Phimosis: When to Consider Circumcision and Treatment Options

Q: Phimosis: When to Consider Circumcision and Treatment Options

Hello： The costs vary by hospital, generally ranging from a few thousand to not exceeding ten thousand. <br>Recovery may take about two weeks. <br>Since your weight is relatively important, it is advisable to consult the urology department at the hospital to determine when surger

Doctor, I have phimosis?

Doctor, I would like to inquire.
I am almost 23 years old, overweight, weighing 123 kg and standing 172 cm tall.
Since childhood, I have felt that my penis is different from others, and later I found out that I have phimosis.
I now want to retract the foreskin, but I cannot pull it down.
When I try to retract it, I feel pain and cannot expose the glans.
Does this mean I need a circumcision? Additionally, I sometimes feel like I haven't fully emptied my bladder after urinating, and I often feel the urge to urinate again.
Sometimes, I even leak urine onto my pants, which is quite distressing.
Should I see a doctor? Since I live in Hsinchu County, the only hospitals I can go to are the Veterans General Hospital in Zhudong and National Taiwan University Hospital in Zhudong.
The hospitals in Hsinchu City have a high patient volume daily.
Which hospital would be better for me to visit? Also, if I do need a circumcision, what is the typical cost of the surgery? How long is the recovery period? Thank you, doctor.

Huang Yao, 20~29 year old female. Ask Date: 2017/09/15

Dr. Du Shixi reply Urology

Hello: The costs vary by hospital, generally ranging from a few thousand to not exceeding ten thousand.
Recovery may take about two weeks.
Since your weight is relatively important, it is advisable to consult the urology department at the hospital to determine when surgery can be performed.
You might consider National Taiwan University Hospital in Hsinchu.
Wishing you good health.

Reply Date: 2017/09/15

More Info

Phimosis is a condition where the foreskin of the penis cannot be easily retracted over the glans (the head of the penis). This can lead to discomfort, hygiene issues, and urinary problems, as you've described. Given your symptoms, including pain when attempting to retract the foreskin, feelings of incomplete urination, and occasional dribbling, it is advisable to seek medical attention.

When to Consider Circumcision
Circumcision is often considered when:
1. Severe Phimosis: If the foreskin cannot be retracted at all, or if retraction causes significant pain, circumcision may be recommended.

2. Recurrent Infections: If you experience recurrent urinary tract infections or balanitis (inflammation of the glans), circumcision can help reduce these occurrences.

3. Hygiene Issues: Difficulty maintaining proper hygiene due to phimosis can lead to infections and other complications.

4. Urinary Problems: If you have issues with urination, such as dribbling or a feeling of incomplete voiding, these can be exacerbated by phimosis.

Treatment Options
1. Topical Steroid Creams: In some cases, a doctor may prescribe a topical steroid cream to help loosen the foreskin. This can be effective for mild cases of phimosis.

2. Stretching Exercises: Gentle stretching of the foreskin over time may help in some cases, but this should be done under the guidance of a healthcare provider to avoid injury.

3. Circumcision: If conservative treatments are ineffective, circumcision is a definitive solution. This surgical procedure involves the removal of the foreskin and is typically performed under local or general anesthesia.

Consultation and Hospital Choice
Given your location in Hsinchu County, you have two hospital options: Zhu Dong Veterans Hospital and Zhu Dong National Taiwan University Hospital. Both are reputable facilities, but you may want to consider:
- Zhu Dong Veterans Hospital: Known for its comprehensive care and potentially shorter wait times for certain procedures.

- Zhu Dong National Taiwan University Hospital: A larger facility with a wide range of specialists, which may be beneficial if you require further evaluations or treatments.

It may be wise to call ahead and inquire about the availability of urology specialists and the average wait times for appointments.

Cost and Recovery
The cost of circumcision can vary widely based on the hospital, the complexity of the procedure, and whether you have insurance coverage. In Taiwan, the out-of-pocket cost for circumcision can range from NT$10,000 to NT$30,000 or more, depending on the facility and whether it is performed as an outpatient procedure or requires an overnight stay.

The recovery period typically lasts about one to two weeks, during which you may experience some discomfort and swelling. It's important to follow post-operative care instructions to ensure proper healing and to minimize the risk of complications.

Conclusion
Given your symptoms and the impact they have on your quality of life, it is advisable to consult a urologist. They can provide a thorough evaluation and discuss the best treatment options for your situation. Don't hesitate to seek help; addressing these issues can significantly improve your comfort and well-being.

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