The foreskin is a flap of skin that covers the head of the penis and attaches at the base of the head. Baby boys are born with the foreskin fully attached to their penis, but it gradually loosens as they age. By the time boys reach puberty, the foreskin can usually be retracted down to the base of the glans (the head of the penis) with ease. All men are born with a foreskin, but many undergo circumcision, where the foreskin is removed.
Circumcision is a surgical procedure that removes the foreskin, the loose tissue covering the glans on the rounded tip of the penis. The method is encouraged because it reduces the risk of some sexually transmitted diseases in men. It can protect them against penile cancer, inflammation of the internal glans, a condition called balanitis or foreskin glans or balanoposthitis.
However, circumcision is a choice and there are men who prefer not to get circumcised. Moses Mukudde says he has not found reason to go for circumcision because if his creator wanted him to be, he would have created him without the foreskin.
“My partner has not complained about my foreskin because I always keep it clean. Every time I bathe, I pay extra attention to my penis. I draw back the foreskin and wash it thoroughly,” he explains. He adds that during his adolescent phase, he was not a fan of bathing and recalls drawing back his foreskin and seeing so much white stuff under the skin.
It was smelly and, for a moment, feared that he was sick so he confided in his brother during holidays. He advised him to wash his private parts well and assured him that all would be fine. From that day on, he has been keen on maintaining cleanliness.
Dr Dennis Buwembo, a public health specialist, says caring for the foreskin is very simple. “In childhood the foreskin is not completely separated from the head of the penis. This is normal and no forceful separation of the foreskin for cleaning purposes is warranted. Separation of the foreskin from head of the penis follows these steps on average,” he explains.
Dr Buwembo adds that by year one, only 40 per cent of boys have their foreskins completely separated from the head of the penis, by year four only 90 per cent of boys and by 15 years at least 99 per cent of boys. He warns any attempts to forcefully separate the foreskin from the head of the penis in young boys is unwarranted. He further explains that after the foreskin has completely separated from the head of the penis, it should be emphasised to boys that they can gently roll back the foreskin and clean it with soap and water as they do while cleaning the face.
Dr Vincent Karuhanga, a general physician at Poly Friends Clinic, points out that uncircumcised men who do not clean their penis well will develop a bad odour or smell. He adds that a man should make it a habit to clean the penis after sex because the fluids released during the act may be a breeding ground for bacteria. Instead of wiping it with a tissue, clean it with water as a way of keeping away bacteria.
Dr Buwembo observes that there are healthy practices that men who are uncircumcised can adopt, more for health reasons of controlling infections. “One should engage in safe sex practices such as having one partner whose status for any sexually transmitted infections is known and use a condom consistently,” Dr Buwembo explains.
In an article in Daily Nation, Dr Torooti Mwirigi says cleanliness should not be a preserve of the foreskin but the general genital area, including the anus, which, if not attended to, will cause irritation in unwanted areas.
Dr Buwembo says for disease prevention, apart from safe sex practices, there is nothing much one can do because the foreskin is like a sleeve of a jacket with a delicate, easily bruised inner skin; which becomes exposed during a sexual act thereby leading to easy bruising.
“The outer skin is tough and not easily bruised but this becomes the inner part during sexual activity as the foreskin rolls backwards,” he adds. “Your member is a sensitive organ, a point that should always be kept in mind. For some odd reason, some men feel the need to vigorously scrub their units with powerful soaps or disinfectants to keep clean,” an article on askmen.com, a men’s website with health-related issues, reads.
The online platform adds, “Just lather up that mild soap and make sure to clean the base, shaft and head of your penis as well as your testicles. Uncircumcised men should slide the foreskin back and wash the head of the exposed penis with warm water, not soap. Then, be sure to dry the area very well.”
Foreskin care for children
The foreskin and penis of an infant or child need no special care. A child’s foreskin should never be pulled back (retracted) by force.
• During the first few years of life, the foreskin is stuck to the head of the penis by a membrane (called the synechia). This membrane or connective tissue dissolves naturally – a process that should never be hurried.
• The foreskin can be pulled back when its inside surface separates from the head of the penis, and the foreskin’s opening widens. This process happens naturally in childhood or during puberty and has usually happened by the age of 18. Even if the head of the penis and the foreskin separate naturally in infancy, the foreskin may still not be able to be pulled back because the opening in an infant’s foreskin may only be large enough for the passage of urine.
• When a young boy pulls at his foreskin, he usually pulls it outward. This is normal and natural and no cause for concern; he will not hurt himself.
• Once the foreskin is ready to be pulled back, your son will most probably discover this for himself. He should be the first person to pull back his foreskin.
• Telling your son about pulling back his foreskin beforehand will keep him from becoming alarmed the first time it happens.
Key points to remember
• The foreskin is the loose skin that covers and protects the end of the penis.
• The foreskin and penis of an infant or child need no special care.
• A child’s foreskin should never be pulled back (retracted) by force.
• There is no need to clean inside the foreskin in young boys - just wash their penis the same as any other part of your son’s body and be careful to wash off any soap.
• Once the foreskin is easily pulled back, your son should learn to do this as part of normal washing in the bath.
• Make sure he rinses off any soap and pulls the foreskin back over the head of the penis afterwards.