Boys Genital Infection: Common Penis Problems Every Parent Should Know

It always feels a bit weird using the term ‘old fella’ around little baby boys, but on the other hand, referring to their ‘penis’ always seems clinical and formal.

No matter what mums call it, most are (understandably!) clueless when it comes to looking after their baby’s ‘willy’. And what astounds me is that despite using one to get bub underway in the first place, dads can be lost on what to do too.

So mums AND dads, here’s what you really need to know about your son’s penis.

It goes without saying, the willy is a delicate organ with an important future ahead of it. So it’s imperative that you look after your child’s genital area – namely the penis and foreskin- to keep it healthy and prevent issues that could cause dramas down the track.

First, an anatomy lesson, because some parents (dare I say, mums…) won’t be as familiar with how the crown jewels all fit together as others will be. The head of the penis, called the glans, is covered by a loose fold of skin called the foreskin. For the greatest majority of newborns, the foreskin is closely adhered to the glans – and this is entirely normal. Hanging underneath is the scrotum with testicles inside.

For any young boy, a willy is one of the most fascinating things in the world. So that means it gets touched and played with constantly! And let me reassure you, that’s a completely normal part of development. Exploring the body is how kids learn about themselves. And yes, that does include getting little erections. A tad awkward perhaps, but no cause for concern there.

So what should you be keeping an eye out for and when do you need to seek help?

Phimosis

Your son will work out when their foreskin is ready to be retracted – and they’ll proudly show you. 7452 times a day.

While the foreskin and the glans start out connected, 4 per cent of male newborns already have a foreskin that retracts. For the majority of boys (90 per cent), by the time they are three, the adhesions have separated and they can retract their foreskin all the way.

But what if your son can’t? That’s called a phimosis. The good news – it will naturally peel away over the coming years and by the time they hit 17 only about one percent of boys have any permanent adhesions or problems and it doesn’t mean it can’t do all its jobs properly.

The downside – there can be some symptoms and issues along the way.

• Small opening. A lot of the time all you’ll notice is a tight opening at the tip of the foreskin – where the wee come out. It can send the wee off in all directions, so that annoying puddle on the floor under the toilet may not always be the little fella’s fault.
• Ballooning. As boys wee, it can sometimes cause the foreskin to balloon out as the pressure builds up. This tends to freak parents out as they worry about pressure building up back to the kidneys – but I can assure you that doesn’t happen.
• Smegma. Yep, it’s really a thing. Inside the foreskin dead skin cells, wee, and secretions collect to form a natural white pasty material, that can even collect into a little ball. It’s entirely natural and not an infection.
• Pain and redness. It’s entirely normal for the long tip of the foreskin to get a little red, painful, or itchy – whether there’s an issue with a phimosis or not. Urine or poor hygiene irritates the delicate skin, and boys may complain of a little discomfort through the day or when they wee.

How to keep the willy in tip-top shape

• Be generally clean and tidy. Kids who remain hot, sweaty, dirty, manky, and covered in wee or poo are destined to get more irritations down below – including their willy. Consider regular nappy free time, ensure regular washes when kids are dirty, and avoid prolonged periods in wet or damp clothes.
• Be gentle Mabel. When cleaning, just gently pull the foreskin back as far as it will go. Don’t yank on it! Forcing the foreskin back can lead to injury and permanent scars.
• Don’t wipe around inside. There’s no need to clean inside the foreskin. Just pull it back gently and swish a bit of water over it. If stubborn bits of smegma don’t seem to budge with gentle wiping, then leave them, they won’t do any harm.
• Rinse soap thoroughly. You probably don’t need any soap down there, but if you do use it, make sure none gets trapped in and around the foreskin, as it can irritate very quickly.
• Let your son own it! Once your son is old enough and the foreskin can retract, they can look after their own willy, and can learn to wash it every bath or shower.
• Always pack away your toys after you use them. Boys need to learn that if they do retract the foreskin, they need to roll it back up into place.
• Change nappies regularly. Simple nappy rash can effect your son’s willy too. So make sure you wipe gently, change nappies regularly, and use barrier creams early when things get a bit irritated down there.
• The over fiddly little boy. The best way to tackle little boys who spend too much time in their pants is distraction. Making a “song and dance” about their activities is sure to bring attention and increase their vigor. You’ll have to repeatedly remind them to stop, but provide an immediate alternative activity to keep the fingers occupied rather than chastising them endlessly. Remember – it’s completely normal.

When you need to see a doctor

As I’ve mentioned, little redness and mild irritation probably just needs some more regular (gentle) washing and some barrier cream slapped on for a few days. But if that fails, or some more worrisome issues arise, you need to know when to seek help, and what’s on offer.

Red and swollen penis, pus, or discharge

Sometimes the foreskin or head of the penis can become infected – causing it to swell and become hot and painful and be sensitive when they wee. Balanitis is a common condition and can often be treated with simple saline washes, but sometimes your doctor will need to prescribe antibiotic creams or tablets, especially if there’s a fever. A really tight phimosis could underlie the issue as they can be harder to care for and allow infections to set in more readily.

Faint red rashes or little spots

Sometimes rashes over or inside the foreskin, even over the glans can be fungal, so anti-fungal creams might be needed. Whilst they’re very safe, best to chat to your doctor first before you use them to ensure you’re not missing a more serious infection.

Tight worrisome phimosis

There’s no magical age or degree of tightness that determines when to treat issues with non-retracting foreskins. But certainly, as boys get older the tight opening should slowly open. So if you’re not seeing any change then chat with your doctor. Many respond well to some gentle stretching of the foreskin each day – simply pulling it back till it stretches. If that fails, topical steroids work wonders to accelerate the retraction and opening of the foreskin at the tip. Don’t stress parents – this is entirely safe.

Persisting troubles with phimosis and it’s complications may lead to discussions around circumcision. Your GP will refer you off to an expert paediatric surgeon.

Ballooning

Any time a phimosis leads to ballooning you should get your doctor to check things out, exclude infections, and discuss when best to start steroid cream treatments.

A stuck foreskin

Occasionally, after the foreskin is retracted, it can get stuck behind the head of the penis. Known as paraphimosis, this is a medical emergency – think strangulation of the penis! (And it is as painful as it sounds!) If this ever occurs, don’t pass go, get your child straight to emergency.

Buried penis

No, this isn’t a sandpit emergency. A buried penis is when the little willy is submerged or concealed by the surrounding fatty area. It literally looks like the penis is missing or buried. These kids will need a check up with a surgeon, and possibly need some operations to correct everything. But unless there are issues with urinating or infections, there’s no massive urgency.

Urinary tract infections

It’s true, girls do get them more often, but we still see UTIs regularly for boys. Older boys may complain of classic pain when urinating, but babies might just be unsettled and feverish. Any smelly urine will need to get checked out too.

This article was first published in AsiaOne and republished on theAsianparent with permission.

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