Penile Care in the Uncircumcised Male Infant Goals of Treatment/Clinical Assessment With the high rate of circumcision in the United States, the recommended care of an intact foreskin is not always clear In uncircumcised male infants, adhesions between the glans and the foreskin are normal ( Fig 119.1 ) The foreskin is not normally retractable in this age group No effort should be made to strip the foreskin back in infants because this produces undue pain for the child and may result in inflammation and scarring Between ages and 4, spontaneous lysis of the adhesions occurs in 90% of boys It is rare for the male infant to have any adverse hygienic consequence from leaving the foreskin in place until that time The small, whitish lumps that may be seen and felt beneath the foreskin represent desquamated epithelium, smegma, and are benign After toilet training, boys should be taught to retract the foreskin enough to expose the meatus during voids —this avoids leaving the inner foreskin wet with urine, which can lead to inflammation, mucosal abrasions, and balanoposthitis By age to years, the foreskin should be drawn back as far as it can go at every bath FIGURE 119.1 Male anatomical landmarks A: Circumcised B: Uncircumcised (Reprinted with permission from Urinary Elimination In: Timby BK Fundamental Nursing Skills and Concepts 11th ed Wolters Kluwer: Philadelphia, PA; 2017:695–727.) Post Circumcision Concerns Immediate Concerns While rare, post circumcision bleeding can be of significant concern, or it can be a minor issue After circumcision done either with a clamp (in the newborn time