Foreskin Problems
The foreskin is the piece of skin that covers the top of the penis. Conditions that can affect the foreskin include:
- Hypospadias where the hole (meatus) through which urine is passed is not positioned right at the end of the penis, and the foreskin is gathered at the back of the penis rather than the front.
- Tight foreskin (phimosis) where the foreskin cannot be pulled back to reveal the head of the penis. This is normal in boys under five, but the foreskin should begin to retract on its own accord as boys get older and reach puberty. A tight foreskin in puberty or adulthood can increase the risk of infection and cause problems with urination.
- Paraphimosis – where the foreskin has retracted but gets trapped, restricting blood flow to the head of the penis. The penis will turn dark purple. Paraphimosis requires immediate medical attention as this condition can cause permanent damage to the penis if not treated early.
- Balanitis an inflammation of the tip of the penis and foreskin usually caused by chemical irritation, bacterial or fungal infection. The head of the penis will become red, swollen and sore and there may be a thick and lumpy discharge.
How are foreskin problems usually treated?
In the case of infection, a child may be given a course of antibiotics or a steroid cream to reduce inflammation and irritation. The course of treatment may last between two and four weeks, depending on the severity of the strain of infection.
Other conditions may require a surgical procedure, such as:
- Stretching of the foreskin.
- Preputialplasty - where the opening of the penis is widened by an incision without removing the foreskin.
- Circumcision - where the foreskin is removed altogether.
- Surgical reshaping of the foreskin.
All of these procedures are carried out under anaesthetic a urologist will explain which might be most appropriate, as well as the benefits and risks involved.
Can foreskin problems be prevented?
Good hygiene is key to preventing problems that can be caused by infection.
In babies and children, the best way to clean the penis is by using water and baby soap. Don't worry that you are not able to pull back the foreskin at this age it's very important not to try to retract a child's foreskin forcibly, because this may cause damage to the delicate tissues of the penis. It could lead to bleeding, inflammation and the formation of scar tissue.
Once the foreskin begins to retract, the glans will naturally become more visible and easier to clean. It is important to be gentle the less scrubbing the better. When boys reach adolescence, they should be encouraged to retract and clean their foreskin regularly.