In this episode of The Good GP, host Dr Tim Koh speaks again with Dr Bhavesh Patel, a Queensland-based paediatric surgeon, about foreskin problems in boys, an area where general practitioners often face questions from families but might have limited training or exposure.

Dr Patel outlines the normal development of the foreskin, clarifying common misunderstandings around the expected age of retraction. He explains that full retraction occurs at a median age of 10.4 years, with wide normal variation, and describes how outdated perceptions have contributed to anxiety and misinformation among families.

Giving practical advice for parents regarding hygiene and caring for the foreskin, he emphasises avoiding forced retraction and outlining appropriate bathing routines. They identify normal findings such as the presence of smegma and occasional ballooning during urination, and distinguish them from signs that may indicate pathology.

Treatment options were also discussed, starting with conservative management such as topical steroid creams, highlighting a regime that achieves a high rate of success. Dr Patel also touches on the management of preputial adhesions and when to consider surgical intervention.

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