If the patient is not circumcised, the foreskin should be retracted. Some examiners ask the patient to retract it himself; others prefer to determine the tightness of the foreskin. The cheesy, white material under the foreskin is smegma and is normal.
Phimosis is the condition in which the foreskin cannot be retracted, and it prevents adequate examination of the glans. Because the glans also cannot be cleaned, smegma builds up, leading to possible inflammation of the glans and prepuce (balanoposthitis). This chronic irritation may be a causative factor in cancer of the penis.
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