and Treating Partial Phimosis: Options and Concerns - Urology

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Treatment for incomplete phimosis?


Hello, doctor.
I discovered in my first year of high school that I might have a partial phimosis.
When not erect, I can retract the foreskin for cleaning (I just realized today that I had never retracted it to the coronal sulcus before, and I have a distribution similar to pearly penile papules).
However, when erect, only about 1/4 of the glans is exposed, which I believe indicates a tight foreskin.
I would like to preserve my foreskin to protect the glans, so I am considering trying steroid therapy, but there is little information online.
Since the medication "Lidocaine" is no longer available, I am afraid that if I go to a urologist, I might only be offered circumcision.
I have a few questions:
1.
Which medical institutions in Taichung offer steroid therapy?
2.
If there are no medical institutions providing this therapy and I need to self-medicate, what alternatives to Lidocaine are available, and what should I be cautious about when applying it?
3.
Is circumcision necessary for partial phimosis? In my daily life, the phimosis does not have a physiological impact on me, but psychologically, I always feel abnormal.
I fear that future partners may not accept me, and I am quite apprehensive about the possibility of surgery in urology.
I hope you can help alleviate my concerns.

Niming, 10~19 year old female. Ask Date: 2017/07/24

Dr. Du Shixi reply Urology


Hello: 1.
Both China and Zhongrong are acceptable.
2.
It seems that Lindelung is still in production; self-purchasing medication is not recommended, and based on experience, the effectiveness of ointments is minimal, so you may be disappointed.
3.
Medically, there is no recommendation that incomplete circumcision must be surgically corrected.
Wishing you good health.

Reply Date: 2017/07/24

More Info


Understanding and treating partial phimosis can be a complex issue, especially for young individuals who may feel anxious about their condition. Partial phimosis refers to the inability to fully retract the foreskin over the glans (the head of the penis) when erect, which can lead to discomfort and hygiene issues. Here, I will address your concerns and provide insights into treatment options, including the use of topical steroids, as well as alternative approaches.

1. Steroid Therapy for Partial Phimosis: Topical steroids, such as betamethasone or hydrocortisone, can be effective in treating phimosis by reducing inflammation and promoting skin elasticity. This treatment is often recommended before considering surgical options like circumcision. However, it is essential to consult a healthcare professional before starting any treatment. In Taichung, you may want to check with urology clinics or dermatology departments in hospitals, as they may offer steroid therapy for phimosis. It is advisable to call ahead and inquire specifically about this treatment.

2. Alternative Treatments: If you cannot find a medical institution that provides steroid therapy, you might consider over-the-counter options. However, it is crucial to avoid self-medicating without professional guidance. Instead of "臨得隆" (which is a specific brand), you can look for other topical corticosteroids that are available in pharmacies. When applying any topical treatment, ensure that the area is clean and dry. Apply a thin layer of the cream to the affected area, and avoid excessive use, as this can lead to skin thinning or other side effects. Monitor for any adverse reactions, such as increased irritation or allergic responses.

3. Surgical Considerations: While many individuals with partial phimosis may not require circumcision, it is essential to understand that surgery is sometimes the only option if conservative treatments fail. However, many cases can be managed effectively with topical treatments. If you are not experiencing pain, recurrent infections, or significant hygiene issues, you may not need surgery at this time. It is also worth noting that many men live with partial phimosis without any significant problems.

4. Psychological Impact: Your feelings of anxiety and concern about acceptance from potential partners are valid. It is essential to remember that many individuals experience similar concerns about their bodies. Open communication with partners about any medical conditions can foster understanding and acceptance. Additionally, consider speaking with a mental health professional if these feelings of inadequacy persist, as they can provide support and coping strategies.

5. Follow-Up Care: Regardless of the treatment path you choose, regular follow-up with a healthcare provider is essential. They can monitor your condition, adjust treatments as necessary, and provide reassurance. If you decide to pursue steroid therapy, follow the prescribed regimen closely and report any side effects or lack of improvement to your doctor.

In conclusion, while partial phimosis can be concerning, there are effective treatment options available that do not necessarily involve surgery. Topical steroids can be a viable first-line treatment, and many individuals find relief without needing circumcision. It is crucial to seek professional guidance, maintain open communication about your concerns, and prioritize your mental well-being throughout this process.

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