Guide to dilating baby's foreskin

The article was professionally consulted by Specialist Doctor II Le Thanh Cam - Department of Pediatrics - Neonatology, Vinmec Da Nang International General Hospital.

Physiological stenosis of the foreskin is quite common in neonates. But if the child's foreskin has not been retracted by 4-5 years of age, parents should take the child to a doctor to take measures. Normally, physiological foreskin stenosis only needs conservative treatment according to the instructions for dilating the baby's foreskin.

In Vietnam, the actual percentage of boys with foreskin stenosis is about 5%.
Children with narrow foreskin often have symptoms of difficulty urinating, having to push to inflate the foreskin, and urine rays are far away. Babies are often fussy and red in the face from straining every time they urinate. The foreskin is narrow, making the urethra small, hindering urine output, so the foreskin of the baby is often red and itchy.
Foreskin stenosis includes 2 types: physiological stenosis and pathological stenosis.
Newborn boys often experience physiological narrowing of the foreskin due to slight adhesions between the inner surface of the foreskin and the outer surface of the foreskin, forming an indistinct separation between the foreskin and glans. head. As the child matures, the foreskin will gradually retract to reveal the tip of the penis and the urethral opening.
However, until the child is 4-5 years old and the foreskin still does not fall, parents can consult a doctor to have measures to dilate the baby's foreskin.

Depending on the condition and severity of the foreskin narrowing, the doctor will have treatment indications to suit each patient.
In terms of treatment, if the foreskin stenosis is uncomplicated, regardless of age, it is recommended to start with conservative non-surgical treatment first including dilatation and medication. This technique can be performed both at the hospital and at home.
Circumcision is the word for widening the foreskin for the baby to clean and help the baby to urinate more easily. Children under 2 years old, the foreskin has physiological stenosis that does not require dilation at the hospital, family members only need to gently slide the foreskin back to make it easier for the child to urinate. But in cases where the narrowing is too tight, causing the baby to push hard, cry when urinating, it is advisable to dilate the urinary opening a little wider to help the baby urinate more easily.
This process is done in the hospital, there may be a local anesthetic spray before dilation to reduce pain if the baby's foreskin is too narrow. The dilation process takes about 3-5 minutes, is very gentle and painless, however, some children have too narrow foreskin, when dilating, the baby's foreskin will bleed and hurt more. After the surgery, the doctor will give more pain relievers and topical drugs (which are local anti-inflammatory drugs) to help relieve the pain quickly, so parents should not be too worried.
In case of failure of conservative treatment, surgical treatment is needed. In cases where the baby is too large, with a fibrous foreskin, too tight, it should not be dilated because the results are limited, and it is easy to bleed the foreskin. At this point, the doctor can consider the option for the patient to undergo circumcision surgery.

At the hospital: medical staff
First time: Manual circumcision with local anesthesia with Xylocain 2% gel, or 10% Lidocaine spray anesthetic, wash off residues and lubricate the foreskin with cream Betamethasone 0.05%. In difficult cases, just a slight dilation shows the urinary opening. Prescription for: pain reliever (paracetamol) + Betamethasone 0.05% cream At home:
Parents dilate the baby's foreskin according to the instructions, apply Bethamethasone 0.05% cream 1 to 2 times a day for 1 to 2 months.

Some complications when a patient may experience circumcision are: Bleeding or blockage of the foreskin,...
In fact, if the doctor considers it, the rate of complications is due to Very low foreskin dilatation. However, if unfortunately there are signs of complications, it is necessary to quickly bring the patient to the nearest medical facility for timely treatment.

Hygiene of the genitals or foreskin in general for men is very necessary, especially for those with narrow foreskin.
Usually just using clean water and soap to wash the outside is enough. Take care not to wash the tip of the penis with a cotton swab, flush it with water or use disinfectants.
For infants who have not been circumcised, when bathing the baby, wash the genitals like the rest of the body and dry them. Do not forcefully pull the foreskin toward the abdomen. Because by the time the child is 3 years old, 90% of the foreskin can be retracted.
For older children who have completely turned the foreskin and can clean and wash themselves, parents need to guide the baby to bathe and clean the penis: Gently stroke the foreskin back towards the abdomen and wash the genitals. below and dry. Gently stroke down the foreskin to return it to its original position.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.