Preputial retraction in children

Abstract

ABSTRACT ABSTRACT ABSTRACTObjective: The aim of the study was to assess preputial retractability in children at various ages. Materials and Methods: Nine hundred and sixty boys attending the hospital were included in the study. Children with hypospadias or history of preputial manipulation were excluded. Preputial anatomy was studied and subjects were classified into five groups as described by Kayaba et al. Results:The prepuce could not be retracted at all so as to make even the external urethral meatus visible in 61.4% children aged 0-6 months while this decreased to only 0.9% in children aged 10-12 years. At the other end of the spectrum, while prepuce could not be fully retracted in any child below 6 months, it could be done in about 60% in the age group of 10-12 years. Conclusion Preputial nonseparation is the major cause of preputial nonretraction in the pediatric age group. Prepuce spontaneously separates from the glans as age increases and true phimosis is rare in children. Surgical intervention should be avoided for nonseparation of prepuce.

As nurses, are we meeting the unique needs of the intact client?

“…Additionally, there is an apparent knowledge deficit regarding developmentally appropriate foreskin care, with nurses varying considerably in responses regarding the age of retractability of the foreskin. Scientific literature suggests that retractability occurs at an average age of 10 Agarwal et al, 2005). Carmack and Milos (2017) detail the importance of never forcing preputial retraction, even for catheter placement, and provide procedural details on how this can be accomplished without trauma to the intact child.…”