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Discussion Starter · #1 ·
Is it ever necessary to retract (once he is retractable) my son's penis to clean? I thought I read it wasn't necessary to retract and clean until puberty, but I just want to make sure. Ds is only 20 months and we never mess with his penis in any way, but I was wondering if I will ever have to tell him to retract and wash it when he is still a child?
 

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Teaching about foreskin care should begin in childhood with age appropriate explanations, just like you'll be teaching him to wash between his toes or behind his ears at some point. By the time he is 4-5 years old, he should have the developmental capability (fine motor control, ability to follow instructions) to learn how to Retract and Rinse under his foreskin, always Replacing it back forward (the "three R's" of foreskin care). The boy should be the one to do the retracting, not the parent. (That is, of course, if it IS retractable, otherwise, have him just keep washing off the outside no matter what his age.) Of the sources I have found that have reasonable discussions of foreskin care, the advice (once he's developmentally able and retractable) is that rinsing under the foreskin can be done "occasionally" or "once a week" in childhood. By puberty it is recommended that this be done more regularly, like daily.<br><br>
In other words, if he's not capable of doing the retracting and rinsing himself, just wash off the outside. By age 4-5, he should learn about the 3 R's. If he's not retractable, or unwilling or uninterested in doing the 3 R's yet, I wouldn't worry about it, and just keeping washing off the outside. Having him swish it around in a tub of clean water, or just play with it in clean water as he wishes is probably sufficient in most cases. Still, I think by that time he should have some instruction about correct care, for future reference.<br><br>
Though not a perfect article, here's is an example of a pretty reasonable summary on care of the intact penis from: Camille CJ, Kuo RL, Wiener JS. Caring for the uncircumcised penis: What parents (and you) need to know. Contemp Pediatr 2002;11:61.:<br><a href="http://www.cirp.org/library/hygiene/camille1/" target="_blank">http://www.cirp.org/library/hygiene/camille1/</a><br><br>
"Some physicians believe that the foreskin should be left alone until the child is old enough to retract it on his own. There is no consensus about the appropriate age to teach penile hygiene, including regular retraction of the foreskin. We recommend teaching the school-age child to retract and clean beneath the foreskin at least once a week as part of routine hygiene, whether complete retraction is possible or not. Others advocate waiting until puberty, when complete retraction is readily achieved."<br><br>
Gillian
 

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Discussion Starter · #3 ·
Thank you!
 

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I would add one thing - no, two things.<br><br>
First - is an <i>attitude</i> matter. You need to give your son the understanding that the foreskin is <i>supposed</i> to be retractile at some stage, even if not right now. If he understands that, then he will tend to sort it out for himself.<br><br>
Second, and related, is that I suggest you teach him to retract the foreskin to pee. Some may actually argue that this will cause the foreskin to become <i>too</i> retractable, but it most certainly covers the aspects of "cleanliness" and avoidance of problems.<br><br>
Considering cleanliness, I refer you back to your own vulva. The article cited for example, suggests the use of a washcloth (but not soap). Do you clean inside your vulva with a washcloth? Do you use soap? Do you use a washcloth on your clitoris? I'd be surprised if you did. Cleaning the foreskin follows accordingly - visualise yourself as a girl child of the same age.
 

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<div>Originally Posted by <strong>Paul B.</strong> <a href="/community/forum/post/9069262"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Second, and related, is that I suggest you teach him to retract the foreskin to pee. Some may actually argue that this will cause the foreskin to become <i>too</i> retractable, but it most certainly covers the aspects of "cleanliness" and avoidance of problems.</div>
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Are you an intact male?<br><br>
I don't teach my ds to retract while he pees. In fact, he thinks ballooning is fun. I tell him to dab the end with toilet paper, thats it. The urine is sterile until it hits air. Is it really that important to tell a child, "retract to pee"? This doesn't seem right to me. I certainly don't tell my dd to spread her vulva to pee, nor do I do that and we practice good hygiene.<br><br>
The meatus would become more vulnerable to pathogens if the boy always retracted when urinating.
 

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And indeed ballooning <i>is</i> fun - when I suggest it as a method of evaluating the presence of adhesions, I always go on to say that if you do that once to a child for that purpose, you probably will not get him to <i>stop</i> doing it (and nor indeed, is there any reason to do so).<br><br>
Look, I did allow that people may choose not to advise this, and for various reasons.<br><br>
Your proposed rationale however, opens up a <i>huge</i> set of considerations to argue one way or the other. For example, some women <i>do</i> choose to "spread" to pee, particularly in order to do so in a standing position; a skill that has considerable merit and is a prerequisite for taking a Mid-Stream Urine sample.<br><br>
The "vulnerability" to pathogens relates to when contamination from nappies is still a factor. There's a sort of "all-or-none" phenomenon here, because <i>either</i> you figure that
<ol style="list-style-type:lower-alpha;"><li>the glans and inside foreskin should <i>never</i> be exposed - in which case, you shouldn't be attempting to "clean" it at all, particularly at bathtime when (and this refers particularly to a <i>bath</i> as against a shower) the bath-water will be <i>full</i> of pathogens (I <i>hope</i> you don't imagine that soap kills pathogens?) or</li>
<li>the glans and inside foreskin are gong to get contaminated anyway and thus washing (preferably by showering) and "airing" at each urination, are a good idea.</li>
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It certainly <i>is</i> true that urine is sterile as it is passed, but it is not "hitting the air" that contaminates it, but exposure to skin, and it is itself a <i>good</i> culture medium for bacteria, particularly bowel bacteria - and that is why UTIs occur.<br><br>
The studies used by the pro-circumcisionists appear to show more UTIs in intact infants, and it is argued from this that bowel bacteria <i>are</i> getting into the foreskin - and that's at or shortly after birth. It is suspected that this <i>may</i> be due to hospitals teaching women to interfere with foreskins (or interference <i>by</i> hospital staff, since this connection appears to disappear with breast-feeding and therefore, roomed-in infants).<br><br>
And yet another aspect, retraction in order to pee does not presuppose <i>touching</i> the glans at all - the foreskin rolls back, and rolls over again, surface to surface, with no touching of the glans - while of course, when done to "<i>wash</i>" the glans it clearly <i>is</i> handled.
 
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