Phimosis: Do You Need Circumcision or Alternatives?

Q: Phimosis: Do You Need Circumcision or Alternatives?

Hello： This condition will likely become increasingly loose, unless there is inflammation and scarring causing narrowing. <br>Another option is surgery. <br>Wishing you good health. <br>Based on personal experience, the effect of ointments is minimal and will not lead to signific

Foreskin issues

Hello doctor, I have a problem with phimosis.
I can fully retract the foreskin with my hand, but it becomes tight after engorgement.
However, I can still manage this.
Do I need a circumcision? Are there any methods to make it a bit looser?

7, 20~29 year old female. Ask Date: 2017/07/13

Dr. Du Shixi reply Urology

Hello: This condition will likely become increasingly loose, unless there is inflammation and scarring causing narrowing.
Another option is surgery.
Wishing you good health.
Based on personal experience, the effect of ointments is minimal and will not lead to significant changes.

Reply Date: 2017/07/13

More Info

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (head) of the penis. This can lead to discomfort, difficulty with hygiene, and in some cases, complications such as infections or inflammation. Your description indicates that you can retract the foreskin fully when not engorged, but it becomes tight when engorged. This situation is relatively common and can often be managed without immediate surgical intervention.

Understanding Phimosis
Phimosis can be classified into two types:
1. Physiological Phimosis: This is common in infants and young boys, where the foreskin is naturally non-retractable due to the way it is attached to the glans. As the child grows, the foreskin typically becomes more retractable.

2. Pathological Phimosis: This occurs when the foreskin becomes tight due to scarring, inflammation, or other medical conditions. This type can lead to complications and may require treatment.

Treatment Options
1. Conservative Management: Since you can retract the foreskin when not engorged, you might consider conservative measures first. Regular gentle stretching of the foreskin can help increase its elasticity over time. This can be done during bathing or when the penis is flaccid. Applying a topical steroid cream, as prescribed by a healthcare provider, can also help reduce inflammation and promote stretching.

2. Hygiene Practices: Maintaining good hygiene is crucial. Ensure that you clean the area gently to prevent infections, which can exacerbate phimosis.

3. Circumcision: If conservative measures do not alleviate the symptoms or if you experience recurrent infections, pain, or other complications, circumcision may be recommended. This surgical procedure involves the removal of the foreskin and is a definitive treatment for phimosis. It is generally safe and has a low complication rate.

4. Preputioplasty: This is a less invasive surgical option that involves widening the opening of the foreskin without complete removal. It may be suitable for some individuals with phimosis and can preserve the foreskin.

5. Consultation with a Specialist: It’s essential to discuss your symptoms and concerns with a urologist. They can provide a thorough examination and recommend the best course of action based on your specific situation.

Conclusion
In your case, since you can retract the foreskin fully when not engorged, you may not need immediate circumcision. However, if you experience discomfort, pain, or recurrent infections, it would be prudent to consult with a healthcare professional. They can assess your condition and discuss the potential benefits and risks of circumcision or alternative treatments. Remember, maintaining good hygiene and considering gentle stretching techniques may help alleviate your symptoms without the need for surgery.

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