Penile Fibrosis: Treatment Options and When to Consider Surgery

Q: Penile Fibrosis: Treatment Options and When to Consider Surgery

Hello： Topical corticosteroid ointments are not a cure-all; they are effective only in very mild cases. <br>Additionally, continuing to DIY may lead to new wounds, and repeated attempts can result in more fibrotic scarring. <br>Therefore, you may need to consult a physician to se

Preputial fibrosis

I previously experienced tearing of the foreskin after several instances of masturbation.
After healing a few times, it became increasingly tight, and eventually, I could no longer retract it at all.
I searched online and found that some people mentioned penile fibrosis.
However, some suggested that applying a corticosteroid cream would suffice and that surgery might not be necessary.
What is your opinion, doctor? I am still continuing to masturbate, and the opening of the foreskin only allows for the glans to be visible.
Both ejaculation and urination are normal.
Is it really unnecessary to undergo surgery, and can applying medication resolve the issue?

Wenti hen da, 10~19 year old female. Ask Date: 2017/02/02

Dr. Du Shixi reply Urology

Hello: Topical corticosteroid ointments are not a cure-all; they are effective only in very mild cases.
Additionally, continuing to DIY may lead to new wounds, and repeated attempts can result in more fibrotic scarring.
Therefore, you may need to consult a physician to see if topical treatment can address your condition.
If not, circumcision may be necessary.
Also, avoid using over-the-counter medications indiscriminately, as some are not suitable for your situation.
Thank you for your inquiry.

Reply Date: 2017/02/02

More Info

Penile fibrosis, often referred to in the context of conditions like phimosis or Peyronie's disease, can lead to significant discomfort and complications if not addressed properly. In your case, it seems you are experiencing a tightening of the foreskin (phimosis) following episodes of tearing, which may have resulted in scarring and subsequent fibrosis.

Understanding Penile Fibrosis
Penile fibrosis can occur due to various reasons, including trauma, infections, or chronic inflammation. In your situation, the repeated tearing of the foreskin during masturbation may have led to scarring, which can cause the foreskin to become less elastic and more difficult to retract. This condition can lead to discomfort during sexual activity, difficulty with hygiene, and potential complications such as infections.

Treatment Options
1. Topical Steroids: The use of topical corticosteroids is a common first-line treatment for phimosis. These medications can help reduce inflammation and promote skin elasticity, potentially allowing the foreskin to retract more easily. This treatment is often effective, especially in cases where the condition is not severe.

2. Stretching Exercises: Gentle stretching of the foreskin can also be beneficial. This should be done carefully to avoid further tearing or injury. Regular stretching may help improve the elasticity of the skin over time.

3. Surgical Options: If conservative treatments fail, or if the phimosis is causing significant pain, recurrent infections, or other complications, surgical intervention may be necessary. The most common surgical procedure is circumcision, where the foreskin is completely removed. Another option is preputioplasty, which involves widening the opening of the foreskin without complete removal. This can be a suitable option for those who wish to retain some foreskin.

When to Consider Surgery
Surgery should be considered if:
- You experience recurrent infections or inflammation.

- There is significant pain or discomfort during sexual activity or urination.

- Conservative treatments (like topical steroids and stretching) have not provided relief after a reasonable period (usually several weeks to months).

- You have concerns about hygiene due to the inability to retract the foreskin.

Conclusion
In your case, since you are still able to urinate and ejaculate normally, and if you are not experiencing significant pain or recurrent infections, you might consider continuing with conservative management, such as topical steroids and stretching. However, it is crucial to monitor your symptoms closely. If you notice any worsening of your condition, such as increased pain, difficulty urinating, or signs of infection, it would be advisable to consult a urologist for further evaluation and to discuss potential surgical options.

Remember, every individual’s situation is unique, and what works for one person may not work for another. Therefore, it is essential to have an open discussion with your healthcare provider about your symptoms, treatment options, and any concerns you may have regarding your condition.

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