The prepuce or foreskin is a normal part of the external genitalia forming a natural covering over the tip of the penis (glans).

At birth, the foreskin typically is unretractable or does not easily glide back and forth over the glans. This is a normal condition, and the foreskin will become fully retractable as the child grows.

Today it has been noticed that many baby boys are born with unretractable foreskins, but this disappears as a child grows.

It is important to note that medical or surgical intervention is necessary when a child has urinating difficulties such that the urine pools in the foreskin or problems with infections.

Circumcision involves the removal of the foreskin from the tip of the glans to the ridge of the glans. Circumcision is often a hotly debated issue in terms of when it should be done and whether it should be done especially in children.

Circumcision should never be done if there is a question as to whether the possibility of hypospadias condition exists.
Some conditions prompt people or require urgent need for circumcision, taking an example of phimosis. This is a condition in which the foreskin is tight and narrow, making it impossible or painful to retract. This may cause extreme pain when your child experiences stronger erections.

In addition, it may cause problems with infections, (although this is a normal condition in infancy) if it persists beyond the average age and typically 4–5 years old.

Medical or surgical intervention may be indicated. At this point, your child should be evaluated by a pediatric urologist, who can make the decision as to whether the need circumcision is warranted.

Another condition is Paraphimosis. This condition is somewhat opposite phimosis in that the foreskin is fully retracted behind the ridge of the glans and is unable to be pulled back over the glans. Because the foreskin remains behind the ridge of the glans, it may cause irritation and swelling, making it impossible for the foreskin to be pulled back over the glans. This condition requires urgent medical attention.

Medical Treatment

Some families prefer to try other options before immediately having their child circumcised. If the pediatric urologist believes the child will not be at risk of further problems, it may be appropriate to try a low-potency steroid cream.

The parents or child and if the child is old enough, he will  be instructed to apply the cream 2–3 times a day, with a Q-tip, to the tip of the penis to help the foreskin naturally and easily retract. This is typically tried for one full month, and then the child is re-evaluated.

Surgical Treatment

As stated earlier, circumcision is the removal of the foreskin. If this is not done within the first few days of life, the earliest it will be done is at six months of age. This delay is because general anesthesia is required. By six months of age, infants are healthy and strong, and able to tolerate general anesthesia.

By this time, they have also had some time to bond with their parents and have not reached the separation and anxiety stage of development.

Postoperative Care

Postoperative care is minimal in that you will apply a combination antibiotic and pain ointment called Spectrocin to the penis to help the healing process, and to prevent the penis from sticking to the diaper.

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