Pseudophimosis: When to Consider Circumcision

Pseudophimosis

Hello doctor, my situation is that when I'm not erect, sometimes the foreskin completely covers the glans, and other times it can expose about one-fifth of it.
If I manually push it back, it can fully retract (with a ring of skin accumulating at the coronal sulcus).
When erect, the glans is mostly fully exposed automatically.
The glans is not sensitive, but the area around the frenulum and the upper edge of the sulcus are quite sensitive.
Given this situation, do you recommend that I should have a slight circumcision?

Mr. X, 20~29 year old female. Ask Date: 2020/12/31

Dr. Cai Zhuorong reply Urology

If the glans is fully exposed, surgery is generally not required.

Reply Date: 2020/12/31

More Info

Pseudophimosis is a condition where the foreskin of the penis cannot be fully retracted over the glans (the head of the penis) when it is flaccid, but it can be retracted during erection. This condition can lead to discomfort, hygiene issues, and potential complications such as infections or inflammation. In your case, it seems that you experience some difficulty with retraction when flaccid, but you can fully retract the foreskin when manually assisted, and it retracts automatically during erection.

When considering whether to proceed with circumcision or any surgical intervention, several factors should be taken into account:
1. Symptoms: If you are experiencing pain, discomfort, or recurrent infections due to the inability to retract the foreskin, this may warrant surgical intervention. Since you mentioned that the glans is not sensitive, it may indicate that there is no immediate concern regarding sexual function, but sensitivity can vary among individuals.

2. Hygiene: Difficulty in retracting the foreskin can lead to poor hygiene, which increases the risk of infections such as balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin). If you find it challenging to maintain hygiene due to the pseudophimosis, this is a significant consideration for circumcision.

3. Potential for Complications: If there is a risk of paraphimosis (where the retracted foreskin cannot be returned to its original position), this can be a medical emergency. If you notice any signs of swelling or pain when the foreskin is retracted, it is crucial to seek medical attention.

4. Personal Preference: Some individuals may prefer circumcision for cultural, religious, or personal reasons. If you feel that circumcision would improve your quality of life or comfort, this is an important factor to discuss with your healthcare provider.

5. Consultation with a Specialist: It is advisable to consult with a urologist or a healthcare provider specializing in male reproductive health. They can provide a thorough examination and discuss the potential benefits and risks of circumcision based on your specific situation.

In your case, since you can fully retract the foreskin with manual assistance and it retracts during erection, it may not be an immediate necessity to undergo circumcision. However, if you are experiencing discomfort, hygiene issues, or have concerns about the sensitivity of the frenulum or the corona, discussing the option of a minor surgical procedure to shorten the foreskin or circumcision with your doctor would be prudent.

Ultimately, the decision should be made collaboratively with your healthcare provider, considering your symptoms, lifestyle, and preferences. Regular follow-up and monitoring of your condition are essential, especially if you notice any changes or new symptoms.

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