Foreskin Issues: When to Consider Surgery for Tightness and Pain

Q: Foreskin Issues: When to Consider Surgery for Tightness and Pain

Hello： Surgery may be necessary. <br>If your lesion is circular, it will need to be excised. <br>If there are areas that are too tight, the effectiveness of applying ointment may be uncertain, making it difficult to achieve satisfactory results. <br>Wishing you good health.

Phimosis and tight foreskin

I inquired about the glans and foreskin issues on June 13 (#124432).
The doctor advised me to refrain from sexual activity for two to three weeks, but during instances of excessive arousal and erection, the skin gets stretched outward, and after the two to three weeks, the skin continues to tear.
There is also a small area next to the wound that has a striped appearance, resembling zebra stripes.
Should I consider a circumcision or a dorsal slit procedure?
Additionally, there is a particularly tight ring of foreskin between the tip and the middle, which gets stuck when I retract the foreskin to the coronal sulcus, resembling phimosis.
However, I can retract it back without any issues when not erect.
When I push the foreskin back from the base while flaccid, it feels like there is a narrow band around that area, almost as if it is constricted.
I have been applying a steroid cream prescribed by the clinic to help relax it, but after using it on one area, there has been no change.
Is there any way to resolve this? Currently, when I retract the foreskin during an erection, that tight ring feels particularly uncomfortable.

TT, 20~29 year old female. Ask Date: 2017/07/15

Dr. Du Shixi reply Urology

Hello: Surgery may be necessary.
If your lesion is circular, it will need to be excised.
If there are areas that are too tight, the effectiveness of applying ointment may be uncertain, making it difficult to achieve satisfactory results.
Wishing you good health.

Reply Date: 2017/07/15

More Info

When it comes to issues related to the foreskin, particularly tightness and pain, it is important to understand the underlying conditions that may necessitate surgical intervention. Based on your description, it seems you are experiencing symptoms consistent with phimosis or possibly a condition known as paraphimosis, where the foreskin cannot be easily retracted over the glans (the head of the penis).
Phimosis can be classified into two types: physiological and pathological. Physiological phimosis is common in infants and young boys, where the foreskin naturally separates from the glans over time. Pathological phimosis, on the other hand, occurs when the foreskin becomes tight due to scarring, inflammation, or other medical conditions, leading to pain and discomfort during erections or sexual activity.

In your case, the tightness you describe, particularly around the corona (the ridge of the glans), suggests that you may be dealing with pathological phimosis. The fact that you experience pain and discomfort when attempting to retract the foreskin, especially during erections, indicates that this condition may be affecting your quality of life and sexual function.

The presence of the "zebra-striped" discoloration you mentioned could be a sign of skin changes due to repeated trauma or irritation, which can occur when the foreskin is overly tight. This could further complicate the situation, as chronic irritation can lead to scarring and make the foreskin even tighter over time.

In terms of treatment options, there are several approaches to consider:
1. Topical Steroids: You mentioned using a topical steroid cream to help loosen the tight foreskin. This is often a first-line treatment for mild cases of phimosis. However, if you have already tried this without significant improvement, it may not be the most effective option for you.

2. Stretching Exercises: Gentle manual stretching of the foreskin can sometimes help alleviate tightness. This should be done cautiously and ideally under the guidance of a healthcare professional to avoid causing further injury.

3. Circumcision or Preputioplasty: If conservative measures fail, surgical options may be necessary. Circumcision involves the complete removal of the foreskin, while preputioplasty is a less invasive procedure that involves widening the opening of the foreskin without complete removal. The choice between these options depends on the severity of your condition, your personal preferences, and the recommendations of your healthcare provider.

4. Consultation with a Urologist: Given the complexity of your symptoms, it would be advisable to consult with a urologist. They can perform a thorough examination, assess the tightness of your foreskin, and discuss the most appropriate treatment options tailored to your specific situation.

In summary, if you are experiencing significant discomfort and your symptoms are not improving with conservative measures, it may be time to consider surgical options. A urologist can provide you with the necessary guidance and support to make an informed decision about your treatment. Remember, addressing these issues is important not only for physical comfort but also for your overall well-being and sexual health.

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