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Care of the uncircumcised penis in infants and children

Duncan Wilcox, MD
Section Editors
Laurence S Baskin, MD, FAAP
Jan E Drutz, MD
Deputy Editor
Melanie S Kim, MD


The care and complications of the uncircumcised penis will be reviewed here. The procedures, risks, benefits, and complications of circumcision are discussed separately. (See "Techniques for neonatal circumcision" and "Neonatal circumcision: Risks and benefits" and "Complications of circumcision".)


The foreskin is the redundant skin that typically extends approximately 1 cm beyond the glans (picture 1 and figure 1). It provides protection to the urethral meatus and glans penis.

The normal foreskin begins to develop as an epithelial fold that grows inward from the base of the glans penis at eight to nine weeks gestation with normal completion by 4 to 4.5 months gestation. The squamous epithelial lining of the inner prepuce is contiguous with the glans penis, resulting in the normal circumferentially initial adhesions between the inner layer of the prepuce and the glabrous epithelium of the glans penis.


Separation of the foreskin from the glans penis occurs by desquamation and begins late in gestation, but remains incomplete in most male infants at birth. Only approximately 4 percent of males have a completely retractable foreskin at birth, and in more than half of newborn males, the foreskin cannot be retracted far enough to visualize the urethral meatus [1].

After birth, penile growth and physiologic erection aid in the desquamation process and the formation of keratinized pearls (smegma) between the layers, which loosens the adhesions and allows retraction of the preputial skin.

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Literature review current through: Nov 2017. | This topic last updated: Aug 16, 2017.
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