Common baby penis problems

Understandably, parents — and moms, in particular — are often concerned about a little boy and how best to care for them. This includes the health of their penis and what to look out for in case there is a problem. 

The penis will have a huge impact on his life as an adult. In other words, knowing about the potential infections, injuries, and physical problems your child’s penis could have is essential for him to have a happy, healthy life.

Whether your baby boy is grabbing his private parts and crying, or you want to know all the common baby penis problems, read on…

Terms we’ll use 

These are the definitions you need to know:

• Glans – The tip or head of the penis.
• Penis shaft – The finger-like part which extends from the tip and connects to the lower belly.
• Foreskin – A patch of skin that covers the head and provides protection (This is what is cut away during a circumcision).
• Scrotum – A pouch of skin below the penis which holds the testicles.
• Testicles – The two organs are oval in shape and housed in the scrotum. They are responsible for producing sperm in men.

A paediatric urologist’s advice for keeping the baby’s penis clean: 

• At birth, the foreskin of most little boys doesn’t pull back (retract). Please do not force it back, as this may result in bleeding from a tear. Repeatedly forcing the foreskin back before it has released naturally may actually result in a serious condition known as Phimosis (this will be discussed later). Simply wash the penis with a hypoallergenic soap and water at bath time.
• In uncircumcised boys, the foreskin may begin to retract from around 12 months of age. This varies but at least 50% of boys are able to retract the foreskin by the age of 10 years, and certainly the majority of boys (90%) by the age of 17 years. A non-retractable foreskin is different from the condition known as Phimosis. There is no need to interfere with the normal process of retraction unless a boy begins experiencing problems.
• As soon as it does retract, it is very important to clean under the foreskin daily. This is done by gently pulling the skin back, cleaning with a mild soap and water, and rinsing the soap off. The glans should be dried properly, and the foreskin should be gently pulled back over the glans. A little boy can be taught to do this himself from about two years of age as long as a caregiver ensures it is done properly. 

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Do babies get erections? 

First and foremost, an erection is normal! It is a very natural function for a healthy boy. It begins as early as in the womb. A newborn may have an erection while in the bath or just having his nappy changed.

It has nothing to do with sex and is probably just a response to the air, warm water, or the fact that he needs to pass urine. As your little boy grows up, he will discover his penis, just like any other part of his body. Touching your baby’s penis may cause an erection. This is normal, but as he gets a little older, you may need to explain to him that his penis is private and that touching it is private as well. Only from about the age of 11 years and upwards will an erection lead to ejaculation.

On the whole, little boys do find their penis pleasurable, but for some, an erection is uncomfortable, distressing, or even painful. If this occurs, try explaining to him that the erection is normal. Help him overcome the discomfort by giving him a bath, removing his underwear, or putting some loose-fitting trousers on him.

A normal erection will not last longer than an hour. If it does, then you should seek medical help. 

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Possible baby penis problems  

While there are a number of conditions that may cause boys problems, these are the ones most likely to occur and of greatest concern to parents:

Penile anomalies & physical problems

While penile anomalies are rare, there are some physical issues that can arise. Here are the most common problems and the treatments needed to resolve each concern. 

1. Buried penis 

The penis may be hidden inside a fat pocket in the lower part of the tummy. Another cause may be that the skin of the penis covers the penis unevenly and the penis is concealed. 

The condition usually resolves by the time the child is two years old. In rare cases the child may develop scarring in which case your doctor may recommend a steroid cream and possible surgery.

2. Curved penis or Chordee 

Another name for this is penile curvature. This is often caused by tissue pulling the penis down, especially during an erection. Unfortunately, surgery is required to correct this problem.

3. Webbed penis 

This occurs if the penis doesn’t separate well from the scrotum. A baby may be born with this abnormality, or it can happen following a circumcision where too much of the foreskin has been removed. This webbing can be corrected with minor surgery.

4. Balanitis in babies

This refers to inflammation of the glans, causing a swollen penis. Toddlers and babies can get this as a result of infection, allergy, or irritation. Balanitis may be painful but is generally not too serious. 

Depending on the cause, the doctor will recommend an antibiotic cream or a steroid cream. Sometimes, the balanitis is caused by a tight foreskin, in which case surgery might be necessary.

5. Penile adhesions 

This condition occurs in boys who have been circumcised. The edges of the cut skin stick to the head of the penis. The skin can’t retract from the penis. It doesn’t cause pain and this will usually resolve on its own as the penis grows.

6. Phimosis 

This condition often occurs because of scarring of the preputial ring. It prevents the foreskin from retracting at all. This condition may be as a result of the foreskin being forced back repeatedly or an infection. It is also considered phimosis if the opening of the foreskin is too small or if a boy’s foreskin is still not retractable at the end of puberty. 

This condition makes it difficult to pass urine, and ballooning of the foreskin may be noticed. The tight foreskin may also cause pain during an erection. The first step in treating this condition would be a steroid cream. If this fails, then paediatric surgery may be necessary to release the foreskin.

7. Paraphimosis 

Here the foreskin retracts behind the glans and it is not able to go back. This is a medical emergency because the foreskin acts like an elastic band around the shaft and cuts off blood to the tip of the penis. Urgent care is needed.

8. Penile torsion and twisted testes 

In this condition, the testicle twists and cuts off the blood supply. This is a very painful and serious condition. It can happen at any stage of your child’s life and requires urgent medical attention. If you notice a swollen scrotum, treat it as an emergency.

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Photo by Picsea on Unsplash

Common baby penis infections: 

Infections can occur in a variety of ways, but here are the most common occurrences and their cures. 

1. Urinary tract infections

If your little boy gets a urinary tract infection, your doctor may request an ultrasound of the kidneys and VCU. This is done to check that the kidneys are functioning correctly and that the bladder is able to empty completely when your baby passes urine. Most of the time, the infection is caused by bacteria that have been trapped under the foreskin and then travel up into the urinary tract. 

Your son might experience fever, strong smelling urine, difficulty passing urine, a burning sensation when passing urine, irritability or poor feeding. The urine should be tested so that the correct antibiotic can be prescribed. This is necessary to prevent any damage to the kidneys.

2. Fungal infection 

This is most often caused by a yeast infection, candida. It may occur during very hot, humid conditions or if too much time has passed between nappy changes. Signs of a candida infection may be redness, scaling, or a painful rash. An anti-fungal cream will probably be prescribed for this condition.

3. Post circumcision

During circumcision, the foreskin is separated from the normal tissue and removed, leaving the glans exposed. It is common for the glans to become inflamed and crusty and this causes parents a lot of concern. 

Usually a good layer of nappy cream and a nappy liner is all that is required to prevent the sensitive area from rubbing on the nappy. It is important to watch for infection or bleeding as this can be serious. Seek urgent medical advice under such circumstances.

4. Smegma

Pus-like clumps may form on the glans of the penis if the foreskin is not retracted and cleaned properly. Careful cleaning of the penis will usually resolve this issue.

5. Baby penis rash 

Boys hold their penis to pass urine. In most cases, a rash is caused by an irritant on your son’s hand and that has touched this very sensitive skin. These irritants may include pollen, grass or food. 

Gently washing the penis and applying a hypoallergenic cream is sufficient to settle the rash. In severe cases, your doctor may prescribe a medicated cream.

Common penis injuries in babies: 

There are many ways in which a boy can injure his penis or scrotum whether they are infants or teens.  Here are the most common causes of penis injuries.

1. While riding a bike or playing sport

Boys will experience pain and may even feel like vomiting. Parents should seek medical help if the child develops a fever, nausea continues, or if there is swelling, bruising, or a visible wound.

2. Catching their penis in a zip 

If you can’t safely undo the zip or if there is a chance that you will cause further injury, then this must be treated as an emergency.

3. Twisting and pinching

A hair or thread from underwear may also twist around the penis and cut off blood supply. If the parent is unable to loosen the thread, then urgent medical care is necessary.

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Photo by Jamie Coupaud on Unsplash

FAQs about common penis problems in children: 

1. What are the 5 most common penile birth defects?

They are hypospadias, epispadias, chordee, Paraphimosis, and undescended testicles.

How do you treat hypospadias?

In most cases, it is treated with surgery. That said, hypospadias repair isn’t always necessary, depending on the severity of the issue.

Are premature babies more likely to have penis problems?

Premature babies are more susceptible to illnesses, asthma, and feeding problems. At the time of writing this article, there is no evidence to suggest penis problems are directly related to premature babies.

A paediatrician’s final thoughts on baby penis pain & problems…

Talking about penis problems is easier for parents when their son is little. As boys get older they get increasingly shy about such talk. It is really important that you keep conversations about illness, injury, and normal development open when it comes to any body part.

So being able to communicate and  talk to your son and give him the confidence to ask questions and raise concerns is important so that he functions optimally as a male. 

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557924/
https://www.hkmj.org/abstracts/v22n3/263.htm#:~:text=Parents%20often%20seek%20medical%20advice,short%20are%20the%20common%20complaints.
https://www.hkmj.org/abstracts/v22n3/263.htm
https://www.rch.org.au/clinicalguide/guideline_index/The_penis_and_foreskin/
https://my.clevelandclinic.org/health/diseases/15454-penile-torsion
https://www.medicinenet.com/phimosis_and_paraphimosis_penis_disorders/article.htm

https://www.cdc.gov/fungal/diseases/candidiasis/index.html