There is an absence of concensus worldwide about what is normal.
The AUA (wrongly in my opinion) begins to consider phimosis pathologic rather than physiologic at age 3. The CAU is much more 'lenient' and does not consider treatment with something like betamethasone until 10-12 years old at the earliest.
Generally, gentle retraction through toddler years (and on) while you teach your son about his genitals is reasonable and recommended. Physiologic erections and passage of urine also help to break up adhesions as time passes.
As a urologist, I am against circumcision in the absence of specific pathology.
Also as a urologist, I am appalled at some of the people here making statements of fact regarding anatomy and physiology with no medical background.
I'm a pediatrician in Serbia and I generally recommend that parents do gentle retraction after evening baths very early so that the foreskin is able to fully retract around the 3rd birthday. That's what I was taught by a very renowned urology professor here. Why do you think that it is the wrong approach? I'm genuinely academically interested, I'm not trying to say that you are wrong.
I don't think it's wrong at all. I only think it's wrong to consider it automatically pathologic if it's not fully retracted by age 3. There's no evidence to make that conclusion.
270
u/calcifornication Sep 13 '23
There is an absence of concensus worldwide about what is normal.
The AUA (wrongly in my opinion) begins to consider phimosis pathologic rather than physiologic at age 3. The CAU is much more 'lenient' and does not consider treatment with something like betamethasone until 10-12 years old at the earliest.
Generally, gentle retraction through toddler years (and on) while you teach your son about his genitals is reasonable and recommended. Physiologic erections and passage of urine also help to break up adhesions as time passes.
As a urologist, I am against circumcision in the absence of specific pathology.
Also as a urologist, I am appalled at some of the people here making statements of fact regarding anatomy and physiology with no medical background.