Symptoms of long foreskin in children

In medicine, the layer of skin that wraps around a boy's penis is called foreskin. If the glans cannot be exposed naturally, it is considered that the child's foreskin is too long and affects the penis. However, although parents have heard of foreskin being too long, they have no idea when asked to name its series of symptoms. Next, let us follow authoritative experts to understand the symptoms of foreskin being too long in children! I hope that through the editor’s introduction, parents will be able to understand their children’s bodies.

When the baby is less than 2 years old, the foreskin tightly wraps the glans at the front of the penis to protect it, so the glans cannot be exposed freely. This is called physiological phimosis. After the age of 2, the foreskin and glans are adhered and separated to form a soft outer cover. After the age of 3, the foreskin should be able to be turned over to the coronal sulcus and the glans can be exposed.

If the baby's glans cannot be exposed due to narrow foreskin opening or adhesion of foreskin after 3 years old, it is called "phimosis"; if the glans can be fully exposed but the foreskin still covers the glans when the penis is erect, it is called "phimosis".

symptom

Foreskin infection: When bacteria invade the space between the foreskin and the glans penis, it can cause foreskin inflammation, which can lead to redness, swelling, itching, pain, and even pus discharge from the penis. Repeated inflammation of the foreskin opening can cause scarring and contracture of the foreskin opening, loss of skin elasticity and expansion ability, inability of the foreskin to retract upwards, and urethral stenosis.

Smegma: The secretions in the foreskin cannot be discharged because the foreskin is too tight. White bumps can be vaguely seen on the surface of the penis through the foreskin, or small lumps can be felt. These are all caused by the deposition of smegma.

Difficulty urinating: The foreskin opening is as narrow as a needle tip. When the baby urinates, the foreskin will bulge, making it difficult for urine to be discharged. Crying, dripping or thin urine stream during urination may be complicated by urinary tract infection;

Erection pain: The narrow ring of the foreskin can cause penile erection pain, which affects sexual life in adulthood.

Urine stream is not straight, has an odor, and causes dermatitis: This is caused by the foreskin being too long, with the foreskin exceeding the glans by more than 1 cm. The direction of urination is uncertain, and the pants are often wet. The glans is damp and has an odor and is difficult to clean, and redness and rashes often occur. For older babies, if the foreskin is too long, they need to pull up the foreskin before urinating each time so that the urination can be accurately into the toilet.

Scarring stenosis: Because the foreskin opening is narrow and cannot be opened for cleaning for a long time, it causes repeated infection of the foreskin, which eventually leads to edema, thickening and loss of elasticity of the foreskin, forming scars. The glans penis also becomes dry, keratinized and atrophied due to long-term inflammation. This is called pathological phimosis, which often occurs during school age.

When to see a doctor

A small number of phimosis can be loosened naturally. Those who have the above symptoms or whose glans cannot be exposed at the age of 3 should go to the hospital for treatment and need the help of a doctor to loosen and cure the phimosis. Starting 6 months after birth, the foreskin opening can be expanded through manipulation to help loosen the stenosis ring and adhesions of the foreskin opening, gradually exposing the glans penis.

What the doctor does

Instruct parents to perform chronic manipulation to dilate the foreskin opening. Parents should push up the foreskin every day to dilate the foreskin opening and clean it, so that the narrow foreskin opening will gradually become looser. Foreskin adhesions will gradually decrease and eventually disappear, and you will develop the habit of turning up and cleaning the foreskin every day. This is suitable for male babies whose foreskin is not too long and whose stenosis is not severe.

Circumcision: Circumcision can be performed on an outpatient basis. It is suitable for cases where the foreskin opening is not narrow, and the doctor will manually peel off the adhesion between the foreskin and the glans penis. However, since children's glans penis has abundant nerve endings and is very sensitive, the process of separating the foreskin may cause instantaneous severe pain. Children will be very frightened, cry and struggle, and find it difficult to accept the process. This will leave painful memories for the children, and they will refuse to be cleaned in the future, and it will also cause certain psychological barriers to the baby. For this reason, it is recommended to take appropriate anesthesia and pain relief measures when separating the foreskin so that the child can receive treatment without pain or irritation.

There are two methods for painless foreskin separation. One is to perform the separation under local anesthesia, which is suitable for school-age children, those with less significant foreskin adhesion, and those with partial exposure of the glans. Apply local anesthetic ointment on the surface of the foreskin before separation, and the separation can be performed after 40 minutes. The other method is to perform separation under inhalation anesthesia, which is suitable for preschool children, those with severe foreskin adhesion, and those whose glans cannot be exposed at all. This operation is performed in the operating room. After inhaling the anesthetic, the patient quickly enters a sedated state and wakes up within a few minutes after the separation is completed.

After foreskin separation, there are often superficial lacerations and a little bleeding at the foreskin opening, and a bright red wound on the surface of the glans. No treatment is required on the same day, just avoid strenuous activities. Start local treatment after 24 hours. Soak or rinse the glans penis with 3% boric acid solution, and gently move the foreskin, gradually turning it up to expose the glans penis as much as possible. Apply a small amount of chloramphenicol eye ointment on its surface. Afterwards, be sure to reposition the foreskin to avoid foreskin incarceration. Treatment is given twice a day for about 7 days. After the superficial wounds on the glans and foreskin have healed, develop the habit of pulling up the foreskin to expose the glans and clean it every day.

After phimosis surgery, it is still difficult and painful to turn the prepuce up for cleaning each time. The baby often refuses to turn the prepuce up, and adhesion of the prepuce may recur.

Circumcision: Circumcision is suitable for scar stenosis caused by repeated foreskin infection and phimosis that cannot be turned up after non-surgical treatment at school age. It is also suitable for newborns whose parents request circumcision within 1 week after birth. The surgery was performed under anesthesia to circularly remove the narrow segment and the excessively long foreskin, and most of the glans penis was exposed after the surgery.

Key Points

The degree of stenosis of the foreskin opening and the length of the stenosis section are different for each baby. For babies with severe stenosis, forced separation will cause deep local lacerations, and each time of turning the foreskin up for cleaning is very painful and often cannot be carried out. Circumcision should be performed directly.

For those with abnormal penile appearance such as concealed penis and phimosis, foreskin reshaping is required.

This is an introduction to the symptoms of phimosis. If you find that you do have symptoms of phimosis, you must remember to go to the hospital for treatment. The sooner the foreskin is removed, the better. There is no age limit for this. However, if you want to have surgery, you should consider going to a large andrology hospital, so that the effect and safety are more guaranteed.