i want to learn more.

[lovebug]

when i read these thread i always see "do not retract him" or "OMG they tried to retract him"

i am learning by reading that early retraction is bad, but why?

thanks and i am sorry if its dumb question

[tlh]

For the first few years of life and sometimes up til puberty the foreskin is fused to the glans and retracting it before it becomes naturally unfused would be like peeling a fingernail off.It would be painful and
could cause scarring which can lead to problems in the future like paraphimosis.

[brant31]

lovebug, I'm sure your next question is, "Then how do they do a circumcision?"

Well, close your eyes and try to imagine it. That's why the members of this forum want to devote time and energy to educating about it.

The really cool thing is that there is so much fun stuff to learn about the foreskin and the marvel that is the human body. The foreskin is highly beneficial for development (a circumcised newborn glans is essentially all scar; hmmm), for protection (from diaper ammonia, feces, and more) and in many ways from puberty through adulthood. To enjoy all this, all parents have to do is respect the fact that at birth, a boy's penis is not nearly done developing. It comes in its own adherent cocoon until cellular and neurologic development is sufficient to allow smooth retraction. And best of all for the boy, the wrapper turns into a toy he gets to keep! It's even better at this than Mighty Morphin Power Rangers.

[Pirogi]

Originally Posted by tlh

For the first few years of life and sometimes up til puberty the foreskin is fused to the glans and retracting it before it becomes naturally unfused would be like peeling a fingernail off.It would be painful and
could cause scarring which can lead to problems in the future like paraphimosis.

I was thinking about this the other day, and we often use the analogy of a fingernail and the nail bed. This is a very good analogy for explaining the physiology of an intact foreskin and glans prior to natural retraction. But really, forced retraction is more painful than the fingernail analogy. Imagine ripping up the nails of every fingernail and toenail of a newborn. This is probably close to the same surface area as the infant foreskin. The pain the baby would feel would be localized in each finger and toe nail bed because the fingernails don't have any nerve endings. But the foreskin IS highly ennervated, as well as the glans, so it would be twice as painful to rip the foreskin and glans apart, as in forced retraction of a newborn or in the first part of a circumcision. And although the foreskin is cut (or crushed, or burned, etc) off in a circumcision, the first step is to rip the foreskin from the glans. The baby would endure this double intense feeling of ripping apart his skin for a few (or many) minutes, before the foreskin is actually finally cut away.

[Yulia_R]

Good question! Sorry I don't have the time to read other people's replies so I appologize in advance if it has already been covered by others.

1. It is painful (sort of like ripping off a fingernail) and can lean to infections.
2. It can form scar tissue which isn't as elastic as normal tissue therefore, creating a posibility for true phimosis in the future: failier to retract when it is time (for some kids not until after the puberty, by the way, which is normal).

[PlainandTall]

Wow Pirogi- After all these years... you just floored me with the obvious. I never really thought about the nailbed analogy and the fact that fingernails themselves don't have nerves. >shudders< I once munched a finger in a machine and have good personal knowledge of the sort of pain the faulty analogy spoke to.

To the OP- The aspect of the retraction thing that I see most often misunderstood- is the fact that if a boy IS circumcised- his caretakers need to be diligent to avoid adhesions- because often the skin will bunch up against or over the glans and grow attached to it. This is very different from the instructions to care for an intact child.

There is a dividing layer present at birth (the synechia)- that both attaches and seperates the surface of the glans from the inner surface of the foreskin. When the body matures to the point that these structures can exist independantly- that layer will break down and allow them to come apart. Circumcision tears apart and destroys that layer- so now when the surfaces come in contact with each other they tend to grow connected. So- adhesions that are present at birth are NOT the same adhesions that might develop after a circumcision (or forced retraction)

Also know that the tip of the foreskin is not like some homogenous pie-dough of skin... there is specialized anatomy right at the very tip of the foreskin - the skin can expand and contract (like scrotum skin does) to hold the foreskin tightly closed and snug against the glans. Maturity, temperature, hormones, habit, sexual arousal... many factors can go into what allows that to happen. The ability for that skin to relax should not be forced because if those minute structures are TORN they could heal with scarring- rather than intruduce pliability- you will cause inelasticity problems.

[Yulia_R]

Originally Posted by PlainandTall

To the OP- The aspect of the retraction thing that I see most often misunderstood- is the fact that if a boy IS circumcised- his caretakers need to be diligent to avoid adhesions- because often the skin will bunch up against or over the glans and grow attached to it. This is very different from the instructions to care for an intact child.

For the sake of possible readers I just wanted to point out that these sort of adhesions too should be left alone. It's our body's way to heal the damage and make the foreskin (whatever left of it) function as "normal" as possible. The study has shown that most of circ adhesions will resolve on it's own when it is time for that child to retract (like it would if he was left intact).

[PlainandTall]

Yulia- What you say is correct- but is also not universally agreed upon. I have very mixed feelings on it myself- so I avoid trying to imply that either lysing adhesions or waiting is the better option. I honestly don't know!

I know of at least one study that does call the majority of adhesions "self resolving"...

but I have to ask - what is "self resolving"? Is this a physician-centric view of the patient as if he is a tree in the forest that no one hears fall? Just because the DOCTOR does not do the lysing... does that mean that painful tearing didn't happen at some point (even if not in earshot of the physician?) !? Did the child suffer for years with painful erections? Did debris build up in the space and cause repeated infections? (the circumcised child does not even have the benefit of the "keep out" system of the prepuce) I once read an account online from an embarrassed teen guy who cut his own skin bridge- he used ice and a pair of cuticle scissors... can we consider that was "self resolving"? His story really made me think.

Yes- I am constantly horrified when I hear of Doctors who forcefully and without warning or consent (from either parent or child) tear apart adhesions without pain relief or caution. I am not suggesting that this common assault is the reasonable alternative to "wait and see"... there must be a reasonable middle ground.

[lovebug]

Originally Posted by brant31

lovebug, I'm sure your next question is, "Then how do they do a circumcision?"

oh no! i am well aware of how they do it even before MDC i had this odd feeling its not right! i dont know how anyone, that knows how it is done, could do it to their child...

so then my next question is, how do you know its retracted and if its after puberty, how do you 'teach" a boy to clean it? that is a sensitive age... or is 'teaching' the same as a girl?

[MommytoB]

A boy if he's in preschool will be the more unmodest type and show you that he can retract his foreskin which will more only be partially most of the time to begin with .

The older ones as the preteens/teens will learn by playing with themselves in the shower .

I still say when boys get to around showing signs of puberty and you don't know if they have retractible foreskin to leave a instruction sheet .

About when your foreskin can move back and you can see the slit known as the meatus of the penis it's time for you to do the Three R's in the Shower

Retract as in pull back your foreskin then Rinse and then Recover.

I say that because some boys didn't even know they could make their foreskin could pull back

I wonder if many kids who get forcibly retracted don't play with their foreskin as much as the one's who don't get retracted at all by other people ?

[brant31]

Originally Posted by lovebug

if its after puberty, how do you 'teach" a boy to clean it? that is a sensitive age... or is 'teaching' the same as a girl?

Originally Posted by MommytoB

The older ones as the preteens/teens will learn by playing with themselves in the shower.

Reminds me of this.

[tlh]

Originally Posted by Pirogi

I was thinking about this the other day, and we often use the analogy of a fingernail and the nail bed. This is a very good analogy for explaining the physiology of an intact foreskin and glans prior to natural retraction. But really, forced retraction is more painful than the fingernail analogy. Imagine ripping up the nails of every fingernail and toenail of a newborn. This is probably close to the same surface area as the infant foreskin. The pain the baby would feel would be localized in each finger and toe nail bed because the fingernails don't have any nerve endings. But the foreskin IS highly ennervated, as well as the glans, so it would be twice as painful to rip the foreskin and glans apart, as in forced retraction of a newborn or in the first part of a circumcision. And although the foreskin is cut (or crushed, or burned, etc) off in a circumcision, the first step is to rip the foreskin from the glans. The baby would endure this double intense feeling of ripping apart his skin for a few (or many) minutes, before the foreskin is actually finally cut away.

Very true.The pain would be way worse than just a fingernail being ripped off and would also last much longer.It would also be multiple types of pain from separating the foreskin and then cutting.

[rabbitmum]

Originally Posted by MommytoB

About when your foreskin can move back and you can see the slit known as the meatus of the penis it's time for you to do the Three R's in the Shower

Retract as in pull back your foreskin then Rinse and then Recover.

I would like to add that this is not necessary at all for children, nobody here teaches their young child to do this.

[texmati]

Originally Posted by MommytoB

A boy if he's in preschool will be the more unmodest type and show you that he can retract his foreskin which will more only be partially most of the time to begin with .

The older ones as the preteens/teens will learn by playing with themselves in the shower .

I still say when boys get to around showing signs of puberty and you don't know if they have retractible foreskin to leave a instruction sheet .

About when your foreskin can move back and you can see the slit known as the meatus of the penis it's time for you to do the Three R's in the Shower

Retract as in pull back your foreskin then Rinse and then Recover.

I say that because some boys didn't even know they could make their foreskin could pull back

I wonder if many kids who get forcibly retracted don't play with their foreskin as much as the one's who don't get retracted at all by other people ?

What? leave them a note? I do think you should handle this topic with as much sensitivity as you'd give a girl.