Tight foreskin in a 2 yo?

[christinelin]

My son is intact and his foreskin doesn't retract at all yet (obviously I haven't let anyone try to force it back). The doctor mentioned at his 2 yo visit that his foreskin is a bit tight and said that the rate of infection can be a bit higher in boys who are tight. She also sort of said in passing that needing to circ later is very rare (I think to reassure me).

Clearly I wouldn't circ unless it was a medical necessity and my threshold for that would be very high (including multiple opinions from medical sources very familiar with uncirced boys), but I am wondering what I should expect the normal course of development to look like. When SHOULD it retract? Is it possible it might not? What are the consequences, if any, of it being "tight."

Thanks.

[feebeeglee]

It's totally normal for it to take til puberty to retract - and post-puberty is not unusual at all.

Here's the American Academy of Pediatrics take on it:

Eventually, sometimes as long as 5, 10, or more years after birth, full separation occurs and the foreskin may then be pushed back away from the glans toward the abdomen. This is called foreskin retraction. The foreskin may retract spontaneously with erections which occur normally from birth on and even occur in fetal life. Also, all children "discover" their genitals as they become more aware of their bodies and may retract the foreskin themselves. If the foreskin does not seem to retract easily early in life, it is important to realize that this is not abnormal and that it should eventually do so.

from http://nocirc.org/articles/aap.php

HTH!

[Frankly Speaking]

There have been about a half dozen studies about the normal age of normal retraction and they are about as agreeable as my ex-wife and me. The one thing they all agree about is that full retraction may not come until the late teen years.

One study states that 2/3 of boys are retractile at 3 years old and another says that 70% are not retractile until after puberty. The truth is in there somewhere. However, it seems that the only one doctors read is the one that says 2/3 should be at 3 years old and they forget that that means 1/3 are not and then they promptly diagnose phimosis or “tight foreskin” and prescribe a circumcision.

The normal state of a 2 year old’s foreskin is tight. It is normally only open enough for the urine to pass. Unless there is indication that there is a restriction in the flow of urine, there is no problem. There is an associated condition when separation of the foreskin begins called “ballooning” that is just as it sounds and is nothing to worry about. As separation begins, many boys will have a foreskin that balloons out as he starts urinating and will slowly deflate when he stops. This is totally normal and will usually self resolve in about 8 or 9 months.

A tight foreskin is actually a protection against infections. It prevents anything from getting in. Urine is sterile and each time a boy urinates, he flushes his entire urinary tract out with a sterile solution. If urine were not sterile, he would have a constant urinary tract infection. It’s only not sterile when there is a problem.

The foreskin exudes an enzyme called lysozime that protects the preputial space from infection. This is exactly the same enzyme that protects the eyes from infection and should not be disturbed. Washing inside the foreskin removes the lysozime leaving the area unprotected from infectious pathogens.




Frank

[kxsiven]

Our son is almost 3 and still not retracking. No one is worried. Here in Scandinavia doctors do not do anything until late teenage years and usually by then everything is OK. Unfortenately you and your son are a victims of uneducated doctor.

Just leave it alone and I guarantee that your son will know the right time to retrack!

[paminmi]

My son's ped said the same thing to me when he was at that age. Terrible thing was, I was dumb and started trying to retract because that was his advise.

Marilyn Milos set me straight and started my education in the intact penis. 13 years later...here I am!

Funny thing was, my two daughters also had very small and I'm guessing, tight vaginas. The doctor never mentioned any concerns about that to me...hmmm.



Sad to say, but in many cases I can take or leave the doctors in this country (and I am a Registered Nurse).

Pam

[hummingbear]

Yup, the whole when will "it" retract question in this country is beginning to feel a little perverse to me. DS is almost 4 (this Saturday) and I haven't noticed a peep of glans. I was worried when DS was 2 and two other 2 year olds were retractable. But after two more years of reading and hearing stories it is finally sinking in that everything is just fine the way it is. It is appalling to me that even in our medical community there can be such huge discrepencies: one pediatrician in another thread advising a mother to retract her infant, other stories of doctors advising of tight foreskins at 2 or 3 and the actual AAP statement which says leave it alone, some boys do not retract until their teen years. What's a mother to do?

[nikirj]

My DS wouldn't retract himself at all at 2 (I stopped touching his penis when I stopped changing his diapers, so I wouldn't know how 'tight' it would feel). Now he is 3.5 and my DH says he fully retracts himself (apparently DS won't play with himself so much in the tub if I'm doing the bathtime lookout duty).

I'd venture a guess that it was never meant to be any of our business in the first place.

[christinelin]

Thanks for the feedback. I won't worry. He urinates fine and has never shown any sign of infection. This stuff is harder in a culture where it is not the norm. My DH has no idea what to do with it (and he frankly would have preferred to circ). Our area is more diverse than most (northern California), but I think docs are still relatively unfamiliar with intact boys.

[Karry]

My almost 4 year old is just now starting to retact a tiny bit. He found out he can pull back on his penis, and now he likes to show everyone his new trick. :LOL At two his foreskin was still very tight. My 15 month old probably retracts more that his brother, his doesn't seem as tight.

[hummingbear]

Has anyone else ever come across this statistic or a study referring to this?

Originally Posted by christinelin

The doctor mentioned at his 2 yo visit that his foreskin is a bit tight and said that the rate of infection can be a bit higher in boys who are tight.

[Frankly Speaking]

Nope. I think this must be something that doctor invented.



Frank

[~Kira~]

DH is from Hong Kong (intact) and told me that the first time he ever fully retracted his foreskin was when he was around 11 or 12 years old. So, no worries!





-Kira