

In the first few years of life, gentle retraction with cleansing underneath the foreskin is sufficient during diaper changes or bathing and will result in progressive retraction over time. The foreskin should not be forcibly retracted, however gentle retraction is okay. No special care is required for foreskin in infancy. If there is ballooning of the foreskin during urination, difficulty with urination, or infection, then treatment may be warranted. Forceful foreskin retraction can lead to bleeding, scarring, and psychological trauma for the child and parent. Pathologic phimosis: Phimosis that occurs due to scarring, infection or inflammation. Phimosis is normal for the uncircumcised infant/child and usually resolves around 5-7 years of age, however the child may be older. Physiologic phimosis: Children are born with tight foreskin at birth and separation occurs naturally over time. Current incidence of phimosis is about 1% in 7 th grade boys. Phimosis is divided into two forms: physiologic and pathologic.

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Phimosis may appear as a tight ring or “rubber band” of foreskin around the tip of the penis, preventing full retraction.
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Phimosis is defined as the inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis.

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