Epidemiological data from the US suggest that many parents and even pediatricians make mistakes when it comes to maintaining hyiene in boys with intact penises — so boys who have not been circumcised and have a foreskin. The reason why doctors are often giving the wrong advice is the high percentage of circumcised males, so the importance of the proper care and hygiene for uncircumcised children is being left behind and underestimated. Premature retraction of the foreskin often leads to injury, which then requires circumcision. The problem is usually not recognized right away and those children often end up having problems during adolescence and when they become sexually active.
The Role Of The Foreskin
The role of the foreskin does not differ much from the function of skin on other parts of the body, which is to protect us from injury and pathogens. Additionally, the foreskin contains nerve endings which participate in sexual sensations. In adults, during erection, the foreskin is normally retracted and it leaves the glans of the penis uncovered to allow proper sexual stimulation during intercourse. Opinions regarding the protective function against infections are controversial. Although the foreskin prevents microorganisms from getting through through, it also offers a good environment for the development of already existing microorganisms.
Circumcision Vs An Intact Foreskin
A lot of debate exists on whether men with a foreskin have a higher incidence of penile cancer than circumcised men. Earlier evidence suggested that circumcised men had better chances of eeping good hygiene and therefore a lower incidence of penile cancer. However, later it was discovered that other factors were more important, such as tobacco smoking and infection with the human papilloma virus (HPV). Given the generally low incidence of this cancer, current evidence is not sufficient to draw a conclusion.
Sexual satisfaction is another issue which deserves attention. Namely, some men circumcised during adulthood claim a gradual decrease in the sensitivity of their penis, accompanied by a decrease in sexual satisfaction. Would the burden of impotence be lower if fewer people were circumcised? This is still an unanswered question. However, these are questions reserved for further research.
Maintaining Foreskin Hygiene During Childhood
In uncircumcised infants, the foreskin is firmly attached to the glans of the penis and it is not retractable. The current recommendations are that parents and physicians should not try to retract the foreskin in children, as it is a natural condition which will evolve and disappear itself. Retractions and attempts to wash the glans from the inside are not needed. Only wash the foreskin from the outside. The reason for this is possible injury of the foreskin and consequent scar formation. Scars are not as elastic as healthy skin, so this can cause the foreskin to remain non-retractable even in adulthood. This condition is called phymosis and it requires a surgical procedure (circumcision) in order to enable normal sexual activity in adulthood.
Foreskin Care After Puberty
The foreskin should become retractable once a male reaches puberty. Good hygiene of the foreskin and the glans becomes very important after puberty, especially in sexually active men. By maintaining proper hygiene, pathogens like HPV are removed, as well as potentially harmful substances present in urine. The outer side of the penis should be washed with soap and water, but the use of soap is not recommended for washing the surface of the glans. Perhaps only pH neutral soaps could be used if needed. This is because soaps dissolve the protective layer beneath the foreskin, causing irritation. In general, good hygiene is always recommended, but it has much higher significance in uncircumcised men than in children.
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