Phimosis: Should You Consider Circumcision?

Q: Phimosis: Should You Consider Circumcision?

Hello Mr. <br>Huang： Phimosis can easily harbor dirt and bacteria. <br>If daily cleaning is not feasible, you may consider circumcision. <br>Since it does not meet the criteria for National Health Insurance coverage, it will be an out-of-pocket expense, and the amount varies by h

Phimosis

Hello doctor, I am 19 years old.
A few days ago, while cleaning my genital area, I noticed that the white layer on my glans is difficult to clean.
After researching online, I found out that this is smegma.
I wash with cold water every day, but there still seems to be a lot.
I also discovered that I have phimosis, as my foreskin completely covers my glans and even extends beyond it.
When I try to retract the foreskin, I can only see about one-third of the glans, and it becomes painful if I try to pull it back further.
The same situation occurs during an erection.
Should I consider getting a circumcision? I read online that phimosis may not be suitable for circumcision, but not having the procedure seems quite unhygienic, leading to the current buildup of smegma.
Do I need to get circumcised? Thank you for your response.

Mr. Huang, 10~19 year old female. Ask Date: 2016/06/04

Dr. Chen Jiansheng reply Urology

Hello Mr.
Huang: Phimosis can easily harbor dirt and bacteria.
If daily cleaning is not feasible, you may consider circumcision.
Since it does not meet the criteria for National Health Insurance coverage, it will be an out-of-pocket expense, and the amount varies by hospital.
Please inquire at the outpatient department of the Urology Department at Hsin-Ying Hospital with Dr.
Chen Chien-Sheng.

Reply Date: 2016/06/04

More Info

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). This can lead to various issues, including difficulty with hygiene, discomfort during erections, and potential complications such as infections or inflammation. In your case, it seems that you are experiencing a form of phimosis, as you mentioned that you can only retract the foreskin slightly and that you have been having trouble keeping the area clean.

The presence of smegma, which is the white substance you described, is common in individuals with phimosis. Smegma is a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin. While regular cleaning can help manage this, if the foreskin is too tight to retract fully, it can be challenging to maintain proper hygiene, leading to further accumulation of smegma and potential odor or irritation.

Regarding circumcision, it is often considered a treatment option for phimosis, especially if it causes discomfort, hygiene issues, or recurrent infections. Circumcision involves the surgical removal of the foreskin, which can alleviate the problems associated with phimosis. However, it is essential to consult with a healthcare professional, preferably a urologist, who can assess your specific situation and provide personalized advice.

Here are some factors to consider when deciding whether to proceed with circumcision:
1. Severity of Phimosis: If your phimosis is causing significant discomfort or hygiene issues, circumcision may be a suitable option. If you can manage the condition without surgery, that may also be a valid choice.

2. Hygiene: As you noted, maintaining cleanliness can be challenging with phimosis. If you find it difficult to keep the area clean despite your efforts, circumcision may help improve hygiene.

3. Pain or Discomfort: If you experience pain when attempting to retract the foreskin or during erections, this is a strong indication that surgical intervention may be beneficial.

4. Potential Complications: If you have recurrent infections or inflammation due to phimosis, circumcision can help reduce the risk of these complications.

5. Personal Preference: Ultimately, the decision to undergo circumcision is personal. Some individuals prefer to keep their foreskin for various reasons, including cultural or religious beliefs.

6. Alternative Treatments: In some cases, non-surgical treatments, such as topical steroid creams, may help loosen the foreskin and allow for easier retraction. Discussing these options with your doctor may be worthwhile before deciding on surgery.

In summary, while circumcision is a common treatment for phimosis, it is essential to have a thorough discussion with a healthcare provider to weigh the benefits and risks based on your specific circumstances. They can provide guidance on the best course of action, whether that be surgery or alternative treatments. If you are experiencing pain or significant hygiene issues, seeking medical advice sooner rather than later is advisable.

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