At birth, almost all children have the skin of the foreskin attached to the glans, without being able to withdraw back, leaving only the urinary opening exposed. This is known as physiological phimosis. During the first years of the child, the natural development of tissues and daily hygiene, causes it to take off and retract on its own.
Normally this phimosis resolves approximately between 2 and 3 years, although sometimes it can last a few more years.
Next to the glans, white fat balls called smegma will be formed, which is responsible for protecting the skin from irritations and skin conditions. It is important that you do not remove it, if the pediatrician does not tell you otherwise, simply at bath time you have to gently remove the skin for better hygiene, but without forcing it. Occasionally, the smegma accumulated under the foreskin becomes infected and causes local inflammation, this is known as balanitis. In addition to causing pain, even when urinating, it can delay the process of skin retraction. For the pediatrician, balanitis is not a sign of phimosis, but it may indicate that it is convenient to operate without waiting any longer, since any inflammation or crack around the glans can cause true phimosis in the long run.
The problem that produces a phimosis, is caused by the narrowness of the skin, when the ring does not become wide enough, the skin cannot be completely removed causing pain if it is tried. The specialist will assess the need to operate according to the degree of phimosis. If it is intense, that is, it cannot be removed a bit, it is usually operated, and if it is moderate, being able to perform normal hygiene without causing pain, it will be expected to see how it evolves.
The first reason to operate a phimosis is hygiene, and the second, its future sexual activity. Surgery to correct phimosis is called circumcision or postectomy and involves a cut in the skin of the foreskin to release the glans.
