Circumcision For Children

It's normal for a baby boy's foreskin not to retract or pull back for the first few years of their life.

Around the age of two or later in some cases, the foreskin should start to separate naturally from the head of the penis. Full separation occurs in most boys by the age of five. In some boys, the foreskin can take longer to separate, but this doesn't necessarily mean there's a problem- it will usually detach at a later stage.

As the foreskin begins to separate from the head of the penis, it may start "ballooning out" when the child passes urine. This can occasionally lead to infection, but this ballooning usually subsides with time.

It is rare for circumcision to be recommended for boys due to medical reasons. This is because less risky and less invasive treatments are usually available.

The following conditions affect the penis and, in rare cases, may require a circumcision:

• Phimosis – when the foreskin is too tight to be pulled back over the head of the penis. This may cause discomfort and pain when the penis is erect, and in some cases, passing urine may be difficult.
• Recurrent infection – where the head of the penis and foreskin becomes infected and inflamed
• Recurring urinary tract infections (UTIs). In rare cases, circumcision may be recommended as a treatment of last resort if a boy has recurring UTIs.
• Paraphimosis – when the foreskin can't be returned to its original position after being retracted. This causes the head of the penis to become painful and swollen. In this instance, immediate treatment is required to avoid serious complications, such as restricted blood flow to the penis.
• Balanitis xerotica obliterans – a condition that leads to phimosis. In some cases, the condition affects the head of the penis, which can become inflamed and scarred.

The above conditions can often be treated successfully with non-surgical treatments, which will often be tried first before circumcision is considered. Mild cases of Paraphimosis can be treated with topical steroids to make it easier for the foreskin to retract and help soften the skin. However, circumcision may be required if the foreskin is damaged and won't slide back over the head of the penis. This is very rare for boys before the age of five.