Management of a baby’s foreskin often raises much anxiety. The foreskin is initially adherent to the glans, or head, of the penis, and may not be retractile. Its aperture may look tight on inspection, but as long as the baby is weeing well with a good stream, this is of no concern. The foreskin will spontaneously start to retract later on in childhood – 50% of two-year olds will as yet have a non-retractile foreskin. There is no need to forcefully retract the foreskin. A study in uncircumcised Danish men showed that the median age for foreskin retraction was 10.4 years. Therefore, as long as it is not causing any symptoms, there is no need to be concerned about a non-retractile foreskin until the child is 8-9 years old.
Symptoms of concern are swelling and infection or a tight white scarring of the tip of the foreskin, a rare condition called balanitis xerotic obliterans (BXO). Once the foreskin is retractile, boys must be reminded to pull it back into place to avoid it getting stuck behind the glans (paraphimosis). These symptoms will require review by a paediatric urologist and may, but not always, require a circumcision. Circumcisions for non-medical reasons (cultural, religious or parental choice) are not performed by the NHS – they will require private referral.
Circumcisions may be performed under local anaesthetic (a “penile block” which only numbs the penis) in babies between 0 and 6 weeks of age. It is more comfortable for older babies and children to have a general anaesthetic. Either way the children may go the same day as the procedure, and the post-operative recovery is the same.
Please visit your GP and request a referral to Chelsea & Westminster Hospital Paediatric Urology
Miss MK Farrugia
Please e-mail [email protected] or book an appointment in Chelsea & Westminster Hospital (0203-315-8599) or BUPA Cromwell Hospital (0207-460-5700)