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Advice for tight foreskin in 9 Yr old.

FretfulParent profile image
30 Replies

My son has had increased tightness for over 6 months now, after several GP visits he’s on waiting list for NHS circumcision which we are all anxious about. Has anyone had experience of tight foreskin from early age?

Considering private consult to explore less extreme measures

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FretfulParent
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30 Replies
baileytrev profile image
baileytrev

There’s no harm in getting a second opinion, there are less invasive methods which can be tried such a steroid stretching creams.

My son also had the same issue and we went down the route of steroid creams but unfortunately it was only a ‘temporary fix’, if it’s something he’s been struggling with and is in pain with it then the chances are that creams won’t work for him.

If you have any other questions, feel free to message :)

jeffboy_aust profile image
jeffboy_aust in reply to baileytrev

Hey- good you are concerned about your son. But please give everything else possible a good chance because once the 4skin is gone he will never have the same sense of sexual pleasure that a 4skin affords. There are dev ices that can be used to stretch the skin- and cremes as well. If you can address the issue while he is as young as he is, there's a pretty good chance he will be able to keep his 4skin. Circumcision is a solution. of last resort. PM me if you like, I have put together a few things from the net that might help.

jimfromcalif profile image
jimfromcalif in reply to jeffboy_aust

The proper steroid works, but it must be accompanied by manipulation daily for about six weeks to allow time for skin cells to multiply and divide.

anonym531 profile image
anonym531 in reply to jeffboy_aust

I don't believe that's true. There shouldn't be any noticeable sexual pleasure loss. Of course the sensitivity of the glans will not be present but that doesn't mean that sex won't feel good. If you have phimosis and have never seen your glans before, after a circumcision sex/masturbation should feel much better (after it's healed), and most of the time no problems should occur after a few months. Most people report no change in pleasure and some even say that it felt better after circumcision.

jeffboy_aust profile image
jeffboy_aust in reply to anonym531

Obviously, having been cut as a newborn, I did not know quite what to expect when my wife and I first had sex. She was familiar with a previous dude who was intact. After our fist encounter, her reaction was- "what's wrong with your dick?" She said that intercourse was way more painful and she felt I should have felt more than I seemed to have. Her description was it was merely mechanical. Over time nothing improved, and when I discovered restoration, I had 110% backing. And over that time, I have gained so much sensitivity with the glans, and also the developing inner skinand it is like the lights have come on. I still believe that wherever possible, circumcision should be absolutely the last resort.

anonym531 profile image
anonym531 in reply to jeffboy_aust

How does she know how you felt? I don't get it.

Stones331305 profile image
Stones331305

If you can afford it go private & see a Consultant at Spire Hospital’s (cost you about £250) & have his Circumcision done privately ( cost you another £2000) but it will be done quickly…. NHS wait will take forever 👍

roddythescot profile image
roddythescot in reply to Stones331305

Private hospitals overcharge for such a simple procedure as a childhood circumcision.

The original poster would be best advised to contact one of the many specialist circumcision clinics around the UK. The total cost for a 9 year old, including consultation on the day, should not exceed £400. A list of UK clinics can be obtained from info@circumcisionhelpdesk.org quoting your town/city and county to get a relevant selection.

jaglad profile image
jaglad

I am not sure the NHS would perform surgery unless it was really necessary especially at age nine. If steroids are prescribed encourage your son to use as instructed.It is not a procedure to be entered into lightly so please ensure this is what he needs and make sure he is fully aware of what is happening to him.

Various people looking at and inspecting your private parts can be disconcerting for an adult never-mind a child, reassure him.

Also, it may be good to seek a second opinion.

Best wishes.

BexyBoy profile image
BexyBoy

You don't say what is actually bothering your son about having tightness. If he can urinate OK, can allow bath water to clean him without worrying about the glans and isn't in constant pain, maybe he can wait to see if the issue reolves itself. There's no rule that says he has to be able to retract. Some boys still have an adherent foreskin into their late teens and beyond, then hormones cause the foreskin to loosen naturally.

FretfulParent profile image
FretfulParent

Thanks for all your comments. He’s currently trying a steroid cream, as the GP said there won’t be any point trying to expedite appointment with hospital for the circumcision. Initially the first GP( male) we saw said no conservative measures would work. The consultant urologist confirmed this - albeit in a blaźe manner. My son’s symptoms definitely getting worse since Dec, our first GP appt & referral . I wonder if preputioplasty is an option

xsevenx profile image
xsevenx in reply to FretfulParent

Definitely worth considering less extreme measures. But if you feel your relationship with the urologist is not 100%, ask for a second opinion. On the NHS.

ml66uk profile image
ml66uk

It's very unusual for a nine-year-old to need to be circumcised. What symptoms does he have exactly?

If it's just that he can't retract, that's completely normal at that age, and he shouldn't even be trying to retract it. A Danish study (Øster) found that only 23% of boys could retract by the age of 6-7, and an average age of ten. For what it's worth, I was about ten before I could retract, and my son was about the same age.

FretfulParent profile image
FretfulParent in reply to ml66uk

Ok thank you, that’s really helpful to know. We are certainly intent on exploring all options. This is not something we want him to have to endure, it avoidable

ml66uk profile image
ml66uk in reply to ml66uk

Kayaba 1996 found this:

Abstract

Purpose: We evaluated preputial development in Japanese boys.

Materials and methods: Preputial retractability and formation of a tight ring were evaluated in 603 Japanese boys 0 to 15 years old.

Results: The incidence of a completely retractable prepuce gradually increased from 0% at age 6 months to 62.9% by 11 to 15 years, while that of a tight ring decreased with age from 84.3 to 8.6%. Nine boys had balanoposthitis but none had a symptomatic urinary tract infection.

Conclusions: Incomplete separation of the prepuce is common and normal in neonates and infants, and preputial separation progresses until adolescence. Awareness of these findings will eliminate unnecessary circumcision in boys.

ncbi.nlm.nih.gov/pubmed/886...

roddythescot profile image
roddythescot in reply to ml66uk

On the other hand, the anti-circumcision activist Gairdner stated that the foreskin should be fully retractable by age 5. Not being freely retractable by then is not 'natural' but the result of a problem - usually phimosis. The fact that a number of boys suffer from non-retractability is NOT a sign that it is natural at that age.

ml66uk profile image
ml66uk in reply to roddythescot

I've only just seen this, but small boys don't "suffer" from non-retractability (I wasn't able to retract till I was about ten, but certainly wasn't suffering, and neither was my son).

It's 73 years since Gairdner wrote "the fate of the foreskin", and he was guessing at when being able to retract was normal in times when parents were told to retract infant foreskins (and that's now strongly advised against). Multiple studies since then have shown much later ages for retractability.

This paper quotes more studies about retraction:

ncbi.nlm.nih.gov/pmc/articl...

"Øster,5 Kayaba et al,6 Morales Concepción et al,7 Agarwal et al,8 and Ko et al9 all have demonstrated that the development of preputial retraction is a very gradual and variable event that occurs between birth and the completion of puberty. Moreover, Thorvaldsen and Meyhoff carried out a survey in Denmark and reported that the mean age of first foreskin retraction is 10.4 years.10 All of these authors provide evidence that refutes Gairdner’s 1949 data."

"Gairdner’s values for foreskin retraction belong in a museum of medical history, but they should not be applied in current clinical practice."

jimfromcalif profile image
jimfromcalif

Tightness is absolutely normal. Some boys can’t retract until late teens. The best remedy is to let the boy unharmed.

Nofren64 profile image
Nofren64

Hello ! It is possible that your son does indeed have phimosis. Circumcision is absolutely not necessary, except in extreme cases with infections. Before thinking about depriving your son of his foreskin, you should try to correct the phimosis by gradually relaxing the terminal ring of the foreskin using gentle relaxation exercises, under Betamethasone 0.05% corticosteroid cream. Depending on the country, this product has different names. Here in Europe it is often sold as Diprosone Cream. Try this method. Remember that the foreskin is designed by Nature to protect the glans, keep its natural moisture, the flexibility of its mucosa and greater sensory receptivity.

FretfulParent profile image
FretfulParent in reply to Nofren64

Also, the GP & consultant have all suggested that as the skin is whitening & blood supply hampered that circumcision is only option- BUT we are obviously concerned & wondering having seen this & other posts from medical papers that maybe, it might still be avoided & an alternative found.

FretfulParent profile image
FretfulParent in reply to Nofren64

He has no infection that is obvious. Only short bursts of pain post urinating- he does have bulging & spraying when he pees

ml66uk profile image
ml66uk in reply to FretfulParent

If a GP and urologist both think that circumcision is the only option, then they're probably right, but I'd want a second opinion if it was me or my son, as it still feels like this is something that might just fix itself.

The "bulging and spraying" are probably just what is known as "ballooning", which isn't by itself a problem, and normally goes away.

FretfulParent profile image
FretfulParent

Ok- we will look into this method, thank you. We’ve been monitoring his movements of it in warm baths & when he pees, and have just started on some corticosteroids - Bethametasone vale rate cream- which is 0.1% Betnovate brand

We’re in the UK

jaglad profile image
jaglad

Unfortunately you will get lots of differing opinions, but they are just opinions, some based on experience some on gut feeling. You have to go with what you think is best and medical opinion.My elder brother was circumcised as a baby, me not so. Don't know why.

i Occasionally experienced the ballooning effect and could not retract properly until my twenties but did not cause me any ill effects, hygiene, satisfaction and fathering children where all good.

Later in life I had to have a circ' for unrelated reason. Did I prefer life with a foreskin, yes.

Am I happy with what I got now, yes.

Choose wisely. Best wishes

FretfulParent profile image
FretfulParent in reply to jaglad

Thank you. Appreciate your clear concise & experienced opinions

Well mine wasn't loose until I was about 11 or so I believe this is normal unless it's excessively tight keeping my foreskin was the biggest favour ever done me! So sensitive... Of course doctor knows Best! P

foreskinsaver profile image
foreskinsaver
foreskinsaver profile image
foreskinsaver

Here is a link that might help dailymail.co.uk/health/arti...

ml66uk profile image
ml66uk

Did your son get circumcised in the end or did you find an alternative?

This is what some *national medical organisations* say about retraction btw:

AAP – "Care for an Uncircumcised Penis"

healthychildren.org/English...

"But foreskin retraction should never be forced. Until the foreskin fully separates, do not try to pull it back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding, and tears in the skin."

Canadian Paediatric Society

caringforkids.cps.ca/handou...

"An uncircumcised penis is easy to keep clean and requires *no special care*:

Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Never force it."

caringforkids.cps.ca/handou...

"Keep your baby boy’s penis clean by gently washing the area. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old*, or even until after puberty. Never force it."

ccdimager.net/familypractic...

"It is important not to retract the foreskin forcefully for any reason."

Canadian Urological Association

uroinfo.ca/brochures_pediat...

"Care of the normal foreskin

The uncircumcised penis requires *no special care*. It can be kept clean with a gentle soap and warm water wash daily. No attempt should be made to retract the foreskin until it can be pulled back with ease. Then, your son should be taught to pull his foreskin back gently to clean its inner surface and the glans with soap and water.

It should be thoroughly rinsed with water before being dried with a towel. The foreskin must always be brought back to its usual position covering the glans after washing.

It is important not to retract the foreskin forcefully for any reason. Some parents feel the need to pull the foreskin back to “clean under it”. Since the young boy’s inner foreskin and the glans are initially fused, there is no space to clean.

Forceful retraction also may lead to cracking and bleeding of the foreskin tip. Over time, this may cause scarring of the tip making retraction impossible. Circumcision may then be necessary."

RACP policy statement on male circumcision (Australia)

racp.edu.au/docs/default-so...

"The foreskin requires *no special care* during infancy. It should be left alone. Attempts to forcibly retract it are painful, often injure the foreskin, and can lead to scarring and phimosis."

Paediatric Society of New Zealand

kidshealth.org.nz/foreskin-...

the foreskin and penis of an infant or child need *no special care*

a child's foreskin should never be pulled back (retracted) by force

there is no need to clean inside the foreskin in young boys - just wash their penis the same as any other part of your son's body and be careful to wash off any soap

* The CPS suggests that early retraction is a lot more common than seems to be the case btw. A Danish study (Øster, 1968) found that only 23% of boys could retract by the age of 6-7, and an average age of ten. Kayaba 1996 found this:

"The incidence of a completely retractable prepuce gradually increased from 0% at age 6 months to 62.9% by 11 to 15 years" pubmed 8863623 )

Why would anyone know or care though? We don't go poking around in the genitals of small girls.

uncutforeskin profile image
uncutforeskin

At age 12 my mother found that I had a tight non-retractable foreskin and suggested that my foreskin should be circumcised. She explained how the doctor would cut off the tip so that the remaining foreskin would be retractable. Sounded painful a doctor cutting on my penis so I objected. She explained that it would be just the wrinkly puce colored folds on the very tip that needed to be snipped then the remaining foreskin would retract to exposed my glans. Still sounded painful. She continued the pain will be brief but it needed to be done. Finally I conceded.

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