My first son was circumsised... (Because daddy is). I wish we wouldn't have, but we did. My second son is not. Do I do anything to it. I read on the mens board some of the teens having problem with the foreskin not retracting like it should... Do I start pulling it back at a certain age? Do you think that either of the kids will think they are "different" My oldest is 3 and my youngest is 5 months. Should I go ahead and have my second circumsised? Just asking, please no attacks. I make all my decisions to try to be the BEST for my kids.

I can relate to this...we only have one son who is three and he is uncircumsized. His father is. At his birth, we couldn't come up with any reasons to have it done other than the fact that he would look different from his father. We know we can handle that. But now I'm starting to feel doubts. I'm afraid he'll be different than most boys and feel insecure with his penis. But then again, with open communication we can get through that too. This way, if he comes to us when he's, let's say, 15 and cannot stand the fact that he is uncircumsized, he has the choice to decide. Babies don't get that chance.
It really is a HARD decision because there are pros and cons to each.

About taking care of your son's penis....don't touch it till he's about four. The foreskin is still fused together and will gradually open up as he ages. My son is three now and I can just barely see the head of his penis. When he's around 4 (and I'd ask his doctor about this to make sure he's ready...you can start gently stretching the foreskin. Continue to do this (in the bath is a good time) till he is able to do it on his own. (this may be a few years) He then has to be taught about cleaning the head of the penis and in between the foreskin, because as you know, smegma will collect and he needs to wash this away. I would stay clear of soaps under the foreskin as that can cause infections...just use warm water and gentle scrubbing. If accumulated smegma remains a little bit of baby oil will help loosen it and then can be rinsed off. Another thing that is important is for the head of his penis to be open to air once in a while and stimulated as well (he can do that part himself ;) ) The head of an uncircumsized penis is VERY sensitive because it's been covered and protected. He has to gradually desensitize it enough that he can stand having it touched. I'm not sure by what age his foreskin should totally retract behind the head. Go to Male Anatomy.....they know a LOT about uncircumsized penises.

I hope this helped a bit...I'm new at it too, so I've only told you what I've read and been told by his doctor.
Good luck!
Meg

I am going to offer somewhat different advice. I have been doing research and counseling in the area of circumcision for over 15 years, and I've learned a lot about care in that time.

First of all, there is a general misconception that boys' foreskins should be retracted for cleaning sometime by the age of 3 or 4. I suppose this is preferable to the advice 40 years ago, when parents were told to pull back the foreskin every day from first leaving the hospital. We now know that that usually leads to tearing, adhesions, and sometimes phimosis.

Little boys are born naturally phimosed. This condition is beneficial on several levels, from allowing the undeveloped glans and inner foreskin to continue developing the sophisticated nerve endings on their surfaces to protecting this delicate mucous membrane tissue from the harsh ammonia and bacteria of diapers. There are two closures on little boys that naturally keep bacteria out of the urinary tract. One is the meatal lips, which close snugly when a boy is not urinating. Unfortunately, in many (most) circumcised boys the delicate lips are burned by abrasion and diaper ammonia, and meatal stenosis (narrowing) results. This affects 50-70% of circumcised boys and virtually no intact boys. One result of meatal stenosis is that urine flow is obstructed, slightly or more so, and reflux to the bladder can result.

The other closure is the foreskin itself. The foreskin contains, in addition to a lot of veins to help circulation in the penis, considerable muscle tissue. This is why the foreskin opening (preputial ring) is able to close to a tiny diameter yet stretch to accommodate the glans. The muscle tissue is quite effective in babies and young boys; it forms a whorled or spiraled closure that opens like a camera lens to let boys urinate, then closes again to keep out pathogens. One of nature's incredible designs.

The groundbreaking work of Jakob Oster has been mistakenly interpreted to suggest that boys' foreskins should be retractible by age 5. In fact, Oster never made such a suggestion. It is wholly normal for a boy's foreskin to be too tight to retract on its own until puberty or even a little later. While most natural adhesions between glans and foreskin resolve by age 3 or 5, it is very normal for some residual adhesions to remain around the corona. Retracting your son's foreskin, even gently, risks tearing these prematurely.

When parents ask me at what age they can expect to see their son's glans, I tell them "never". :eek: This surprises a lot of moms and dads, but apart from instances of those boys whose foreskins naturally loosen at an earlier age, parents should not ever expect to see this intimate, interior part of their sons, any more than they should expect to see the head of their daughter's clitoris. The first and only person to retract a foreskin should be the boy himself. Parents should teach sons about the natural separation process, by which the adhesions between foreskin and glans gradually break down over childhood and the preputial ring enlarges.

Infants and young boys can produce smegma, but it is vastly different in composition from the smegma of adult men. Sometimes parents can feel "pearls" of balled smegma under their son's foreskin. This is normal; it's just the bunching of sloughed cells. The penis is designed to discharge these on its own. Don't retract his foreskin to get at them and never stick a Q-tip, finger or anything else into your son's foreskin.

It is only American parents and doctors who have an obsession about foreskin retraction by a certain age and -- guess what! -- intact American boys have about 10 times the foreskin problems of boys in Europe and other parts of the world where foreskins dominate. A Swedish or Chilean parent would never dream of pulling his son's foreskin back, even gently. Stretching? Child abuse! What part of your daughter's sexual anatomy would you "stretch" for cleaning? Nature made the genders equally perfectly and equally well-suited for good health and hygiene. It is a widely-perpetuated myth in Anglo societies that boys need to be "fixed" to be clean or require special attention to the genitals.

By the way, I have many, many friends who come from families where one or more sons is circumcised and one or more is not. Down to the last one, none of these guys says it has ever made an iota of difference. Ditto for differences between sons and dads --if anything, a child is more likely to notice and remember Dad's size and pubic hair, not a foreskin or lack thereof!

Chuff, you have obviously done a great deal of research on circumcision and the uncircumcised penis and the care that is involved. Thank you for some of the information that we as parents may not have known.
This is a very sensitive subject to a lot of moms and dads who basically know nothing about an uncircumcised boy's penis. I had mentioned gentle stretching (something that was suggested by my son's doctor) and you outright called that child abuse. As I am doing the best I can in researching the subject and listening to the doctor's advice, I take much offense to that remark. Never did I say something like "yank" or "pull" at the foreskin. I said gentle stretching. (And by the way, sometimes "gentle stretching" is a must when just cleaning a dirty diaper to reach all areas). Women also collect smegma under their clitoral hoods and YES, gentle stretching of the hood is sometimes needed to reach the area. As for parent's never seeing this intimate part of their son's genitalia, I think that's ridiculous. Parents are responsible for teaching their children how to clean theirselves and the proper way of doing so. You make it sound like it's sexual abuse if we as parents look at our child's genitalia. Now of course if the boy is fifteen and is uncomfortable then by all means a parent should take a step back and not look or feel. There are too many boys out there who have never been taught the right ways to take care of their penises (usually because of the discomfort from his parents) and therefore this leads to later problems in their lives. Children are not born knowing what to do. It's great that nature can take over some of the time and no problems ever pop up but of course you know that isn't always the case. I don't think you should make parents feel guilty about looking or touching their son's penis when they are teaching them about care. And by the way, we see and feel a whole lot more when merely changing their diaper.
Since you are very knowledgeble about the whole thing, try researching sensitivity as well when talking to parents who are asking for help. Please never tell us we are abusing our sons by doing what our doctors have told us to do. They very well be misguided, as you mentioned only because they are North Americans but they are still the best resources we have on the topic.
I'm sure you didn't mean to offend me but you did nonetheless and there are a lot more people who are much more sensitive than I am.
Thank you again for your version of information though.
Meg

Meg, you make an excellent point, and I am sorry for my choice of wording that implied that I was making a value judgment. What I was trying to say was that in those cultures I was referring to, fiddling with a foreskin may be seen as abusive because retracting, stretching, cleaning under, etc. a boy's foreskin simply is not done. I was imitating mock outrage as a "citizen" of one of those cultures.

It is true that in a great part of the world parents never see the glans of their sons. This is because by the age that the foreskin has normally become retractible, the boy is responsible for his own cleaning. I am not saying that it is bad that American parents do so see their son's glans, merely that they get used to the idea that in their family's case it may very well be the situation that they don't, as seems to be true in most European, Asian and South American families. Their rate of male UTI and other maladies is much lower than in the US.

I know that Americans have a different standard of hygiene than the rest of the world. In many senses this is admirable, in others questionable; the overreliance on antibiotics and antibacterial everything may be one reason for the rapid rise in resistant strains of bacteria. The rest of the world has found that, generally speaking, the standard for genital hygiene for daughters and sons is the same: gentle cleaning of all outward surfaces, and leaving all mucosal surfaces free from outside touch as much as possible until a later age (most cases of childhood BXO appear to come from accidental transferance of HPV from the caregiver's hands). In boys, this means that the glans is not an external surface, as much as circumcised US culture has come to think it is. It is a highly private, sexual area that ought to stay covered as long as nature allows until it's time for the boy (=owner) is old enough to want to explore that area.

Again, sorry for the construction. I wasn't laying charges at anyone!

Thank you Chuff, for clearing this up. I've got to hand it to you - you do know your stuff. I think we agree on a lot of points. And the ones we don't, well, that's okay too. Everyone, every culture has their own way of doing things, right? Water under the bridge. :)

Meg

PS. keep doing what you're doing. There are a LOT of us out there who need to be guided. :confused:

Wow...great post, Chuff!
I am going to print a copy and keep it on hand. Very different from what we are learning in medical school, but I totally agree.

Meg, I think from what I've read, you're already doing a great job. :angel:

Thanks for the encouragement, julia_girl! If your medical school is in the US, I'm not surprised... we're only in our infancy in this country when it comes to understanding intact male anatomy. It was second nature 100 years ago and before (remember, the Founding Fathers were all intact!), but by now nearly all the medical professionals and the dads are circumcised and are making their best guesses.

A few years ago I was having a cordial chat about circumcision with a young resident in Pediatrics, I believe. He was asking about intact care, and I said the best care is to just leave it alone! "But...but...but -- that's so counterintuitive!" he said. I had to laugh. I suppose if you don't have a foreskin it looks like something just to be pulled back and cleaned. In fact, it has a fairly complex development in childhood and foreskin care is more nuanced than that... one must be aware and sensitive to so many developmental issues. For example, resolution of adhesions. We should ask: which adhesions are you referring to? The first to resolve naturally are those closest to the meatus at the distal end of the penis. The desquamation of epithelial cells that eventually fully differentiates foreskin from glans takes years, and moves from distal end to proximal end. However, the natural adhesions around the rim of the glans can be the most resilient of all. In some boys, all adhesion resolution occurs fairly quickly, say between the ages of 5 and 6. In my case, I recall being able to retract very easily from an early age to see the glans, but I still had adhesions all around the corona of the glans. These broke loose only when I was 9 or 10, and I can remember them coming apart in stages, releasing small pockets of infant smegma (the general term for all desquamated cells in that space prior to puberty, when smegma changes composition with the addition of prostatic and vesicular fluids).

Sometime after I was 10 the last couple of adhesions broke, bleeding a little as they did. I freaked out! I was in bed, in my PJs, and I ran downstairs in a panic to ask my parents about it (this was a big deal, as I never discussed my "privates" with my parents! :o ) As I whimpered and shifted from foot to foot, I remember my mom saying something about "masturbation." She must have figured that the last bits tore as I was "exploring". Well, I didn't know that word, but I kept insisting it was "menstruation", as I had recently learned that word in health class in school and remembered that it had something to do with bleeding near puberty. :rolleyes:

I don't know how she kept a straight face, but Mother calmly told me 3 or 4 times, despite my protestations, that the drops of blood I was seeing were not "menstruation." She was quite sure, as I recall.

Dad took me upstairs, did a quick exam, and told me I was perfectly fine. What occurred was a natural part of growing up, he said. Well, now I know he was right, but I wish to heck someone had told me what to expect! The final tearing loose of a boy's foreskin near puberty has analogies to the breaking of a girl's hymen (clearly the analogy is far from perfect); both sort of signal, by slight tearing and bleeding, that the individual is physically ready for sex. Emotionally? Clearly not by a long shot. But nature was telling me that my penis had pretty well completed its development, and was now in fully functional order. It wasn't long after that that I was producing semen. Seeing my sulcus for the first time (the groove behind the glans) was rather fascinating. It reminded me of the space behind the back seat in my cousin's convertible where the top went when it was down; even today, I think of that when my foreskin is retracted and fits snugly and perfectly into the sulcus! :eek:

In my case, it clearly helped that my father was born and raised in Europe and had some idea what to expect. I can only wonder what a circumcised, American dad would have done in the same circumstances; probably called the doctor. This is partly why I hope to share information with parents so that our collective awareness can move forward and intact bodies soon won't be a mystery to American doctors, nurses, parents, or health teachers.