Phimosis, Sebaceous Cysts, and Keloid Concerns in Urology

Q: Phimosis, Sebaceous Cysts, and Keloid Concerns in Urology

Hello： 1) It's about the same, just a matter of being more or less obvious. <br>2) No. <br>3) Because the temperature here is relatively high and humid, it's better for pants (including underwear) to be looser. <br>4) If you have a tendency for keloids, be cautious with larger wo

Sebaceous gland acne, keloid, circumcision?

I previously visited a urology clinic, and my main symptoms are: 1.
Phimosis (the foreskin can be easily retracted both when flaccid and erect).
2.
Due to excessive sebaceous gland secretion, there are many small white bumps on the foreskin.
I have the following questions: 1.
The doctors have said that these small bumps will not improve and cannot be treated with laser or other methods; the only solution is circumcision (these bumps are located in a ring under the frenulum).
Is this true? (Because there are indeed many of these bumps, and they are quite unsightly.) 2.
The doctors mentioned that this is a type of chronic inflammation.
Does this mean that I meet the criteria for circumcision? 3.
I open the foreskin and wash it daily.
I do not understand whether these bumps caused by sebaceous gland secretion are normal or if they may have developed due to my phimosis and possibly inadequate cleaning.
4.
When I was younger, I had growths on my face, and the doctor said I had keloid tendency, but they disappeared on their own after a while.
To this day, there has been no keloid formation at the vaccination site on my arm or at the site of previous surgeries.
I asked the doctors if I could undergo laser circumcision despite the potential for keloid formation, and they all said it would be fine.
What do you think about proceeding with the circumcision?

Nìngmíng, 10~19 year old female. Ask Date: 2019/07/04

Dr. Du Shixi reply Urology

Hello: 1) It's about the same, just a matter of being more or less obvious.
2) No.
3) Because the temperature here is relatively high and humid, it's better for pants (including underwear) to be looser.
4) If you have a tendency for keloids, be cautious with larger wounds.
It's best to avoid them if not necessary.
Wishing you good health.

Reply Date: 2019/07/04

More Info

Phimosis, sebaceous cysts, and keloid concerns are important topics in urology, particularly when they affect the genital area. Let's break down your questions and concerns regarding these conditions.

1. Sebaceous Cysts and Treatment Options: The small white bumps you are observing on your foreskin are likely sebaceous cysts, which are caused by the accumulation of sebum (oil) from sebaceous glands. These cysts are generally benign and do not pose a health risk. However, they can be bothersome aesthetically. Your doctor’s recommendation to consider circumcision as the only treatment option is not uncommon, especially if the cysts are numerous and causing discomfort or hygiene issues. While laser treatment is sometimes used for various skin conditions, it is not typically effective for sebaceous cysts, and surgical removal is often the most definitive solution. If the cysts are symptomatic or recurrent, circumcision may indeed be warranted.

2. Chronic Inflammation and Circumcision: Chronic inflammation of the foreskin can lead to conditions such as balanitis or posthitis, which may justify circumcision. If your doctor has indicated that the inflammation is significant and recurrent, this could meet the criteria for surgical intervention. Circumcision can help alleviate these symptoms by removing the inflamed tissue and reducing the risk of future infections.

3. Hygiene and Sebaceous Gland Activity: It is good to hear that you are maintaining proper hygiene by retracting the foreskin and cleaning the area. However, the presence of these cysts is not solely due to poor hygiene; they can occur in individuals regardless of their cleaning habits. Phimosis, or the inability to retract the foreskin fully, can contribute to the accumulation of smegma (a combination of dead skin cells and oils), which may exacerbate the appearance of these cysts. Regular cleaning is essential, but if the foreskin is too tight, it may still lead to issues.

4. Keloid Concerns and Surgical Options: Keloids are a type of raised scar that can occur after skin injury. If you have a history of keloid formation, it is understandable to be concerned about potential scarring from circumcision. However, many surgeons are experienced in performing circumcisions on patients with keloid tendencies and can take precautions to minimize the risk of keloid formation. It is essential to discuss your history with your surgeon, as they may recommend specific techniques or post-operative care to reduce the likelihood of keloids.

In summary, your concerns about phimosis and sebaceous cysts are valid, and circumcision may be a suitable option for you, especially if the cysts are numerous and causing discomfort. It is crucial to have an open discussion with your urologist about your symptoms, hygiene practices, and any concerns regarding keloid formation. They can provide personalized recommendations based on your medical history and the severity of your condition. If you feel uncertain about the proposed treatment, seeking a second opinion from another urologist may also be beneficial.

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