Phimosis: Treatment Options and Sexual Health Impact

Issues related to the foreskin?

Hello doctor, I am a 14-year-old in the second year of junior high school.
I am unable to retract my foreskin whether I am erect or not; there is only a small opening.
Do I definitely need surgery to resolve this, or can it be treated with medication? Additionally, if I do not address this issue, will it affect my sexual activity in the future? Thank you for your response.

An An, 10~19 year old female. Ask Date: 2016/05/06

Dr. Li Xinyi reply Urology

Issues with the foreskin should be evaluated in person, and it sounds like you may need surgical intervention for phimosis.
If left untreated, it can indeed affect sexual activity.
It is advisable to see a urologist after puberty for an examination, as topical treatments may not be effective and often require prolonged application.
You can also discuss your concerns with a urologist.

Reply Date: 2016/05/06

More Info

Phimosis is a condition where the foreskin of the penis cannot be easily retracted over the glans (the head of the penis). This can occur in males of any age, but it is particularly common in young boys. In your case, at 14 years old, it is important to address your concerns regarding phimosis, especially since it can have implications for sexual health and overall well-being.

Treatment Options for Phimosis
1. Conservative Management: In some cases, especially in younger boys, phimosis may resolve on its own as they grow older. Gentle stretching exercises can sometimes help. This involves gradually and gently pulling back the foreskin over time. However, this should be done with caution to avoid pain or injury.

2. Topical Steroid Creams: Applying a topical steroid cream can help to soften the skin of the foreskin, making it easier to retract. This method is often recommended before considering surgical options. It is important to follow your healthcare provider's instructions regarding the use of these creams.

3. Surgical Options: If conservative treatments do not work, or if the phimosis is causing significant problems (such as pain, recurrent infections, or difficulty with urination), surgical intervention may be necessary. The most common surgical procedure is circumcision, which involves the removal of the foreskin. There are also less invasive options, such as preputioplasty, which involves widening the opening of the foreskin without removing it.

Impact on Sexual Health
If phimosis is left untreated, it can lead to several complications that may affect sexual health:
- Pain During Erection: If the foreskin cannot retract, it may cause pain during erections, which can lead to anxiety about sexual activity.

- Infections: Phimosis can increase the risk of infections, such as balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin), which can be uncomfortable and may require treatment.

- Sexual Dysfunction: In some cases, phimosis can lead to difficulties during sexual intercourse, including pain or inability to engage in penetrative sex.

Conclusion
It is essential to consult with a healthcare provider, such as a urologist, who can assess your specific situation and recommend the best course of action. They can provide guidance on whether conservative treatments are appropriate or if surgical options are necessary. It is also important to discuss any concerns you have about how phimosis may affect your sexual health in the future. Open communication with your doctor can help alleviate anxiety and ensure that you receive the best care possible. Remember, addressing these issues early can lead to better outcomes and improved quality of life.

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