Balanitis and Challenges with Retracting the Foreskin

Q: Balanitis and Challenges with Retracting the Foreskin

Hello： 1) Correct. <br>2) 15 minutes should be sufficient. <br>3) Gently push down, do not rush, a little each day; otherwise, the foreskin opening may tear, and if the glans comes into contact, it may cause abrasions. <br>4) Drinking plenty of water is beneficial; it will be les

Regarding balanitis and phimosis?

I experienced some frequent urination along with a slight itch in the urethra, but my urinalysis results were normal.
Today, the doctor pondered for a while and suddenly asked me to retract my foreskin, which led to the discovery of my symptoms: 1.
I can only retract the foreskin to about 1/32 to 1/3 of the glans, and I noticed smegma, suggesting there may be more below that I cannot reach.
2.
I should not be experiencing urethral itching, but rather itching inside the glans, likely indicating balanitis.
Consequently, he prescribed topical medication and oral anti-inflammatory medication.
He advised me to try to retract the foreskin daily, clean off the smegma, and then apply the medication.
If I am unable to fully retract it in a few weeks, circumcision may need to be considered.

Questions:
1.
Since I am currently unable to fully retract it, should I just slowly retract it a little each day and apply the medication where I can reach?
2.
How long after applying the medication can I urinate? I am concerned that urination might wash away the ointment.

3.
Do you have any tips for retracting the foreskin? (Okay, I admit this might be a personal issue, and it feels a bit odd to ask a doctor.)
4.
Since it is likely not urethritis, should I still increase my fluid intake? (Will frequent urination potentially irritate the inflamed glans?) Thank you, doctor!

Xiao Ming, 10~19 year old female. Ask Date: 2019/06/13

Dr. Du Shixi reply Urology

Hello: 1) Correct.
2) 15 minutes should be sufficient.
3) Gently push down, do not rush, a little each day; otherwise, the foreskin opening may tear, and if the glans comes into contact, it may cause abrasions.
4) Drinking plenty of water is beneficial; it will be less irritating if there are any wounds.
Wishing you good health.

Reply Date: 2019/06/13

More Info

Balanitis, an inflammation of the glans penis, can often be associated with issues related to the foreskin, particularly in individuals who have difficulty retracting it. Your symptoms, including frequent urination and itching, suggest that you might be experiencing a combination of balanitis and possibly smegma accumulation due to the inability to fully retract the foreskin. This condition can lead to discomfort and may require careful management.

1. Daily Retraction and Cleaning: Since you are currently unable to fully retract your foreskin, it is advisable to gently attempt to retract it a little each day. This gradual approach can help you become more comfortable with the process and may eventually allow for full retraction. When you do manage to retract the foreskin, it is important to clean the area thoroughly to remove smegma, which can contribute to irritation and inflammation. After cleaning, apply the topical medication as prescribed by your doctor.
2. Timing for Urination: After applying the topical medication, it is generally safe to urinate. However, to ensure that the medication has time to absorb and provide relief, you might want to wait for about 30 minutes to an hour before urinating. This will help minimize the risk of washing away the medication. If you feel the need to urinate sooner, do so, but be mindful of the application process.

3. Techniques for Retraction: When attempting to retract the foreskin, ensure that your hands are clean to prevent introducing any bacteria. You can try using a gentle, steady motion to pull back the foreskin. If you experience pain or resistance, do not force it, as this can lead to further irritation or injury. Over time, with consistent gentle attempts, you may find it easier to retract the foreskin. If you encounter significant difficulty or pain, it may be beneficial to consult your healthcare provider for further evaluation.

4. Hydration and Urination: While staying hydrated is generally beneficial for urinary health, excessive urination may irritate an inflamed glans. It is essential to find a balance. Drinking enough water can help dilute urine, which may reduce irritation when you do urinate. However, if you notice that frequent urination exacerbates your symptoms, you may want to moderate your fluid intake slightly until the inflammation subsides.

In conclusion, managing balanitis and foreskin retraction challenges requires patience and a gentle approach. Follow your doctor's instructions regarding medication application and cleaning, and take your time with the retraction process. If symptoms persist or worsen, or if you are unable to achieve full retraction after a few weeks, it may be necessary to discuss further treatment options, including the possibility of circumcision, with your healthcare provider. This condition is not uncommon, and with proper care, you can improve your symptoms and overall comfort.

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