# HELP PLEASE - "Entrapped" Smegma



## JackieR (Sep 12, 2006)

I have a 4 y 4 mo old son whose penis is intact (despite a urologist's insistence that we were doing him a disservice). Anyway, last night when he was in the bath, he was laying on his stomach blowing bubbles and informed me that his penis hurt. He showed it to me and on the left side where the top of the glans (as opposed to the tip) would be, there was a swollen area that looked whitish underneath the foreskin. Called the after hours clinic and they said come on in. Anyway, after a brain surgeon and an adolescent generalist had a look at it (they _very_ gently retracted the foreskin partially - nothing to get nervous about) they decided it was "entrapped" smegma. The recommendation was to continue gentle retraction and cleaning twice a day with a q-tip or something else very gentle. They said not to forcibly retract it (as if I would!) so that I would not tear or damage anything but hopefully the smegma would work its way out.

So, ok, at this point it is like trapped behind where his foreskin is attached to the glans (which is right below like the ring of his penis) so I don't see how retraction and thorough cleaning is going to help work this smegma out? Are the docs' recs good ones? What should I be doing to care for his penis now? My husband is circ'ed so he doesn't know what to do either.

By the way, it doesn't hurt or bother my son unless he's touching it or is "semi excited" - if you get my drift.









Thanks so much for any help/info.

Jackie


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *JackieR* 
I have a 4 y 4 mo old son whose penis is intact (despite a urologist's insistence that we were doing him a disservice).

No no, the urologist wanted to do him a disservice. You _did_ him a great service.







Now on to your problem.

Quote:


Originally Posted by *JackieR* 
Anyway, last night when he was in the bath, he was laying on his stomach blowing bubbles and informed me that his penis hurt. He showed it to me and on the left side where the top of the glans (as opposed to the tip) would be, there was a swollen area that looked whitish underneath the foreskin. Called the after hours clinic and they said come on in. Anyway, after a brain surgeon and an adolescent generalist had a look at it (they _very_ gently retracted the foreskin partially - nothing to get nervous about) they decided it was "entrapped" smegma. The recommendation was to continue gentle retraction and cleaning twice a day with a q-tip or something else very gentle. They said not to forcibly retract it (as if I would!) so that I would not tear or damage anything but hopefully the smegma would work its way out.

Actually, nobody should be retracting him at all even 'gently'. Also don't try and retract and wash that can lead to infection just wipe like a finger, as you've probably been doing.

Quote:


Originally Posted by *JackieR* 
So, ok, at this point it is like trapped behind where his foreskin is attached to the glans (which is right below like the ring of his penis) so I don't see how retraction and thorough cleaning is going to help work this smegma out? Are the docs' recs good ones? What should I be doing to care for his penis now? My husband is circ'ed so he doesn't know what to do either.

By the way, it doesn't hurt or bother my son unless he's touching it or is "semi excited" - if you get my drift.









Thanks so much for any help/info.

Jackie

Usually the soreness you describe is associated with a separation stage. As the foreskin breaks away naturally from the glans it may leave some raw spots that then feel sore for a day or two. This happens to some, but by no means all, boys and is often misdiagnosed by Drs as 'infection'. In anyevent there is even a poll about it perhaps on page 2 or 3 by now. So I think if you just wait a day or two, the soreness will proabably abate and as for the smegma pearl I think that will eventually wash out during urination.

That being said I will feel better if someone else can also comment and affirm my suspicion. I hope this helps you in the mean time.


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## Raelynn (Apr 7, 2007)

I would almost guess that the pain and the smegma are unrelated, and that your son may be experiencing some normal discomfort/pain due to the natural separation process. The smegma is normal and painless/harmless so I would not continue to work on getting it out, it will come out on it's own.


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## l_olive (Jan 18, 2005)

This wonderful post (which I'll say yet again needs to be stickied) should address your concerns about this completely normal occurrence.

http://www.mothering.com/discussions...d.php?t=764732

And you shouldn't have to do anything except maybe a soak in the tub,and eventually it'll work itself out. And no q-tips! Ack!


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## JackieR (Sep 12, 2006)

From that "should be a sticky" post...

_Smegma Pearl
Something you may also see is called a Smegma pearl. This is a whitish lump that can range in size from very tiny to pea size or larger. Smegma (the Greek word for soap) is a substance that consists of dead skin cells, body oil and other debris that clumps together forming a ball. It is not damaging and will work its way out once separation is sufficient for it to do so. It is not recommended that you try to massage it out or mess with it since this could cause tearing between the foreskin and the glans and result in pain and possible infection._

There is no discharge at this time. I'm just going to leave it alone; how long should I do this before becoming concerned about the fact that it's still there? Thankfully we only had one "cleaning" today and since it was me, I was especially gentle about it. And it made no sense as I was doing it since the part I was cleaning wasn't even near the smegma since the smegma is trapped behind the foreskin adhesion to the top of the glans. No more "cleaning" for us. He does nighttime bath soaks every night - has for years - so hopefully this will help. Again, thank you, and any additional info/experience anyone has is greatly appreciated!!!


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *JackieR* 
From that "should be a sticky" post...

There is no discharge at this time. I'm just going to leave it alone; how long should I do this before becoming concerned about the fact that it's still there? Thankfully we only had one "cleaning" today and since it was me, I was especially gentle about it. And it made no sense as I was doing it since the part I was cleaning wasn't even near the smegma since the smegma is trapped behind the foreskin adhesion to the top of the glans. No more "cleaning" for us. He does nighttime bath soaks every night - has for years - so hopefully this will help. Again, thank you, and any additional info/experience anyone has is greatly appreciated!!!

Smegma isn't always a 'discharge' it ranges in color and viscosity. In your son's case it is a kind of pearl because the physical cells got trapped but the moisture has pressed out. I don't think there will be any maximum length of time. Here is the general situation. Intact boys begin a process of separation at a range of ages but 2-4 seems average for a start. Some times this leads to periodic soreness which usually self resolves with in 48 hours. You should only be come concerned if he gets noticeably worse, has trouble urinating, or develops a fever. And to be honest, the first point (noticeably worse) also describes boys who have separation issues (of those who get it some get it more than others). I don't think any of that will happen, based on your description.

So to summarize give it about two days see if the soreness goes away, you shouldn't be too concerned unless he has trouble urinating or develops a fever. The smegma will work itself out but even if it takes time it shoudn't in and of it self be an issue. I am sure more posters will chime in but I don't think there is anything to worry about at this point or in the near future.


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## MCatLvrMom2A&X (Nov 18, 2004)

It wont hurt anything at all for it to stay there even for years. When your ds's penis is more retractable and a suffecient path has opened up it will come out on its own.

Like others have mentioned the pain is due to seperation not the smegma. The only time pearls form is when the seperation process is underway and there is room in there for the smegma to collect but not to come out the tip.

Something to remember that even gentle retraction done by someone other than the owner of the penis can cause infection due to the risk of micro tears. Not saying the foreskin is tissue paper thin but there is no way for anyone but him to know when it is to much.

You can ask him if he wants to retract but in no way should you or anyone else do it. Rubbing the glans can be very painful when seperation is first starting the equivelent of pulling back the clitoral hood and rubbing directly on the nerves there or for me even touching my urethra will burn. Not to mention soap in that area can cause irritation and pain as well.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *JackieR* 
There is no discharge at this time. I'm just going to leave it alone;

Good choice. The information comes from a belief in the medical profession in the early parts of the 20th century that smegma itself was a harmful substance and a repository for infectious agents. In fact, smegma is an entirely healthy substance and is important for the health of your son. In short, no attempts should be made to remove it.

Quote:

how long should I do this before becoming concerned about the fact that it's still there?

There is no time limit. The smegma pearl may be there for days, weeks or even months. It may work its way out as a lump or it may exude itself as a continual process in small amounts. You may not even realize it is working it's way out and one day, you'll just notice it's gone. Even if it does come out as a lump, you may miss it in the process of changing his diaper. (Oh, I just realized he is 4 years old and no longer in diapers!)

Frank


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## glongley (Jun 30, 2004)

Quote:


Originally Posted by *Frankly Speaking* 
There is no time limit. The smegma pearl may be there for days, weeks or even months.
Frank

Or even years. My older son started getting an accumulation of baby smegma (the product of the break down of the cell layer connecting the foreskin and the glans, via the separation process) under his foreskin aroudn age 1. He got a noticeable lump at the base of his foreskin, which gradually got bigger and bigger to where his pennis looked pretty lopsided. Then at age 3 it spontaneously discharged as about 1/4 tsp of dryish-pasty whitish odorless material, and that wa the end of that.

It is not harmful, and it will take care of itself in time. I wouldn't worry about it or mess with it. It will come out in time, as the foreskin continues to separate and and exit route to the opening is eventaully created.

Good for you for leaving your son intact. Don't let anyone ever make you feel bad about that, especially over something NORMAL like a smegma pearl!

Gillian


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## Quirky (Jun 18, 2002)

To add to the great advice from the PPs, just be aware that smegma is harmless. It's not like pus or something that's indicative of an infection or may have harmful bacteria in it. The tissues of the inner foreskin have beneficial bacteria colonizing there as well as an enzyme called lysozyme that has antibacterial properties.

That's one reason I think it's especially important not to retract or try to clean it out -- as long as you're leaving it alone, then the natural bacterial balance will prevail. When you retract, or even introduce water, you're messing with the natural balance and that can throw things out of whack -- much as if you douched yourself and therefore got a yeast infection because you'd thrown the beneficial bacteria out of balance in a space that's meant to be internal and self-cleansing.

So I'd just leave it alone and not worry about it.


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## Frankly Speaking (May 24, 2002)

Quote:

The tissues of the inner foreskin have beneficial bacteria colonizing there as well as an enzyme called lysozyme that has antibacterial properties.

There is also the recently discovered enzyme langerin. That gives harmful bacteria and fungals the double whammy! It's amazing how well designed our bodies are.

Frank


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