By Gary M. White, MD
Smegma pearls are white balls on the penis of uncircumcised boys. They tend to form if the prepuce is not retracted regularly to clean the glans and coronal sulcus.
The typical patient is a boy 1.5 to 7 years in age. Examination shows a single or multiple white lesions over the glans. The lesion appears as a pearly white lump, ranging in size from 0.5 to 2 cm. They are round to ovoid in shape and are located between the base of the glans and the distal junction of the attachment of the preputial membrane with the glans.
No treatment is recommended as these lesions will spontaneously resolve. If needed, the bimanual retractile maneuver (BMN) may be performed. After partial retraction, gentle pressure is applied over the lesion with both thumbs and index fingers, causing the contents of the lumps to pop out. The area may be cleansed with saline.