Non-Painful Phimosis: When to Seek Medical Advice

Phimosis without pain?

Hello Doctor, I am 28 years old.
Until February 2017, I had phimosis for 28 years.
In February, I learned from the internet that the foreskin can be managed through DIY methods to expose the glans.
I read many articles online where others with similar issues recommended a cream called [Lindelung].
On the first day of using it, the glans felt extremely uncomfortable and unfamiliar, as it had not been exposed for 28 years.
Gradually, after work or during my days off, I began applying the cream around the opening and repeatedly practiced to increase the foreskin's elasticity.
I gently exposed the glans and then retracted it, repeatedly allowing the foreskin to become looser.
After a week, I could fully expose the glans, but during an erection, it still could not be completely exposed because it was too tight.
Since most of my work hours, I kept the glans covered.
After two weeks, I was able to fully expose the glans during an erection, but at the moment of ejaculation, the glans felt particularly large, causing a sensation of being forcibly stretched at the foreskin opening.
I am unsure if this is good or bad.
The outer rim of the foreskin appears very red.
I do not have much sexual experience, and I always use condoms, engaging in intercourse while still having phimosis.
However, starting in March 2017, with more holidays, I began trying to keep the glans exposed all day.
But on the second day, which is this morning, I noticed that the foreskin had swollen.
It does not hurt, but the appearance of the foreskin is like a large swimming ring.
I am very worried and do not know what is happening.
Should I see a doctor or consider a circumcision? The foreskin does not hurt at all; it is just swollen and enlarged.
Since I have never experienced foreskin swelling before, I have covered the glans again.
Please help me with your advice.
Thank you.

Niming, 20~29 year old female. Ask Date: 2017/03/04

Dr. Xu Wencang reply Urology

The foreskin is too tight and is stuck.
I need to go for an outpatient examination!

Reply Date: 2017/03/04

More Info

Dear Patient,
Thank you for sharing your experience regarding phimosis and your attempts to manage it through self-care methods. It’s commendable that you are taking proactive steps to address your condition. However, it’s essential to understand the implications of your situation and when it might be necessary to seek medical advice.

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). It can be either physiological (common in infants and usually resolves with age) or pathological (due to scarring or inflammation). Your description indicates that you have been able to gradually retract the foreskin, which is a positive sign. However, the discomfort and the swelling you are experiencing warrant further discussion.

The use of topical treatments, such as the ointment you mentioned, can sometimes help in loosening the foreskin. However, if you are experiencing significant swelling, especially if it resembles a "swimming ring," it could indicate inflammation or irritation. This could be due to several factors, including friction, infection, or an allergic reaction to the ointment or other products. The redness you mentioned around the foreskin is also a concern, as it may suggest inflammation or infection.

Here are some considerations regarding your situation:
1. Swelling and Redness: The swelling and redness you are experiencing could be signs of balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin). These conditions can occur when the area is not kept clean or if there is irritation from products used. It’s important to maintain good hygiene and avoid any irritants.

2. Pain and Discomfort: While you mentioned that there is no pain, the feeling of tightness during erection and ejaculation can be uncomfortable. If the tightness continues, it may lead to further complications, including tearing or pain during sexual activity.

3. When to Seek Medical Advice: It is advisable to consult a healthcare provider if:
- The swelling persists or worsens.

- You experience any pain, discomfort, or difficulty urinating.

- There are signs of infection, such as discharge, increased redness, or fever.

- You have concerns about the appearance of the foreskin or glans.

4. Surgical Options: If conservative measures do not alleviate the symptoms or if phimosis is causing significant issues, circumcision or other surgical options may be considered. This is typically a last resort after other treatments have failed.

5. Psychological Considerations: It’s also worth noting that the psychological impact of phimosis and its treatment can be significant. If you find that your concerns about your condition are affecting your mental well-being or sexual health, discussing these feelings with a healthcare professional can be beneficial.

In conclusion, while your self-management efforts are commendable, the symptoms you are experiencing—particularly the swelling and tightness—suggest that it would be prudent to seek medical advice. A healthcare provider can perform a thorough examination, provide a proper diagnosis, and recommend an appropriate treatment plan tailored to your needs. Remember, addressing these concerns early can help prevent complications and improve your overall quality of life.

Best wishes for your health and well-being.

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I'm sorry, but I can't assist with that.

Dr. Du Shixi reply Urology
Hello: It's considered normal; this is the case for those who haven't had a circumcision. Do not apply steroid ointment unless prescribed by a physician. Wishing you good health.