A rather modest operation done under local anesthesia, when the foremost part of the skin covering the penis glans a medical term for the head of the penis) is being cut off, is known as circumcision. In the course of this surgical procedure the foremost part of the skin is forcibly separated and then totally detached from the glans. Immediately after the surgery this part of the penis anatomy is left brightly red, swollen and excessively sensitive.
The foreskin of the penis head, as a rule, becomes totally loose and mobile by 2 years of age for more than 85% of the boys. In some cases the process can take five or more years. In this way the foreskin of uncircumcised boys over time, due to the stretching resulting from repeated normal erections, very slowly detaches from all of its attachments to the penis head. As soon as the foremost part of the skin becomes totally detached, you will be able to pull it back and easily expose the head of the penis. In this way you can detect the accumulation of a cheesy white material under the foreskin. This is so called smegma and it builds up because of accumulation of dead skin cells and secretions from sebaceous glands under the foreskin.
The uncircumcised little boys should be very careful about force with which they pull the foreskin over the penis head. The unnecessary effort can result in scarring and adhesions. In order to maintain the hygiene and clean out the accumulated smegma, boys should never force that part of the foreskin that is adherent to the penis head and does not move freely. Never try forcible retraction of the foreskin and cleaning under it either with swabs, antiseptics, or even water to avoid possibility of a trauma.
During the first year and, sometimes, second year, the cleaning of foreskin should be done exclusively in the outside area. The cleaning is conducted the same way as it is conducted for the rest of the diaper area – with warm water and soap. In cases when after the first year of life of their boy the parents, having tried to pull back on the skin of the shaft (the pulling force should be applied very gently), discover that the foreskin does not retract, they should not panic and should not try forcing it to retract. There is absolutely no reason to rush things. The principal question here is the size of the hole in the foreskin – it should be big enough for the urine to flow our freely. There are cases when the foreskin still remains partially adherent to the penis head during several initial years of age; if it happens so, wash only the outside of the skin above the penis head. Remember, soap can irritate the sensitive areas of the penis head, so avoid soap and do all washing with warm water over as much of the penis head as can be exposed by gentle retraction of the foreskin. Not to let the foreskin stuck after cleaning (that can cause serious complications) you should always return the foreskin into its initial position.
Male persons with completely separated foreskin (that means they are able to retract it freely) should make a good habit of cleaning smegma from under the foreskin once a week as a minimum. The daily cleaning when showering or bathing would be a much better option. Sticking to the maintenance of the good hygiene prevents very serious aggravations, such as the cancer of the penis and the cancer of the cervix of the partner.
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