Phimosis: Treatment Options and Insights for Patients

Phimosis issue

Doctor, I originally had not been able to retract my foreskin before the second year of high school (I remember it was a bit difficult to pull down even when not erect).
Later, I used a medication called Clobetasol ointment, and when I was erect, it could fully retract below the glans, but it still feels a bit tight (my body is relatively stocky).
Will continued application of the ointment be effective?

K, 10~19 year old female. Ask Date: 2022/01/17

Dr. Chen Jiansheng reply Urology

Please schedule a medical examination.

Reply Date: 2022/01/17

More Info

Phimosis is a condition characterized by the inability to retract the foreskin over the glans (head) of the penis. It can be a source of discomfort and can lead to complications if not addressed properly. Understanding the treatment options and insights for patients dealing with phimosis is essential for managing this condition effectively.

Treatment Options for Phimosis
1. Topical Steroid Creams: One of the most common non-surgical treatments for phimosis involves the use of topical steroid creams, such as betamethasone or clobetasol. These creams can help to soften and stretch the foreskin, making it easier to retract. It seems you have been using a medication called "臨得隆" (likely a topical steroid), which can be effective. It is important to apply the cream as directed, typically twice daily for a few weeks, and to gently attempt to retract the foreskin during this time.

2. Gentle Stretching Exercises: Along with the use of topical steroids, gentle stretching exercises can be beneficial. This involves gradually pulling back the foreskin during bathing or while applying the cream. It is crucial to be gentle to avoid causing pain or injury.

3. Circumcision: If conservative treatments fail or if phimosis is causing significant discomfort, recurrent infections, or other complications, circumcision may be recommended. This surgical procedure involves the removal of the foreskin and is considered a definitive treatment for phimosis.

4. Preputioplasty: This is a less invasive surgical option that involves making small incisions in the foreskin to widen it without removing it entirely. This can be a suitable option for those who wish to retain their foreskin.

Insights for Patients
- Patience is Key: Treatment for phimosis, especially with topical steroids and stretching, can take time. It may take several weeks to notice significant improvement, so patience and adherence to the treatment regimen are essential.

- Consultation with a Specialist: If you are not seeing improvement with topical treatments, or if you have concerns about the tightness of your foreskin, it is advisable to consult a urologist. They can provide a thorough examination and discuss the best treatment options tailored to your specific situation.

- Avoid Forceful Retraction: It is crucial not to forcefully retract the foreskin, as this can lead to pain, tearing, and scarring, which may worsen the condition.

- Monitor for Symptoms: Keep an eye out for any signs of infection, such as redness, swelling, or discharge. If you experience these symptoms, seek medical attention promptly.

- Emotional and Psychological Considerations: Phimosis can sometimes lead to anxiety or embarrassment, especially in adolescents. It is important to discuss any feelings or concerns with a trusted adult or healthcare provider.

In conclusion, while phimosis can be a challenging condition, there are effective treatment options available. Continued use of topical medications, combined with gentle stretching, can often lead to improvement. If conservative measures do not yield results, surgical options are available. Always consult with a healthcare professional for personalized advice and treatment plans.

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