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10-30-2006, 02:08 AM
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The basic definition of retraction means "Pulling the foreskin back toward the body to expose the glans (head of the penis)".
But retraction has a broader meaning than that. Specifically "pulling back any on the foreskin toward the body is retraction". Even just a tiny bit it still falls under the heading of the word. It also means manipulating the opening of the foreskin by stretching it out or moving it around to see the opening.
Why some Dr. do not know this is beyond me. : Some hear the word and only think about full retraction and say no they do not do that, then they proceed to push the skin back anyway. The reasons they give run a huge range. Including but not limited to: "to see inside"; "out of curiosity"; "to break adhesions (the attach points are synechiae, not adhesions)"; "to see if the foreskin retracts"; "to clean it"; "to visualize the meatus (the urethra opening)" etc.
There is NOTHING in there that they need to see. They have no reason to even touch the penis other than moving it so they can check the testicles. If there was a problem with hypospadias (a condition were the urethral opening is not at the tip of the penis), for example, severe enough to require treatment it would be obvious with just looking at the penis.
A babies skin as we all know is fragile. Pulling back any on the foreskin can result in micro tears that allow bacteria to enter causing infection. There is NO way anyone but the owner of the penis can be 100% sure that they are not pushing things to much. Especially a Dr/health care worker since they tend to push things as far as they will go just to see how far it will go :
When a catheter is required (after all other avenues have been tried) to diagnose or treat a problem it is fairly simple to get the catheter in without causing damage. They should gently move the opening of the foreskin to line up with the urethra, without retracting, then clean the area throughly, then insert the catheter gently until urine is obtained.
Any time a possible infection is present and needs treatment a swab should be done before prescribing any medication to treat the problem. Because it could be yeast or bacterial, abx if prescribed for bacteria when it is yeast will make things much worse not better. The swab should be done on the tip of the foreskin only, any infection that is inside will be present on the tip as well.
So it is imperative that when you tell a Dr./health care worker not to retract you get specific, instead of saying, Do not retract, say Do not pull back any on his foreskin or do not touch his penis.