Physiological phimosis in boys: when does the head open?

Phimosis is defined in medical practice as a physiological or pathological condition in which the head of the penis cannot be exposed due to insufficient elasticity of the foreskin. This is considered normal only up to a certain age. The number of boys suffering from physiological phimosis, according to statistics, is within 100%. At the same time, spontaneous “cure” occurs only in 75% of cases. Other clinical situations are associated with the transition of phimosis to a pathological form. But why does this happen and when should parents sound the alarm?

Anatomical structure of the reproductive organ in boys

The foreskin is the prepuce, a skin area that, when the genital organ swells, moves away, exposing the head.

In children, the foreskin completely covers the head of the reproductive organ, merging with it by soldering and causing a phenomenon such as physiological phimosis. Phimosis is the inability of the head to exit the prepuce without outside intervention. In this case, the head is slightly open for the unhindered outflow of urine.

As the boy grows up and reaches puberty, the skin gradually moves away, completely freeing the head of the genital organ, that is, it completely opens.

At what age does the head of the reproductive organ open in boys?

No doctor will give you an exact answer to the question at what age a boy’s head opens completely. The whole point is that the individual characteristics of the development of the child’s body are of particular importance. The period of physiological phimosis lasts differently for each future man. According to statistics, in only 4-5% of newborns the head opens in the first months of life. The norm is considered to be the period from 6 years to 12-14 years.

The head of the reproductive organ does not open: normal or pathological?

Physiological phimosis is a normal condition of development of the genital organs in boys. It goes through several stages of development:

• with some effort, the head is removed freely and painlessly;
• the head does not come out, but it is visible;
• the head is poorly visible, only 2-4 mm;
• The head is completely closed and cannot be removed.

In the first two stages, the development of phimosis occurs naturally and without pathologies. Parents should sound the alarm in the final stages. At the third stage of development, only medical supervision is necessary. But the last phase requires medical intervention in the process of opening the head of the genital organ.

There are cases when phimosis occurs with complications, which can lead to infection of the genital organ. Symptoms of complications are as follows:

• redness of the glans or foreskin;
• pain and burning when urinating;
• problems with urination (the child has to strain, urine does not come out completely, accumulating in the free space under the foreskin);
• suppuration under the foreskin;
• pronounced scars on the foreskin.

If you find at least one of the above symptoms in your child, immediately contact a urologist. But know that circumcision should be done only if phimosis has developed into a pathological advanced stage.

When does a situation arise that does not allow surgical intervention to be avoided?

The inability to expose the head necessitates surgical therapy. It is indicated in all cases where frequent inflammatory processes develop and urine flow is impaired. In addition, excision of the foreskin is performed on boys if it has not opened independently at the age of 14. When performing circumcision, the degree of phimosis is taken into account. Stages 2, 3 and 4 are considered operable. General anesthesia is used to perform the operation. The circumcision procedure lasts for half an hour, and in order to prevent complications, it is recommended to change the bandage 2 to 3 times a day. Surgery can sometimes cause complications, resulting in severe swelling of the head of the penis. It is also possible for a change in color and the appearance of painful sensations, which are accompanied by suppuration and the release of blood in the form of clots. Such symptoms necessitate contacting a medical facility.

The process of exposing the genital organ in boys can take a long time (up to 14-15 years). Therefore, parents should not worry and take any action to speed up this process. It is necessary to speed up the opening of the head only if there are alarming symptoms, when it is painful for the child to empty the bladder and signs of inflammation appear.

What to do if the head of the genital organ in boys does not open?

As already mentioned, complete removal of phimosis (circumcision) and the help of a surgeon should be resorted to only when other treatment methods do not help.

Conservative methods:

• Exercises for gradually retracting the foreskin. To do this, you do not need to have any special skills, consultation with a pediatrician and patience - these are all the necessary components. During such exercises, it is advisable to take baths with herbal decoctions.
• Dilation of the head by a urologist. The doctor will use a special spoke-shaped instrument to carefully open the head. After this procedure, it is necessary to constantly lubricate the organ with antiseptics until complete healing.

Is it worth dilating the head of the reproductive organ on your own?

Forced opening of the head is inappropriate if your child does not complain of anything during bowel movements, the skin around the genitals is a natural color, and there are no signs of inflammation.

Parents should know that forced discovery is a very painful process that can lead to serious consequences: from the development of complications of phimosis to psychological trauma.

Children's hygiene of the genital organs of boys

The main task of mom and dad should be to maintain hygiene of the boy’s genital organs:

• During daily water procedures, you should not try to thoroughly wash the head of the reproductive organ with soap. This can lead to disturbances in the structure of the microflora of the prepuce and, as a consequence, to inflammatory processes.
• Once a week, you need to wash the reproductive organ and scrotum using baby soap, without opening the head.
• Baths using decoctions of chamomile and sage herbs 2-3 times a week will also be useful.
• After each trip to the toilet, boys should only be washed in the direction from the scrotum to the anus.

As a rule, by the age of 15, the head of the genital organ in boys opens completely. Proper care of your child's genitals will help you avoid possible problems. If you notice some deviations from the norm, you should not delay going to the doctor. Everyone knows that it is better to stop the disease in time than to treat its consequences.

Many parents, especially mothers, are concerned about the question: at what age do boys’ heads open? Most often, from birth, it is fused with special adhesions (synechias), which do not allow it to open completely or completely eliminate this process. This phenomenon is called physiological phimosis and is temporary. Gradually, during the process of maturation and as the male genital organ grows, the foreskin begins to very slowly separate from the glans. As a result, its complete opening occurs

When exactly does the head open?

In medicine, it is not customary to talk about certain age limits. However, parents who are puzzled by the question of at what age the head opens in boys should be aware of some features. This process depends on many factors, which include the individual and development of a particular child. Therefore, you should prepare for the fact that discovery can occur at almost any age, and there are no strict norms in this matter.

Doctors noted that in only four percent of newborn babies, the foreskin is mobile to such an extent that the head of the penis can be safely removed. In almost a fifth of all babies this happens before six months. But by the age of three or four, the foreskin begins to move freely in 90 percent of future men, which allows the head of the penis to open unhindered. Therefore, it is believed that before this time, parents should not be concerned about the age at which the head opens in boys.

Head opening

If the baby calmly goes to the toilet, does not complain about anything, is not inflamed and has a normal color, then no special actions should be taken. The fact is that there are many nerve endings on this part of the penis, so any manipulation can be very painful.

Some parents, puzzled by the question of at what age the head opens in boys, can take independent actions aimed at opening the head. However, this can lead to paraphimosis, which will require further surgery. Therefore, the only thing that is required is to monitor the hygiene of the organ. Usually, during the bathing process, the foreskin area cleans itself. And yet the penis and scrotum must be washed at least once a week

What to do if the head does not open

Sometimes it happens that parents are too late to puzzle over the question of what age a boy’s head opens. In this case, we may be talking about pathological phimosis. This disease definitely requires treatment, since the consequences can be quite serious. For example, during an erection various pains and ruptures will occur. Moreover, if you do not take active steps, sexual intercourse will be impossible or difficult.

When to see a doctor

If parents have any doubts, then they should consult a doctor about the age at which the head opens. An operation may be prescribed if the following symptoms are detected: changes in the foreskin, frequent inflammation of the head of the penis and foreskin, and problems with urination. However, modern low-traumatic techniques can eliminate the problem forever.

Many mothers who have boys try very hard to monitor the development of the genital organs, so they try to understand when the boys' head opens. This is a very important question, because if problems arise and are not resolved in time, over time, the boys will have serious consequences.

Some parents do not know at what age it opens and therefore they do it themselves. To understand this, you need to look at the structure of the penis in boys and find out at what age the head opens completely.

Phimosis: an ordinary story with a sad ending

My son turned one year old. You must undergo a routine examination of all doctors at the clinic. During the examination, the surgeon asks to undress the child, looks at the arms, legs, tummy, goes lower... suddenly with a sharp movement he pushes back the foreskin, revealing the head of the penis. The child screams and starts crying. “There was a small adhesion there, but it’s okay,” says the doctor, “make baths with chamomile at home and everything will go away.”

But here's a different picture. Day surgical inpatient unit of the Filatov Hospital, 10 a.m., 10 boys aged 6 to 14 years old are in line for surgery. Everyone has the same diagnosis: cicatricial phimosis.

And there is a very clear connection between these two events.

Phimosis is a persistent narrowing of the foreskin that does not allow full exposure of the head of the penis. May be congenital or acquired.

I had to study this problem in detail, since my eldest son and I went all the way from physiological phimosis of newborns to surgical excision of the foreskin, which is popularly called circumcision. I decided to write about our experience because perhaps it will help someone avoid our fate.

A boy was born in our family. Everyone was incredibly happy: parents, grandparents, and other numerous relatives. The baby had no health problems, everything was fine: neurology, physiology, and orthopedic problems passed us by. At the 3-month examination, the surgeon told us that there was slight phimosis, but that at this age it was normal and that it would go away over time. After her “examination,” the foreskin at the end became a little inflamed, but after baths with chamomile everything went away, and we didn’t think about it anymore. Then the same thing happened again a year later. This time the surgeon was able to expose the head, and then we again saved ourselves with chamomile baths. And they themselves were glad that the head was opening, which meant that the phimosis was over.

Much later, after consulting with many urologists and surgeons, I learned that forced exposure of the head of the penis to boys under 3 years of age is contraindicated. More than 90% of newborn boys have physiological phimosis. Their foreskin is usually hypertrophied and completely covers the head of the penis; it is, as it were, “glued” to the head with delicate embryonic adhesions. As the penis grows, the adhesions are separated, and by the age of 6 years, the glans is released freely. Forcibly exposing the head in children under 3 years of age, something that doctors love to do in clinics, leads to rupture of physiological adhesions. Every time inflammation occurs on the delicate tissues of the head and the inner surface of the foreskin. Scar tissue forms.

We heard about cicatricial phimosis when our son was about to turn 5 years old. By that time the adhesive process was in full swing. We were offered to circumscribe the head - surgical separation of adhesions. We have done. I will not go into details of this manipulation, I will only say that it is very painful for the child. My son had to go through this twice. And every time we were promised that after that everything would be fine with him.

But with each “examination” and manipulation there were more and more adhesions, the head opened worse and worse. This is a natural reaction of tissues to the inflammatory process. The alternating processes of inflammation and healing and inflammation again led to the fact that the scar tissue became each time more dense and resistant to stretching. The edges of the foreskin narrowed and stopped stretching. Often the inflammation spreads to neighboring tissues, affecting the head and opening of the urethra. If at the age of one year my son’s head of the penis opened quietly, then by the age of 7 we received a diagnosis of “cicatricial phimosis” - the ring of the foreskin was only 3-4 mm in diameter. At the Filatov hospital, my son underwent surgery to remove his foreskin. I hope this is the end of his problems. But all this could have been avoided.

First the manager The urology department, and then the surgeon who performed the operation, made it clear to me that our problems were associated with constant injury to the foreskin. I have already encountered this point of view before during numerous consultations with various luminaries. If the doctors had not been eager to separate the foreskin before the time allotted by nature, if we had eaten ourselves, following the recommendations of the same doctors, and had not constantly opened our son’s head, then with age he would have outgrown this problem. Statistics show that the number of boys diagnosed with cicatricial phimosis has increased significantly in recent years. If previously 2-4 percent of boys needed surgical treatment, now, according to unofficial statistics, 3 out of 10 boys are circumcised for medical reasons.

Fortunately, many doctors now come to the conclusion that early opening of the head can have much more serious consequences than its non-opening before 6 years of age or even later. Adhesions can be removed even in adolescence, when the tissues are no longer as tender and vulnerable as in early childhood. It is useless to fight scars.

When our second son was born, we had a completely different attitude towards the issue of intimate hygiene. Now he is 5 years old, phimosis persists, but there are no scars, no inflammation, and therefore doctors give favorable prognoses and see no reason for concern.

Many people may object to me that the doctor also opened their head, but the child is fine. Of course, this is often the case. But our history is far from an exception. No one knows in advance how prone a child’s skin tissue is to scarring; this can only be verified experimentally. But is it worth experimenting on your own children?

Ignatova Elena

A little physiology

A detailed examination of the physiology of the penis helps to understand when the head of the penis should open. The penis can be divided into three parts:

• The root, that is, the scrotum and ovaries,
• Body or trunk
• Head.

It is in the head that there is a small hole through which urine comes out, and in an adult man, sperm. The foreskin that covers the head consists of petals. One of them is located outside and the other inside. They secrete a special fluid that prevents infections from multiplying.

Many mothers who have never had sons worry whether the baby should have foreskin. In fact, all newborn boys have a closed head

, since between the foreskin and the head there is a so-called synechiyama, which does not allow the head to open. Only over time, it disappears and in an adult man, the head is completely open.

Possible complications of physiological and pathological phimosis

The physiological form gives fewer complications, and they occur less frequently. First of all, we are talking about the following conditions:

• balanitis - inflammation of the foreskin;
• balanoposthitis - inflammation of the foreskin and glans penis.

Both conditions develop due to insufficient intimate hygiene. Important to keep in mind. Under no circumstances should you try to expose the head on your own. Some particularly zealous parents try to artificially overcome phimosis. This won't end well. There is a high probability of developing paraphimosis - pinching of the head by a ring of tight foreskin. This condition is similar to wearing a tie that compresses the neck. The result is often necrosis of the head, or even the entire penis.

Sometimes a tight ring of foreskin extended beyond the coronary sulcus leads to paraphimosis

At what age do boys' heads open on average?

Since each child has a different body, it is impossible to say specifically at what age the head should open, it’s all very individual. Practice has shown that only 5% of boys' heads begin to open just a couple of months after birth

.

In 20% of children, this process occurs after six months, or even a year.

However, it can be observed that by the age of five the boy’s head should fully open. If the child is more than five years old, then you need to open the head yourself. Since the penis is a very sensitive organ, you need to know how to do this procedure. In view of this, it is better to seek help from a specialist, namely a urologist.

Advice!

If after 15 years the head still has not opened, be sure to go to the doctor.

It is worth remembering that physiological phimosis is a normal phenomenon in a boy. Do not interfere prematurely with the development process of the body, otherwise you can only do harm

. At the same time, do not lose your vigilance, as sometimes there are failures in development and then your help is needed. Monitor your child's condition.

When should you start worrying?

If the head does not open for a long time as it should, then you need to pay close attention to this problem. A condition in which synechiae does not allow the head to open at the appointed time is called phimosis. Doctors say that this is a completely normal human condition.

Phimoses come in different stages, for example:

1. At the first stage, the head comes out on its own, you just need to push it a little, this is a painless procedure.
2. The second stage is characterized by the fact that the head is visible, but it is not removed.
3. In the third stage, only a small part of the head is visible.
4. In the fourth stage, the head is not visible at all.

The last stage is the most dangerous, as bacteria can develop that will lead to an inflammatory process. Moreover, during this period it is very difficult for the boy to go to the toilet in small ways. It is at the fourth stage that an operation must be performed, after which the penis must be closely monitored. Other types of phimosis are not scary.

From separate articles you can find out why the head does not open in both men.

If a boy has an infection on his genitals, then phimosis can become more complicated. It manifests itself with the following symptoms:

• Purulent formation on the penis,
• Redness of the foreskin,
• Itching, pain and burning in the groin area,
• Painful urination,
• Bad smell.

Having discovered such symptoms, you urgently need to take the baby to a urologist and he will open the head on his own, using a special tool or a knitting needle.

For reference!

If, after six years, you notice that your boy’s head does not open or the above symptoms are additionally present, then you need to devote time to this issue and resolve it as quickly as possible.

Complications

When a boy’s head does not open for a long time, the risk of developing the following types of complications increases:

• Balanoposthitis. The disease becomes a consequence of the proliferation of pathogenic microflora, which causes an inflammatory process to develop. In childhood, this occurs due to non-compliance with personal hygiene standards.
• Obstruction of the urethra is observed when the foreskin is excessively narrowed. The appearance of discomfort and pain necessitates surgical therapy.
• Accumulation of urine residues. When the head does not open, discharge may appear that has a thick and hard consistency. In this case, they will interfere with the physiological development of the penis.

Pathological phimosis

Untimely assistance from a doctor can result in pathological phimosis for the baby. This disease must be treated, otherwise in adulthood the boy will experience severe pain during an erection.

If you do not approach this issue seriously, then the future man may never feel pleasure from sex or sexual relations will be painful and unpleasant.

Sometimes, doctors advise giving the child local anesthesia and using a circular excision, this is a new type of surgical intervention, to get rid of the substrate of phimosis.

Hygiene rules are an important point!

Opening the head on your own can trigger the development of infection and its rapid spread. It is very important to thoroughly wash the baby’s genitals with baby soap. Gently pull back the foreskin if possible and wash the penis to prevent germs from developing there. Good personal hygiene will protect the baby from the inflammatory process.

When a child’s head does not open for a long time, then he needs to be washed daily or even several times a day. Personal hygiene also plays a very important role in the case of phimosis. The last stage occurs in those babies whose mother washed the foreskin very poorly.

Moreover, wash your baby after every trip to the toilet so that remaining urine does not contribute to the spread of germs.

If you teach your child to take personal hygiene seriously, this will help him avoid many problems in the future.

The famous doctor Komarovsky gives very important recommendations on this matter. He says that if the head of the baby's penis does not open and this does not cause him discomfort, then you need to leave this problem alone for a while. Komarovsky is sure that it is the parents who create problems for the baby with their excessive worries.

If you notice redness in the penis area, you need to wash the foreskin with furatsilin using a syringe, but under no circumstances expose the head yourself.

The doctor says that some of his colleagues advise mothers to retract the foreskin, thereby helping the head come out. However, sadly, it is precisely such actions that lead to severe injuries to the genital organs.

If the child has phimosis of the fourth degree, then circumcision is necessary. According to Komarovsky, this is a completely normal operation, which is simply necessary for such a disease.

Important!

Dr. Komarovsky is categorically against opening the head of the penis on his own, as this can lead to very serious consequences.

The doctor advises taking a lot of vitamins so that after the operation the child’s immunity returns to normal and the scar heals quickly.

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The genital organ of boys has the same structure as that of adult men. A feature of the children's penis is congenital phimosis, that is, the inability to completely expose the head. It is covered by the foreskin - this is a piece of skin that on the inside has special glands that secrete smegma.

The skin fold or prepuce consists of two lobes - external and internal. Natural secretions and dead epithelial cells, in the absence of proper hygiene, accumulate between the penis and foreskin, causing inflammation. From the first days of their sons’ lives, young mothers must learn to properly care for their babies and figure out when boys’ foreskin opens.

Symptoms when phimosis becomes a pathology

Lack of exposure of the foreskin may be accompanied by the following manifestations:

• the child shows signs of suppuration of the genital organ;
• the color of the foreskin becomes hyperemic and accompanied by swelling;
• there is a feeling of discomfort in the groin area;
• urine discharge causes burning and pain;
• urine has an unpleasant and pungent odor.

The pathological course of phimosis has 4 stages, which are characterized by the following manifestations:

1. At the first stage of development, the opening of the foreskin can be gently pushed, but the baby does not experience any discomfort.
2. The stage is accompanied by difficulty when trying to expose the penis.
3. The stage allows the foreskin to be opened only partially.
4. The inability to expose the head of the foreskin causes pain, which poses a threat to the baby’s health, as the risk of infectious and inflammatory processes increases.

Synechia of the foreskin in boys - normal or pathological?

The wisdom of nature is manifested in many things, especially with regard to defense mechanisms in newborns. The foreskin and natural secretions (smegma) protect the child’s genitourinary system from infections. Pathogenic microbes settle on sebaceous secretions and are then washed off with urine and water when washing the child.

The delicate skin of the penis and its head are fused together by adhesions. This phenomenon is called synechia. Fusion should not worry parents; this is a normal process. By the age of 6-8 years, the foreskin will open independently; in some children this happens earlier - at 3 years. In rare cases, it is delayed until adolescence, when surgical intervention cannot be avoided.

Before the age of one year, the head opens in only 15% of boys; in most children it becomes mobile after 6 years. It is extremely dangerous to try to forcefully move away the fused parts; this will cause pain in the baby and lead to an inflammatory process.

Signs of a problem are:

• pain when urinating;
• swelling;
• swollen head of the penis;
• redness;
• itching in the foreskin;
• temperature rise to 38°;
• purulent discharge.

These are symptoms of balanoposthitis, in which the head of the prepuce becomes inflamed. In the acute stage, the disease is treated in 2-4 days, and in the chronic stage - over the course of months, and with varying success. If you find the listed signs of pathology in boys, you should see a doctor as soon as possible.

Causes of balanoposthitis

Inflammation is provoked by several reasons; even if all hygiene standards are observed, redness and other unpleasant symptoms of the disease may appear:

1. Uneven divergence of synechia leads to the formation of small “bags” in which natural secretions accumulate. The accumulated smegma becomes a haven for a large number of microbes.
2. Balanoposthitis can result from an allergic reaction to diapers, food or medications. The allergen is excreted in the urine, which causes inflammation. The body may also react to synthetic underwear or detergents used in washing children's clothes.
3. Inflammation due to traumatic rupture of synechial adhesions. Retraction of the prepuce opens access to bacteria and microbes, which affects the head of the baby's penis.
4. The chronic form of balanoposthitis is often caused by pathological phimosis. In this case, narrowing of the foreskin in boys and the appearance of scar changes are observed. If the prepuce is too narrow and does not allow the head of the penis to emerge, circumcision is performed.

Treatment options

Young mothers do not know what to do if the boy’s foreskin turns red. First, show your baby to the doctor. He will prescribe treatment and quickly help the baby get rid of pain and itching.

The basic procedures are very simple, they are performed by mothers at home:

• Warm baths with a solution of furatsilin, which have an anti-inflammatory and bactericidal effect, are prescribed every 2 hours (excluding night time). For the procedures you will need to buy several packs of tablets. To prepare the solution faster, the medicine can be crushed into powder. The dosage is 2 tablets per glass of water. The liquid must be boiled; the higher its temperature, the sooner the powder will dissolve. It is important to remember that the procedure begins only after the water has cooled to 37°. It is not necessary to prepare a basin of the composition; you can lower the inflamed organ into a glass. There is no need to touch the head and try to rinse it; the product penetrates well into the preputial sac.
• Baths with chamomile infusion are no less effective. It is prepared from 1 tbsp. spoons of flowers and a glass of boiling water. The product is infused under the lid for up to half an hour and filtered. After cooling, the chamomile decoction is used as a furatsilin solution. Some parents use a solution of potassium permanganate to treat boys. This method is not recommended by doctors, despite the fact that potassium permanganate is a powerful antiseptic, it excessively dries out the baby’s delicate skin.
• If the head and flesh are severely inflamed, treatment includes Levomekol antiseptic ointment. It is applied to the reddened area and, as recommended by the doctor, left overnight.
• In difficult cases, when the temperature does not subside and there is no visible improvement, antibiotics are prescribed.
• Taking baths and applying ointment continues with noticeable positive results. Treatment should continue for up to 4 days for a lasting effect.

If one of the symptoms is acute urinary retention as a result of severe swelling of the foreskin, then you need to call an ambulance. The main thing is not to confuse this condition with the child’s reluctance to urinate due to the unpleasant sensations when urine gets on the inflamed skin.

Circumcision of the foreskin in boys

If balanoposthitis becomes chronic and torments the child with frequent inflammation, an operation to circumcise the foreskin is prescribed. The indication for circumcision is pathological phimosis, in cases where drug treatment with glucocorticosteroids has not helped.

After the procedure, the problem causing the inflammatory process disappears. At what age is circumcision done? If surgery is not performed before age 3, it is recommended to postpone it until age 8. The surgical intervention itself takes place under general anesthesia and lasts several minutes. With proper care, the boy's wounds will heal in 3-5 weeks.

Prevention of inflammation

Hygiene plays an important role in preventing inflammation of the foreskin, but you should not make excessive efforts.

When bathing a 1-2 year old child, you should not forcefully pull the skin off the head in order to wash it better. Parents must remember that the synechia adhesions will break down on their own and this process cannot be accelerated.

If the cause of inflammation is an allergy, you need to change the brand of diapers and laundry detergent. It is better to use baby clothes made from natural fabrics that do not cause skin irritation.

If your baby has had inflammation of the penis, it is recommended to take preventive baths with a decoction of chamomile or celandine once a week.

A large number of parents have a very important question related to the dilation of the glans penis among boys. In such problems, fathers of boys are calmer and more oriented, but for many mothers this causes quite a bit of panic. Why is the opening of the head a very important issue and why does it sometimes happen that the head cannot open?

Reasons for the transition of phimosis to a pathological form

The time of transition from a normal state to a pathological state, as a rule, occurs at 6-7 years of life. The main reasons for the development of pathological phimosis are as follows:

• Insufficient amount of connective tissue. This is an inherent problem. Phimosis in this case is primary and a predisposition to it develops in the prenatal period.
• Frequent inflammatory processes in the foreskin area. Each subsequent inflammation (balanitis and balanoposthitis are frequent visitors in children, because the same phimosis interferes with normal hygiene) causes the formation of microcracks in the foreskin area. The tissues scar and become less elastic, which becomes a factor in the development of phimosis.
• Injuries to the foreskin area. As the body matures, boys begin to have an erection. If the foreskin is not mobile and elastic enough, there is a high probability of its tears. What this entails has already been said.

In older patients, if the process is delayed, the elasticity of the skin fold is insufficient due to the low production of specific male androgen hormones.

How should a boy's head open?

After birth, the head of the penis is covered by the skin of the foreskin. The skin is fused to the mucous membrane of the head with light special adhesions, they are also called synechiae. This does not allow the head of the penis to be completely or partially freed from the skin of the foreskin. At an early age, this phenomenon is considered normal for boys and is called physiological phimosis. Over the course of a boy's life during puberty, the foreskin gradually releases the head of the penis and opens.

Features of childhood phimosis

During infancy, the foreskin is closed. This helps prevent the development of various infectious processes. In this case, there are two main reasons why the penis is not exposed. They are:

• oblong condition of the foreskin;
• insufficiently wide opening in the head of the penis.

This condition in children is not a deviation unless the functionality of the urethra is impaired. But upon reaching 15 years of age, this situation is a pathology. Based on statistical studies, only 5% of children have an opening of the foreskin in the first months after birth. When the head does not open in a boy of 1 year of age, this is not considered a pathological process, since its mobility is formed by 3 or 5 years. Sometimes this process drags on for up to 12 or 14 years.

It is important to know! When the head does not open in boys 2 years of age, any procedures that expose the foreskin are not recommended. In this case, the chance of developing a strangulation of the head increases, which can cause disruption of blood flow and subsequent development of tissue necrosis.

When does a boy's head open?

There is no specific time frame for opening the head of the penis. This is influenced by many different factors. The individual development of a given child is of particular importance. Therefore, the period of physiological phimosis lasts differently for each boy. In medicine, there are no specific dates for opening the head on this issue.

According to medical statistics, it has been established that 4% of newborn boys have a very well mobile foreskin and they can easily remove the head of the penis. By 6 months, physiological phimosis resolves in 20% of boys. And somewhere around the age of 3-4 years, in 95% of children, unhindered opening of the head of the penis is possible due to the free displacement of the foreskin.

Until what age is phimosis considered normal?

This is a controversial issue in medical science and practice. There are several periods of probable self-elimination of the problem of physiological phimosis:

1. The first period covers age up to 6 years. According to the same statistics, the issue resolves on its own in most patients. But there is a possibility that the foreskin will remain immobilized for a longer period of time.
2. The second period concerns the age range from 6 to 13 years. During this period, the foreskin becomes mobile in another third of the urologist’s patients.
3. The third period lasts from 13 to 17 years. At this age, in most young people, the foreskin moves on its own. We are talking about patients with late puberty.

As already mentioned, the final figure for normalization of the condition is 75% of all clinical cases. In other young people, phimosis becomes pathological.

How to open the head in boys?

Forced opening of the head of the penis is inappropriate if your child does not have any complaints when urinating and the penis is visually unchanged, of normal color and without signs of inflammation. The use of force in resolving this issue can cause painful sensations for the boy, since this organ is rich in nerve endings. Independent attempts can lead to failure and provoke the development of such complications of phimosis as paraphimosis. It requires surgical treatment only.

Based on this, the main task of parents is to observe the rules of hygiene of the boy’s genital organs. To do this, simply wash the foreskin while bathing the child. For washing, it is advisable to use special baby soap on average 2-3 times a week.

In this case, you need to wash the scrotum and penis without opening its head. You need to wash boys, observing the following rule: after each act of defecation and when changing a diaper, you need to wash only in the direction from the genitals to the anus.