The foreskin, or prepuce, as it is known medically, is probably the most misunderstood piece of flesh in the human body. The foreskin itself is anatomically just a simple fold of skin that covers the head of the penis, or glans. No one is sure what its exact function is, but it does protect the head of the penis against irritation and injury from urine and faeces, etc, and it has a high concentration of sensory nerve endings, making it a very sensitive part of the male anatomy. It very probably also serves a sexual function, namely, protecting the sensitivity of the glans. The presence of the foreskin is not some cosmic error to be lopped off because it is the fashion at the time. Religious beliefs do not belong in this discussion.
At birth, the prepuce is actually part of the glans. It is fused to the glans. There does not even seem to be a communication through which the baby boy will urinate, although he will urinate, forcefully and profusely, usually to the dismay of his new parents. It certainly cannot be separated from the underlying penis. The foreskin slowly and naturally separates from the glans, without any help, as the child gets older. By the age of two, half of all boys have a retractable foreskin. In nine out of ten boys, it can be retracted completely by the age of five. Sometimes it takes longer. Occasionally, it does not retract until puberty, when it is helped to do so by normal erections.
Now, all this causes a serious problem in Trinidad and Tobago. Most modern mothers do not have a clue what a normal foreskin is supposed to look like. On the one hand, there is an entire generation of boys who were circumcised, so that a circumcised penis may have come to be accepted as the norm. On the other hand, the foreskin of adult males always retracts completely, so that when a new mother sees her firstborn son, his penis does not look at all like his father’s. In addition, it is always surprising how few penises most mothers have seen. All this may cause some serious discussion, and the child may then be taken to the local nurse or doctor. Here is where the trouble starts, because quite a number of doctors and nurses are ignorant about the fate of the foreskin.
All sorts of advice is given to the poor mother, apparently in the holy name of hygiene. Advice to forcibly retract the foreskin is common and is even acted upon by the medical professional, which is an oxymoron if there ever was one. That is one of the most amateurish things a doctor or nurse can do. If the mother baulks because her son screams, she is put out of the room whilst the child is held down and the foreskin is manually torn off and retracted. Every year, I see one or two children who have had this barbaric procedure done. Sometimes, the children present with the foreskin stuck behind the head of the penis, resulting in severe swelling and pain. If the forced retraction causes bleeding, scar tissue may form and interfere with natural retraction. This explains the difficulty some males have in adult life with erections and why they then need a circumcision.
All of this is completely unnecessary. Leave the newborn foreskin alone. It is not supposed to retract for the first few years of life. The baby will urinate very well without your help. There is no need to clean the glans because it is protected by the foreskin precisely during the years when unrestrained urination could irritate it.
Be concerned about a baby’s foreskin if the urine stream is weak or dribbles; if the foreskin is pulled back and gets stuck behind the head of the penis; if the foreskin is red and tender to the touch; or if the foreskin is swollen. Contact your doctor immediately.
Unfortunately, all of these, with the exception of the first, relate to forceful manoeuvres by someone trying to pull the foreskin back.
Leave the foreskin alone, and it will begin to retract, naturally and easily, around the time when your son attains full control of his bladder, at three years of age, just as if someone designed it to happen this way.
