Phimosis: When to Consider Circumcision for Relief

Q: Phimosis: When to Consider Circumcision for Relief

Hello： It is likely adhesions or scar formation. <br>I recommend seeing a doctor to determine the situation. <br>If it is scar tissue, surgery may be necessary. <br>Wishing you good health.

Concerns about circumcision?

Hello Doctor, during my last visit to the hospital, I received some medication to apply around the glans, and the pain has resolved after resting for several days.
However, when I tried to retract the foreskin myself, I found that it no longer retracts completely as it used to.
When erect, I can retract the foreskin to expose the glans, but it only goes as far as the coronal sulcus.
The glans is fully visible, but the remaining foreskin cannot be retracted further down.
Attempting to retract it forcefully causes pain, and when not erect, I can retract the foreskin completely.
I initially thought it was due to insufficient lubrication or moisture.
I also tried retracting it while showering, but it still only goes to the coronal sulcus.
This has caused issues with using condoms, as the foreskin does not retract fully and gets stuck.
I would like to ask the doctor if this situation means I will need a circumcision in the future, or if there are any methods to restore the ability to retract the foreskin completely as before?

Mr. Zheng, 20~29 year old female. Ask Date: 2019/02/10

Dr. Du Shixi reply Urology

Hello: It is likely adhesions or scar formation.
I recommend seeing a doctor to determine the situation.
If it is scar tissue, surgery may be necessary.
Wishing you good health.

Reply Date: 2019/02/10

More Info

Phimosis is a condition where the foreskin cannot be fully retracted over the glans (the head of the penis). This can lead to discomfort, difficulty with hygiene, and complications during sexual activity. In your case, it seems that you are experiencing a form of phimosis where the foreskin can retract partially but not fully, which can be uncomfortable and may lead to issues with using condoms effectively.

When considering treatment options for phimosis, it is essential to evaluate the severity of the condition and the symptoms you are experiencing. In mild cases, conservative treatments may be effective. These can include:
1. Topical Steroid Creams: Applying a steroid cream to the foreskin can help reduce inflammation and increase elasticity, making it easier to retract the foreskin over time. This method is often recommended for children and adolescents with phimosis.

2. Gentle Stretching Exercises: Gradually and gently stretching the foreskin can sometimes help. This should be done carefully to avoid pain or injury. It is advisable to do this after a warm bath when the skin is more pliable.

3. Improved Hygiene: Maintaining good hygiene can help prevent infections and irritation, which can exacerbate phimosis. Ensure that the area is cleaned gently but thoroughly.

However, if these conservative measures do not provide relief or if the phimosis is causing significant discomfort, recurrent infections, or complications during sexual activity, circumcision may be considered. Circumcision is a surgical procedure that involves the removal of the foreskin and can provide a permanent solution to phimosis. It is typically recommended in the following situations:
- Severe Phimosis: When the foreskin cannot be retracted at all, or if it causes pain during erections.

- Recurrent Infections: If you experience frequent infections or inflammation of the glans (balanitis) due to the inability to retract the foreskin.

- Impact on Sexual Activity: If phimosis interferes with sexual function or the use of condoms, as you mentioned.

Before making a decision, it is crucial to consult with a urologist or a healthcare provider who specializes in male reproductive health. They can assess your specific situation, discuss the potential benefits and risks of circumcision, and explore other treatment options that may be appropriate for you.

In summary, while there are non-surgical options available for managing phimosis, if these do not resolve the issue or if you are experiencing significant discomfort, circumcision may be a viable option. It is essential to have an open discussion with your healthcare provider to determine the best course of action based on your symptoms and lifestyle.

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