Penile Foreskin

The penile foreskin, covering the glans penis, is a normal developmental aspect in males. In some cases, incomplete development may signal an underlying issue. Circumcision, the removal of the foreskin, carries both benefits and risks. The foreskin, initially called physiologic fibrosis at birth, doesn't require retraction until around 3 to 5 years of age. However, circumcisions or foreskin retraction may be advised in cases of balanitis or urinary obstruction. Decisions around circumcision should align with parents' cultural, societal, or religious beliefs. Pros of circumcision include easier hygiene, swift recovery, reduced UTI risk, and decreased penile cancer risk. On the downside, potential complications involve bleeding, infection, poor appearance, and rare urethral or penile injury.

Hypospadias

Hypospadias is a congenital condition where the urethral opening in males is on the underside of the penis rather than at the tip, due to incomplete fetal development. Severity varies, ranging from minor displacement to significant curvature. Diagnosis is typically at birth. Surgical correction, called hypospadias repair, repositions the opening to improve urination and appearance. Done in infancy, the procedure reconstructs the urethra and addresses curvature if needed.

Hidden Penis

Hidden penis, also referred to as buried penis or concealed penis, is a condition where the penis is not easily visible due to excessive surrounding tissue, often caused by factors like obesity or scarring. This issue can occur in both children and adults, leading to hygiene difficulties, urination challenges, and discomfort. Treatment options depend on the cause and severity, ranging from lifestyle changes to surgical interventions that involve tissue removal or repositioning. Consulting a medical professional, like a urologist, is crucial for personalized treatment plans based on individual needs.

Penile Torsion

Penile torsion is a urological condition where the penis twists to the left or right side, usually left (90-95 percent). It affects about 10 percent of the population, noticeable through the twisting of the median raphe and the entire penis, including the meatus, in the same direction. This often leads to penile curvature, affecting urine flow and potentially vaginal penetration. The condition can also affect body image in older children due to a snake-like appearance. If you or your son notice abnormalities or urinary issues, contact my office for evaluation and consultation.

Phimosis

Phimosis is a common occurrence in boys aged 3 to 5, known as physiologic phimosis. Unless complications like UTIs, infections, or urination difficulties arise, there's no need to retract the foreskin. If issues occur, a steroid cream is applied to the tight skin twice daily for a month after treating the infection. This softens the area, allowing gentle retraction. This approach succeeds in 90% of cases, with circumcision needed in the remaining 10%. By age 3-5, the skin should naturally retract. If not, steroid cream is used, often resolving the issue. Circumcision remains an option if steroid treatment is ineffective.

Meatal Stenosis

Meatal stenosis involves scarring at the penis tip, where urine exits. Common in circumcised boys, it can be due to diaper or underwear irritation, causing a reaction at the meatus. This scarring may lead to urination difficulties. It can also occur in uncircumcised boys due to repeated balanitis. Steroid cream is tried for scarred, ballooning foreskin, softening it for potential resolution. If meatal scarring occurs, surgical excision and advancement of fresh urethral tissue may be needed to address the issue.