevent any further irritation, Other than that, just leave it alone.
    And in the mean time, possibly try to find an 'intact friendly' pediatrician. Hope your son heals soon!

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  74. Hi, I realise this is an old article, but I'm looking for some help.
    From birth, my son's penis wouldballon with urine before any would make it out through the small opening in his foreskin. It was handy-I'm one of the few mums of a son who NEVER got an arc of pee in the face! We had a warning system. As he got older I realised that this was not typical, but any information I could find relating to 'ballooning' related to older children or, to forskin only balooning- his whole penis seems to blow up-have you ever seen Horton hears a who? the part where Horton has his trunk filled with water, and a not in the bottom is an EXACT representation of what happens to my son. When the urine does finally escape, it tends to squirt a bit wild and to one side. I took him to our family GP when he started kinder, and would be sharing toilet facilities. My aim was to AVOID circumsision. Our doctor said he had a 'true' phimosis, and recommended steroid cream, at twice a day instead of once, due to the 'severity' of the phimosis. The cream did seem to work, but part of the prcess involved gently pulling his foreskin back, to stretch and loosen it, and, even though the kin did loosen, I became concerned about the retractiuon, once we finally saw a glimpse of his glans, we ceased the cream and thought nature would take it's own course from there. The skin tightened right back up, and wse were back at square 1 within a couple of weeks. We trie the cream again about 6 months later, and stopped it once the skin bacame loose enough to pass over his glans (we almost couldn't get it back over again, so I was too frightened of creating an emergency circumsision situation to keep using the treatment) So now he's 5, and we're still seeing Horton's trunk everytime he urintes. A nurse told me he is t risk for chronic UTI's because the urine backs up like that, and I worry. I really, really don't want to subject him to surgery, but apparently, if he starts getting the UTI's they'll want to do it anyway. There's no QUESTION of retraction. when the skin is moved backwards towards the base of his penis, the top just squezes tight into a cone shape, there's no visable opening. Do you think he's one of the small percentage of boys who actually will need intervention? Should we be taking care of this for him before it becomes something he's embarrassed to talk to a doctor about as a sexual issue later? r self concious about in school or around other boys? I'm conflicted about our resposnsibility to keep him intact if it;'s going to be posible for him, yet also healthy and happy in himself. It's not the norm to be circumsised in Australia anymore, he'd be 'different' to most boys if he had a surgery, and his dad is also intact. My friend's little brother had to have surgery for the same reason, around the same age- a litle older-and he remembers. Plus, he was in school, so his friends were aware, and remembered too. I don't know what I should do. Nothing is changing as he gets older.

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    1. To me, it sounds normal and not phismosis. Natural retraction can happen any time, sometimes well into teenage years. As for the ballooning, check this article out http://www.savingsons.org/2014/03/extreme-ballooning-in-intact-child.html

      I highly doubt circ'ing is the answer for him. And for UTI's he would only need antibiotics just like girls do. As he gets older and his foreskin can retract he should be able to pull it back a bit(himself) so the ballooning does not occur when he pee's.

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    2. This is completely normal. Ballooning actually helps slowly and naturally separate the foreskin from the glans of the penis. Full retraction does not occur in some boys until the onset of puberty, so your son is in the natural time frame of this occurring. Forcibly retracting the foreskin over the glans is not necessary, no matter the age of a child. Please refer to this article for care of the intact penis: http://www.doctorsopposingcircumcision.org/info/physiciansguide.html

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  75. Thanks ladies, that extreme ballooning article was helpful. We Don't try and retract anything. There's no way retraction is going to be possible for him for years, there's a particularly tight band of skin that seems impervious to stretch. Like a ring. He's noit had any UTI's yet, and it's not bothering him. I guess we'll cross those bridges if and when we come to them. I do feel like he will end up in that small percent, somebody has to be! But he's not in it yet. There's no problem yet, and that will do for now.

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