Are you worried that your son's foreskin is ballooning when he tries to pass urine? Well you're in the right place! In this post I will teach you about what ballooning means and how nearly all boy's foreskins will become retractable over time.
Almost every boy is born with a foreskin that is non-retractile (physiological phimosis). It is normal, in young boys, for the inner surface of the foreskin to adhere to the head of the penis (the glans). The foreskin gradually becomes retractable due to a combination of intermittent erections (common in boys of all ages), and toughening (or keratinization) of the inner surface. Only 1% of 16-year-old boys will have non-retractile foreskins, compared with 10% at 3 years of age.
Ballooning is one of the most common causes of worry for the parents that bring their boy's to see me in the clinic. In fact ballooning is another way that the foreskin becomes retractable - as it helps to loosen the adherent bits between the inner surface of the foreskin and the glans. As the foreskin becomes more retractable ballooning will settle.
Is there anything that I can do to help my son's foreskin become retractable?
I would not recommend that you try to pull your son's foreskin back for him. It is important to know that forceful retractions cause micro-tears and scarring that can actually make your son's phimosis (tight foreskin) even worse.
Once your son is old enough to understand the principles (my two son's were about 4 or 5 before they were ready) he should be instructed how to gently retract his own foreskin.
It is also really important to try to keep the inner surface of the foreskin as clean and dry as possible. This is easier said than done for a boy with a very tight foreskin. I suggest to all the boys that come to see me that they run the bath just before bedtime, do a wee and then clean the foreskin with soap and water in the bath just before bed. This ensures that the inner surface of the foreskin is clean and dry every night and will reduce the risk of infection or inflammation (such as balanitis).
Is there any cream or other treatment available for my son's phimosis?
Applying steroid cream to the inner prepuce twice daily for 6 weeks can help soften the skin and give your son the best chance of being able to retract his own foreskin. Using steroid cream for longer periods is not recommended as it then weakens the skin causing cracking and bleeding.
What about surgery to treat my son's phimosis?
Thankfully this is not commonly required. If there is white scarring of the prepuce then your son most likely has BXO and this requires a circumcision. If there is no BXO but he is either having painful erections, recurring balanitis or urinary tract infections then either a preputioplasty (procedure to widen the foreskin) or a circumcision can be considered. For more information on the procedures click here.
If you think your son might need my help why not get in touch:
you can email me directly at info@mrbrianmaccormack.com
or simply call 02890667878 to book an appointment
Until next time, take care of yourself and of your family. Best wishes