Cleaning "it"

[APToddlerMama]

DS is 2.5 and unfortunately, we were foolish enough to go ahead with circumcision after he was born.  Please be gentle...I feel bad enough about it already.

The question is, DH has always told me that we need to pull back the foreskin and clean when DS takes a bath, and I recall MIL telling me this too after he was born.  My response to DH was that he had the equipment and that could be his responsibility, which it has been for some time.  Now, I seem to come across info on here from time to time that says not to pull the foreskin back (on an intact child), so I am wondering if the same is true for a child who is not intact.  DH insists not cleaning/pulling the foreskin back is why DS is itchy.  Help please!

[AnnDMFT]

I'm confused as to what foreskin you are referring to.  If your son is circ'ed and it was done correctly, it's my understanding that he shouldn't have any foreskin left....I've changed many, many little circ'ed boys' diapers and my hubby is circ'ed too so I am really trying to understand what you are talking about....

Of course, this could just be something I haven't come across....curious as to what other people say about this...

[Galatea]

It is likely a loose circ, which leaves some foreskin.  After the circ, the foreskin often tries to heal itself by reattaching to the glans, like it would be had it not been circ'ed.  This can include adhesions, which is where the sutured/scar area is trying to attach itself to the glans inappropriately, but not completely, which allows poop, etc. to collect under the remnant of the foreskin.  Thus, the modern "loose" circ is causing more problems than what it was intended to "fix."  You ought to tell your husband that the circumcision is actually causing the cleanliness problems.  My intact boys have never had any itchiness or anything collecting under there, as their foreskins remained tightly adhered to their glanses until they were 3 and 4 years of age and out of diapers.  But I digress.

If indeed his remnant foreskin is no longer adhered, then you have to clean under it.  Do not use soap as this would be irritating, like if you got soap inside your inner labia.  Just some warm water should be sufficient.  And then don't do this to any future sons.  Aside from the human rights issues, it is much easier to care for the intact penis.  I just wipe it off like a finger.

[APToddlerMama]

Originally Posted by Galatea 

It is likely a loose circ, which leaves some foreskin.  After the circ, the foreskin often tries to heal itself by reattaching to the glans, like it would be had it not been circ'ed.  This can include adhesions, which is where the sutured/scar area is trying to attach itself to the glans inappropriately, but not completely, which allows poop, etc. to collect under the remnant of the foreskin.  Thus, the modern "loose" circ is causing more problems than what it was intended to "fix."  You ought to tell your husband that the circumcision is actually causing the cleanliness problems.  My intact boys have never had any itchiness or anything collecting under there, as their foreskins remained tightly adhered to their glanses until they were 3 and 4 years of age and out of diapers.  But I digress.

If indeed his remnant foreskin is no longer adhered, then you have to clean under it.  Do not use soap as this would be irritating, like if you got soap inside your inner labia.  Just some warm water should be sufficient.  And then don't do this to any future sons.  Aside from the human rights issues, it is much easier to care for the intact penis.  I just wipe it off like a finger.

Yes, I think it must be a loose circ.  Thank you for the info.  Please don't feel like you need to lecture me though on not doing this to future sons.  I already said that I regretted it.  It doesn't help to be called out on a "human rights issue" when I feel guilty enough and stated so.  I'm not sure why I'd need to be reminded not to circ another son. 
 

[Galatea]

I did not mean to offend you.  Many people continue to circumcise even though they don't want to b/c they feel the children have to "match" - we read this here all the time - so I was trying (in a poor manner) to convey this.

[AllMyChildren]

It sounds like a loose circumcision, which can lead to adhesions, but is better than a tight circ, because the extra skin gives the penis room to grow. If the skin pulls back easy, than you should pull it back and clean under it. But if it has adhered, please do not or let anybody rip it loose.

It will release on its own in time. Ripping it back is very painful to the child and can cause scar tissue and infections.

Just as the foreskin on an intact penis will release on its own(may take up until puberty, but that is totally normal) the foreskin that is left on a loose circ will release too.

[Lauren82]

Originally Posted by AllMyChildren 

It sounds like a loose circumcision, which can lead to adhesions, but is better than a tight circ, because the extra skin gives the penis room to grow. If the skin pulls back easy, than you should pull it back and clean under it. But if it has adhered, please do not or let anybody rip it loose.

It will release on its own in time. Ripping it back is very painful to the child and can cause scar tissue and infections.

Just as the foreskin on an intact penis will release on its own(may take up until puberty, but that is totally normal) the foreskin that is left on a loose circ will release too.

I 2nd this. If it is adhering please don't rip it. Ouch.
 

[MCatLvrMom2A&X]

There are 2 schools of thought on the issue for a circed penis. Some say leave it alone and do not retract some say retract to clean and prevent adhesion. My personal opinion is that it should be left alone to heal back down where it can especially after a loose circ then allow nature to cause retraction when it is needed.

If it is itching under there and he is easily retractable I would retract to rinse under there I would not use soap at all and I would make sure that after a bath you rinse him with clear water before he gets out.

[PlainandTall]

I do not think the same rules apply in caring for intact and circumcised children.

First I will explain that (you probably know this by now) the intact foreskin is fused to the surface of the glans at birth.  But it's not actually attached to the glans- there is a membrane called they synechia that bonds the two surfaces together.  the synechea gradually breaks down and the two surfaces, when they have the maturity and hormones to support this, will become seperate and able to exist ajacent but unattached to eachother.

When parents of intact boys are old to not forcefully retract- part of what they are protecting is this layer of synechia from being disturbed or torn.

If the synechia is torn before the body is ready, the surface of the glans and the skin touching it may grow attached to eachother in the body's effort to heal itself.

When an infant is circumcised, the synechia is torn as the first step in inserting the circumcision tools past the corona of the glans.  If enough skin is left (or enough pubic fat pushes skin forward) skin touching the immature surface of the glans may become re-adhered.  This is very common, much more common in the first months after a circumcision, but for some children this can contine for several years- it seems that if adhesions keep getting torn over and over- the glans stays raw and keeps clinging back to anything touching it. If you aren't dealing with adhesions, you are probably out of the woods with that.  There are mixed medical opinions about how best to treat adhesions... I can't offer advice on that but I do advocate for consent/information and anesthesia before anything is ever done.  Seems many moms and babies are hit by a "sneak attack" when the adhesions are discoverd and torn apart in one fell swoop infront of thier disbelieving shocked faces.

What not such a grey area is in regards to adhesions involving the scar line as scars tend to run amok when forming adhesions and will grow beyond attached and go into the surface of the glans.  These result in what is called "skin bridges" in an adult.  You could look up a picture gallery of skin bridges at circumstitions.com (but you probably shouldn't) Anyway- ev en thought you haven't said that you even are dealing with adhesions- I'm just bringing it up because the presence of scar tissue in the equation is the reason why the care for intact and circumcised babies is different.  Retracting intact babies can cause scar tissue that makes problems... retracting circumcised babies can prevent the scar tissue of the circumcision from causing problems.

I hope that was clear and helpful.  Gentle rinsing in the bath is all that's needed- no soap as that can be irritating to genital tissue.

[APToddlerMama]

Thanks everyone!  PlainandTall--wonderful explanation and very helpful.