Why to dilate the baby's foreskin? When should it be done?

This is an automatically translated article.

The article was professionally consulted by Dr. CKII Tran Van Trong - Department of General Surgery - Vinmec Danang International General Hospital. Uncle used to work at Hanoi Central Children's Hospital, Da Nang Maternity and Children's Hospital. Uncle has over 10 years of experience in Pediatric Surgery and Plastic Surgery - Aesthetic.
It is quite common for boys to have physiological narrowing of the foreskin. Many parents do not pay attention to timely intervention, or conversely, arbitrarily dilating the baby's foreskin may affect the health and quality of life of the baby in the future.

1. Narrow foreskin

The foreskin is the skin that surrounds and covers the tip of the penis and protects the male genitals. Foreskin stenosis, translated from English as Phimosis - is a condition in which the skin is tight around the glans and cannot be completely removed from the glans. Most boys will have physiological narrowing of the foreskin at birth, but over time, the foreskin will automatically separate from the glans. The older men get, the lower the rate of foreskin narrowing, specifically:
Newborns: 96% 1-year-olds: 50% 3-year-olds: 10% 17-year-olds: 1% Although It is thought to be a normal physiological phenomenon, but when this foreskin is too narrow, it will interfere with the baby's urination process, causing pain every time he urinates as well as difficulty in maintaining hygiene. Different from physiological stenosis of the fores foreskin.

2. Circumcision for the baby

2.1. Why to dilate the foreskin? Circumcision is a technique often prescribed by doctors to widen the foreskin of the baby, making it easier for the baby to urinate and clean. The procedure to dilate the baby's foreskin can be done in the hospital or the doctor will instruct the parent to slowly dilate the baby's foreskin at home.
However, there have been many cases where parents tried to dilate the baby but encountered many difficulties, partly because the baby often did not cooperate, partly because the parents were afraid of the baby's pain and did not dare to do it. In fact, the parents' support to dilate the foreskin will gradually bring about the effect, the foreskin can be pulled out naturally. But if done incorrectly, or afraid to touch the painful area of ​​​​the baby to practice dilation and hygiene, soon the foreskin will narrow again.
Why to dilate the foreskin at home? Through examination, the doctor can conclude that surgical intervention for the child at this time is not necessary. Moreover, arbitrary dilation or circumcision poses many potential risks, such as:
Acute complications: Bleeding, swelling, infection, immediate damage to the glans or urethra after the procedure. Chronic malformations: Leaving bad scars, recurrent narrowing of the foreskin, even narrowing of the urethral opening or fistula. As a result, many medical experts worldwide recommend that parents carefully consider when to dilate their baby or explore other appropriate treatment priorities. with the child's condition.

2.2. When should the baby's foreskin be dilated? Foreskin stenosis is quite common in children, but the severity of each child is completely different. Parents should keep a few notes in mind when to dilate the baby's foreskin as follows:
For children under 2 years of age, physiological stenosis does not require dilatation at the hospital, family members may slightly slip the foreskin. Head back makes it easier for baby to urinate. If the child is over 2 years old but not too narrow and the foreskin is still soft, proactive cleaning of the foreskin and dilation is still the optimal solution. In case the narrow is too tight, causing the child to have to push hard to urinate and cry when urinating, you should go to a medical facility to slightly dilate the urinary opening a little. In older babies, the foreskin is already fibrous, accompanied by too tight narrowing, it should not be dilated because of its limited effectiveness, easily causing bleeding of the foreskin. At this point, the doctor may recommend circumcision. Not all circumcision surgery is good. Sometimes there may be specific complications including: bad scars after cutting, bleeding of the foreskin, infection of the incision. Therefore, depending on the nature of the foreskin of each child, the doctor will consider choosing the optimal treatment.
2.3. The process of dilating the baby's foreskin

For babies who are sent home by the doctor, parents should listen carefully to the advice and instructions of the medical staff to follow correctly. Limit causing pain, injury or infection to the baby without achieving the desired results.
If circumcision is done at the hospital, the process will take about 3-5 minutes, quite gentle and less painful. In case the baby's foreskin is too narrow, the doctor may apply a topical anesthetic before dilating it to reduce pain, sometimes bleeding and the baby will cry more. After the dilation procedure is finished, the doctor will prescribe more oral pain relievers and topical anti-inflammatory drugs containing topical anti-inflammatory agents, the baby will quickly return to normal activities, so parents do not need to worry too much. settle.
Physiological stenosis is a relatively normal phenomenon and is not cause for concern. However, parents should not be subjective, arbitrarily dilating the baby's foreskin or taking the child to be circumcised when the baby is too young. If you find that the child has symptoms of difficulty urinating, pain in the vagina, it is necessary to visit the doctor as well as ask clearly when to dilate the baby's foreskin. In addition to surgical intervention, natural remedies or topical medications can also safely support the baby.
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