Friday, August 31, 2012

Should a Baby's Foreskin Be Retracted?

Original educational video in French here.
Translation by Erkki

Commentary: 

Pediatrician Edwdge Antier discusses the question: Should a baby's foreskin be retracted?

This is a question that parents ask after their child's birth, since they have often read that one should retract a baby's foreskin in the bath. And I challenge anyone to find a baby's miniscule penis in soapy water and succeed in retracting the foreskin!

First off, what is the anatomy of your little boy's penis?

You need to understand that there are already adhesions between the prepuce and the glans. Here I've drawn a little penis with some adhesions, and here, what we call phimosis -- the famous phimosis which concerns many parents.

video

Understand the difference:

When a baby is born, the prepuce or foreskin of the little penis is what completely surrounds the glans or head of the baby's penis, and is attached, completely attached, to the head for 99% of little boys, and this is normal. It does not prevent the baby from urinating at all, and underneath it is sterile.

Sometimes you hear that it is necessary to pull the prepuce down, or to rip it away from the glans. This causes bleeding and creates a lot of pain for the child. Moreover, once the prepuce is forcibly retracted, it will reattach around the glans, and then it will become truly unretractable.

Therefore, don't touch the adhesions! 

Little by little as the baby grows up, he's going to have some small erections. Yes, he's already had some little erections while inutero. He's going to have more erections which will cause his little glans, his little penis, to swell, and gradually the prepuce or foreskin will separate from the glans or head of the penis. It's sufficient that he finds this out for himself at the age of 10-12 years old. Yes, I said 10-12 years old! Before that, there is no need to retract the foreskin.

Okay, now phimosis. Phimosis can be a pretext to do a lot of harm to little boys. You need to understand, here, in this case, the prepuce is really tight. And even if the adhesions have come free, the little penis will never be able to fully extend itself outside the prepuce spontaneously -- that won't be possible. In this case you must not pull down on the foreskin. You must not create a lot of misery for your child! No, you have to have it done surgically.

Is there a need for a circumcision in cases of true phimosis? The circumcision cuts the foreskin here and here, taking it off completely and leaving the head of the penis bald or exposed. It's a cultural or religious practice, but from a medical point of view, it has no justification. The medical answer is not to cut off the skin, but to make a small incision in one direction, and then sew it up again in the the other. We haven't cut off any skin, and the baby's foreskin will retract naturally. This plastic surgery on the foreskin for phimosis is usually done around ages 3-4, when your child is well aware that no one is going to cut off his penis, because that is a great fear of little boys.

So let me remind you of the Danish proverb:

No one has the right to touch the penis of a little boy except him!


News clip at Magic Maman TV: http://www.magicmaman.com/,video-le-decalottage-du-petit-garcon,377,1111465.asp


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