Foreskin Issues: When to Seek Urological Help

Q: Foreskin Issues: When to Seek Urological Help

Hello： 1) It is recommended to clean in multiple sessions for 1-2 minutes each time, as excessive cleaning can cause redness and swelling. <br>Generally, it is manageable, but most people may feel anxious. <br>The next day, rinse with water and pat dry; gradual improvement is bet

The foreskin nearly got stuck?

Hello, Doctor Du.
About two to three weeks ago, I visited a urologist regarding a small pimple on my penis and whether I needed a circumcision.
The doctor said it was sebaceous secretion and advised me to ignore it unless it grew larger.
He also inquired about my erection and, after retracting my foreskin, mentioned that it was a bit long but not enough to require circumcision.
However, he advised me to clean the area as there was too much smegma.
Recently, I have been following his advice to clean it.
While showering, I finally managed to retract the foreskin and noticed quite a bit of smegma.
I used a water stream to rinse some of it off, but I was worried about retracting it for too long, so I pushed it back.
I did manage to pull it down again slowly, but halfway through rinsing, I thought it might be too stimulating, so I decided to continue tomorrow.
After rinsing, I noticed that the glans appeared slightly red or pink, and I'm unsure if it was like that before.
Suddenly, I felt like it got stuck in a groove, making it difficult to retract as easily as before.
I became quite anxious and tried to pull it back gently with both hands, but it wouldn’t budge.
After about a minute of tension, I continued to rinse with warm water, and with my left hand at an awkward angle, I managed to push it back.
I was hesitant to retract it further for cleaning.
I would like to ask if it is necessary for me to visit a major hospital's urology department tomorrow.
Currently, I have no symptoms, but I would only be able to mention that I almost got stuck yesterday.
Is it common for something to get stuck for a minute or so to cause any penile necrosis? At that moment, I noticed the foreskin had turned red, and it is still slightly red now, but the appearance of the penis seems the same, and I have pushed the foreskin back.
However, there is a slight pain at the tip of the foreskin, and I am unsure if it is due to the repeated pushing and pulling.
I only applied a bit of ointment, fearing there might be a tear.
Lastly, I would like to know if this situation is considered normal, even though it doesn’t happen often.
Why did it suddenly get stuck in a groove, and could it be due to the natural anatomy of the glans being wider in certain areas?
If I notice anything unusual in the next couple of days, should I seek medical attention or go to the emergency room? I found some news online about people getting stuck and experiencing swelling and discoloration, but since I managed to retract it, does that mean I have avoided a crisis? I apologize for disturbing your rest at night, but since my father is not home and my mother is unsure, she just said that since I managed to retract it and the appearance seems fine, I should be okay.
The pain might be due to my own pulling.
I apologize for the lengthy message, but this is my first experience with such a situation, and I was really scared during the shower, thinking I might need to go to the emergency room if I couldn’t retract it.
Now that I have managed to do so, I am still worried about whether there is any danger and if I should go to the hospital in the next couple of days.
I hope to get the correct information and advice from you before deciding whether to seek medical attention.
If I wake up tomorrow and notice any discoloration of the penis, I will definitely go to a major hospital immediately.

Lin, 20~29 year old female. Ask Date: 2020/05/27

Dr. Du Shixi reply Urology

Hello: 1) It is recommended to clean in multiple sessions for 1-2 minutes each time, as excessive cleaning can cause redness and swelling.
Generally, it is manageable, but most people may feel anxious.
The next day, rinse with water and pat dry; gradual improvement is better.
2) How could it suddenly get stuck in a fold or almost not return? This is likely due to the anatomical structure of the glans, which has a naturally wider area.
The reason for infrequent cleaning is often due to some adhesion, which can create resistance when trying to push it back.
A few more attempts should help (as the doctor noted, there is no significant issue).
3) If I notice something unusual within a day or two, should I seek medical attention or go to the emergency room? I found online reports of cases where individuals got stuck and experienced swelling and discoloration.
Now that I have managed to pull it back, am I out of danger? I apologize for disturbing your rest at night, but since my dad is not home and my mom is unsure, she just said that since I pulled it back and the appearance seems fine, it should be okay.
The pain I feel might be due to my own pulling.
--> If you have successfully pulled it back, there should be no problem.
There may be minor abrasions causing pain.
It is advisable to clean during the day.
If it does get stuck, seek medical attention (which is generally uncommon).
If it gets stuck and cannot be pushed back, doctors will usually be able to reposition it.
However, if this happens repeatedly, the doctor may recommend circumcision.
The key is to proceed gradually, keep it dry, and rinse with warm water.
If there is redness underneath, it may indicate a skin tear, so avoid being too forceful.
Do not take too long; if the area of redness is extensive, seek medical attention.
If there is any bleeding, it is essential to go to the hospital.
Wishing you good health.

Reply Date: 2020/05/27

More Info

When it comes to foreskin issues, particularly those involving tightness or difficulty retracting the foreskin (a condition known as phimosis), it's essential to understand the potential implications and when to seek medical help. Based on your description, it seems you experienced some discomfort and difficulty while cleaning under the foreskin, which can be a common concern for many men.

First and foremost, it's important to note that the foreskin is designed to cover the glans (the head of the penis) and can sometimes be tight, especially in younger individuals. In adults, if the foreskin is too tight, it can lead to complications such as pain, inflammation, or infection. Your urologist's advice to clean under the foreskin regularly is crucial, as this helps prevent the buildup of smegma, which can lead to irritation or infection.

From your account, it sounds like you experienced a moment of panic when you felt the foreskin was stuck. This can happen if the foreskin is pulled back too forcefully or if there is a natural anatomical constriction. The redness you observed after cleaning could be a result of irritation from the cleaning process, especially if you were pulling on the foreskin more than usual. It's not uncommon for the area to appear slightly red or inflamed after such an event, but this should resolve with gentle care.

Regarding your concerns about potential injury or necrosis (tissue death) due to the brief period of tightness, it is unlikely that a couple of minutes of being stuck would cause significant harm, especially if you were able to retract the foreskin without excessive force. The penis has a good blood supply, and while any prolonged constriction can lead to issues, a short duration typically does not result in serious complications. However, if you notice any significant changes in color (such as darkening or persistent redness), swelling, or if you experience severe pain, it would be prudent to seek medical attention.

As for your question about whether this situation is normal, many men experience similar issues at some point, especially if they have a longer foreskin or if they are not accustomed to retracting it. The anatomy of the penis can indeed have variations, and some men may have a natural "tight spot" where the foreskin can get caught. This is not necessarily a cause for alarm, but it is essential to be mindful of how you clean and handle the area to avoid discomfort.

If you continue to experience pain, swelling, or any other concerning symptoms, or if you find that the foreskin becomes difficult to retract again, it would be wise to consult a urologist. They can assess your situation more thoroughly and provide guidance on whether any further intervention, such as circumcision or other treatments, is necessary.

In summary, while your experience sounds alarming, it is not uncommon, and it seems you have managed to resolve the immediate issue. Continue to monitor your symptoms, practice gentle cleaning, and do not hesitate to seek medical advice if you notice any persistent or worsening symptoms. Your health and comfort are paramount, and a urologist can provide the best guidance tailored to your specific situation.

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