Tight Foreskin After Balanitis: Causes and Solutions

Q: Tight Foreskin After Balanitis: Causes and Solutions

Hello： If the skin is not red, it is mostly a scar after inflammation. <br>If you need to apply a corticosteroid, it requires a doctor's prescription; do not buy it randomly, as some may have side effects. <br>If there is no improvement after a few months, surgery may be the main

After the recovery from balanitis, the concern of tightness of the foreskin?

Hello, Doctor.
About two months ago, after having sexual intercourse with my partner, I experienced itching under the foreskin the next day, possibly due to inadequate cleaning.
I tolerated it for two days, but then it started to sting.
Initially, I thought it was just a temporary inflammation and didn't pay much attention.
However, after about two weeks, it became quite bothersome, and the foreskin appeared to be constricted.
Before this, I could fully retract the foreskin behind the glans when erect, but after the inflammation, I experienced complete phimosis.
I visited a urology clinic and received a topical ointment.
By early January, the inflammation and redness had completely subsided, and I could barely retract the foreskin.
However, there is a noticeable rough, dry, and tight ring of skin around the mid-shaft of the penis that feels resistant and tight when retracting the foreskin, even causing pain.
Unlike before the inflammation, it lacks elasticity.
After sexual intercourse or masturbation, this rough skin can even tear, resulting in multiple small wounds.
Today, I returned to the urology clinic, and after a brief examination, the doctor prescribed Betagen Cream and Betamethasone Ointment, stating that the oily ointment could help if the area is too dry.
I feel that the doctor at this clinic does not take my concerns seriously, so I would like to ask you:
1.
Does the tightness of the foreskin indicate that the inflammation has not fully healed?
2.
Will using the steroid ointment improve my symptoms and restore the original elasticity of the foreskin? (The doctor at the clinic warned me that it might not recover...)
3.
If the elasticity cannot be restored, is circumcision the only option left?
4.
If circumcision is necessary due to this condition, will it be covered by health insurance? I am quite worried about this issue...
Otherwise, if I continue to experience discomfort just from retracting the foreskin during an erection, I am concerned about my future sexual life...

Taipei Jinu Liwei, 30~39 year old female. Ask Date: 2017/01/12

Dr. Du Shixi reply Urology

Hello: If the skin is not red, it is mostly a scar after inflammation.
If you need to apply a corticosteroid, it requires a doctor's prescription; do not buy it randomly, as some may have side effects.
If there is no improvement after a few months, surgery may be the main option.
As for whether circumcision is covered by health insurance, it needs to be determined by a doctor's examination; it is not something I can decide.
(Be cautious with DIY; if there are lacerations, be careful, as repeated actions may cause scarring and lead to further tightening.)

Reply Date: 2017/01/12

More Info

Understanding tight foreskin after experiencing balanitis can be a concerning issue, especially when it affects sexual function and comfort. Balanitis, which is inflammation of the glans (the head of the penis), can lead to various complications, including phimosis, which is the inability to retract the foreskin fully. Let's address your concerns systematically.

1. Is the tightness of the foreskin a sign that the inflammation has not fully healed?
Yes, the tightness of the foreskin can indicate that the inflammation has not completely resolved. After an episode of balanitis, it is common for the skin to become scarred or thickened, leading to a condition known as post-inflammatory phimosis. This can result in the foreskin becoming less elastic and more difficult to retract, even after the initial inflammation has subsided. If the skin remains irritated or inflamed, it may contribute to ongoing tightness.

2. Will the use of steroid creams improve my symptoms and restore the elasticity of the foreskin?
The application of topical corticosteroids, such as Betamethasone, can help reduce inflammation and promote healing of the skin. These medications work by decreasing the immune response in the area, which can help alleviate symptoms of irritation and promote skin regeneration. In many cases, consistent use of these creams can improve the elasticity of the foreskin over time. However, it is essential to follow the prescribed regimen and monitor your symptoms closely. If there is no improvement, further evaluation may be necessary.

3. If the foreskin does not regain its elasticity, is circumcision the only option?
If conservative treatments, including topical steroids and proper hygiene, do not yield satisfactory results, circumcision may be considered as a last resort. Circumcision is a surgical procedure that removes the foreskin and can provide a permanent solution to phimosis and recurrent balanitis. However, it is essential to discuss all options with your healthcare provider, as they may suggest other interventions, such as preputioplasty, which is a less invasive procedure aimed at widening the foreskin opening.

4. Is circumcision covered by health insurance?
In many cases, circumcision may be covered by health insurance, especially if it is deemed medically necessary due to recurrent infections or complications from phimosis. However, coverage can vary based on your insurance plan and the specific circumstances surrounding your condition. It is advisable to check with your insurance provider and discuss the situation with your healthcare provider to understand the coverage options available to you.

In conclusion, it is crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment options. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another urologist may provide you with additional insights and reassurance. Remember that while the situation may feel distressing, many men experience similar issues, and effective treatments are available to help restore comfort and function.

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