Foreskin Issues: Phimosis, Treatment Options, and Sexual Health

Q: Foreskin Issues: Phimosis, Treatment Options, and Sexual Health

Hello： 1) This appears to be phimosis, and the doctor may recommend surgery. <br>2) You mentioned that you saw online that by retracting the foreskin during daily showers, over time the foreskin may loosen, allowing the glans to protrude outside the foreskin during an erection—th

Foreskin issues

Hello doctor, I would like to ask a question.
When my penis is flaccid, I can retract the foreskin to the coronal sulcus, but when it is erect, I can only see the urethral opening.
Is this condition phimosis or just a long foreskin? Is circumcision absolutely necessary? Additionally, I recently learned that the foreskin can be retracted, so it feels quite tight.
I read online that I can retract the foreskin during my daily shower, and over time, it will become looser, allowing the glans to protrude beyond the foreskin when erect.
Is this method effective? Lastly, if I have symptoms of a long foreskin or phimosis but do not undergo surgical treatment, is that acceptable? Will it affect my sexual activity in the future?

Niming, 20~29 year old female. Ask Date: 2019/08/22

Dr. Du Shixi reply Urology

Hello: 1) This appears to be phimosis, and the doctor may recommend surgery.
2) You mentioned that you saw online that by retracting the foreskin during daily showers, over time the foreskin may loosen, allowing the glans to protrude outside the foreskin during an erection—this can be tried, but it is advisable to consult a doctor first.
3) Lastly, if there are symptoms of excessive foreskin or phimosis but no surgical treatment is undertaken, is that acceptable? Will it affect sexual intercourse later on? Some individuals may experience pain during erection, and if the erection cannot be retracted, the doctor will usually recommend surgery, although there are cases of patients who have not undergone surgery.
Wishing you good health.

Reply Date: 2019/08/22

More Info

When it comes to issues related to the foreskin, particularly phimosis (the inability to retract the foreskin over the glans) and concerns about sexual health, it's important to understand the anatomy and the potential implications of these conditions.
From your description, it seems that you can retract your foreskin when your penis is flaccid, but you have difficulty doing so when erect. This situation may indicate a condition known as phimosis, where the foreskin is too tight to be pulled back over the glans during an erection. Phimosis can be classified into two types: physiological (normal in infants and young boys) and pathological (occurring in older boys and men due to scarring or other issues).

Treatment Options
1. Conservative Management:
- Gentle Stretching: Some individuals find success with gentle stretching exercises. This involves gradually pulling back the foreskin during bathing or while applying a topical steroid cream prescribed by a healthcare provider. Over time, this may help loosen the foreskin.

- Hygiene: Maintaining good hygiene is crucial. Regularly cleaning the area can help prevent infections and other complications.

2. Medical Intervention:
- If conservative measures do not work, or if you experience pain, recurrent infections, or other complications, you may need to consider medical options.
- Topical Steroids: A doctor may prescribe a topical steroid cream to help soften the foreskin and make it easier to retract.

- Circumcision: In cases where phimosis is severe or recurrent infections occur, circumcision (the surgical removal of the foreskin) may be recommended. This is often seen as a definitive solution to the problem.

Concerns About Sexual Health
Regarding your concerns about sexual health and the impact of phimosis or a tight foreskin on sexual activity, it is important to note that:
- Pain During Intercourse: If the foreskin is too tight, it can lead to discomfort or pain during sexual activity. This can affect your sexual experience and may lead to anxiety or avoidance of sexual encounters.

- Erectile Function: While phimosis itself does not directly cause erectile dysfunction, the anxiety or discomfort associated with it can lead to performance issues.

- Long-term Effects: If left untreated, phimosis can lead to complications such as recurrent infections, scarring, or even paraphimosis (where the retracted foreskin cannot return to its original position), which can be a medical emergency.

Conclusion
In summary, while some individuals may manage mild cases of phimosis with stretching and good hygiene, others may require medical intervention. If you are experiencing discomfort or have concerns about how this condition may affect your sexual health, it is advisable to consult a healthcare provider, preferably a urologist. They can provide a thorough examination and discuss the best treatment options tailored to your situation.
Remember, it is essential to address these concerns proactively to maintain both your physical health and sexual well-being.

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