Foreskin Issues: When to Consider Surgery

Foreskin issues

Hello Doctor,
1.
After I achieve an erection, I can retract my foreskin behind the glans (though it feels somewhat tight), but if I try to retract it further, it becomes very tight and painful.
Would keeping the foreskin retracted behind the glans for an extended period help improve this issue?
2.
When my foreskin is retracted behind the glans during an erection, I can pull it back to about halfway down the shaft of the penis.
Is this normal, or do I need to consider a circumcision?
Thank you, Doctor.

Renren, 20~29 year old female. Ask Date: 2018/06/07

Dr. Du Shixi reply Urology

Hello.
1.
If the foreskin is retracted behind the glans for an extended period, can this issue improve? --> Be cautious; if circulation is compromised and it cannot be retracted, emergency surgery may be required.
2.
It depends on the individual; as long as there is no tightness, surgery is not necessarily required, although some people do opt for surgery.
Wishing you good health.

Reply Date: 2018/06/07

More Info

Understanding foreskin issues can be quite complex, and it’s essential to approach this topic with both medical knowledge and sensitivity. Your concerns about the tightness of the foreskin during an erection and the potential need for surgery are valid and deserve careful consideration.

1. Foreskin Tightness and Pain: It’s not uncommon for individuals to experience tightness in the foreskin, especially when attempting to retract it during an erection. This condition is known as phimosis, which refers to the inability to retract the foreskin fully over the glans (the head of the penis). If you find that the foreskin can retract to the glans but causes pain when attempting to retract it further, this could indicate a mild case of phimosis. Over time, some individuals may find that regular retraction (when comfortable and without pain) can help stretch the foreskin and reduce tightness. However, this should be done gently to avoid injury or pain.
It’s important to note that if the foreskin remains retracted for an extended period, it can lead to complications such as paraphimosis, where the retracted foreskin cannot return to its original position, potentially leading to swelling and pain. If you experience significant discomfort or if the tightness does not improve with gentle stretching, it would be advisable to consult a healthcare professional for further evaluation.

2. Normal Retraction of the Foreskin: The ability to retract the foreskin to the glans and then further back to halfway down the shaft of the penis can be considered within the range of normal anatomical variation. However, if this retraction is accompanied by pain or discomfort, it may warrant further investigation.
The decision to undergo circumcision or another surgical procedure often depends on several factors, including the severity of the phimosis, the presence of recurrent infections, or other complications. If the tightness is causing significant pain, recurrent infections, or impacting your quality of life, discussing surgical options with a urologist would be a prudent step.
Surgical options may include circumcision (removal of the foreskin) or a less invasive procedure called preputioplasty, which involves widening the opening of the foreskin without complete removal. The choice between these options should be made in consultation with a qualified healthcare provider, who can assess your specific situation and provide personalized recommendations.

In summary, while some tightness in the foreskin can be normal, persistent pain or difficulty with retraction should be evaluated by a healthcare professional. They can provide guidance on whether surgical intervention is necessary based on your symptoms and overall health. Always prioritize open communication with your doctor about your concerns and symptoms to ensure you receive the best possible care.

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