Phimosis: When Is Foreskin Considered Too Long?

Issues related to the foreskin?

I have always had a question about what exactly is phimosis.
I have read a lot of information and answers from many doctors, but I still can't seem to understand it clearly.
My understanding is that if the foreskin can retract to the coronal ridge when the penis is erect, it is not considered phimosis, right? I have seen male actors in adult films where the entire glans is exposed, and I wonder if that is considered normal.
If, when erect, only the tip of the glans is visible and there is pain when trying to retract the foreskin, does that mean I need a circumcision? If I don't get circumcised, will it affect my sexual activity or fertility?

Adi, 20~29 year old female. Ask Date: 2003/07/17

Dr. Xu Weikai reply Urology

1.
The term "phimosis" does not have a clear definition.
Some physicians believe that if the foreskin still covers the entire glans during an erection, it is considered too long.
Others think that covering even a small part of the glans during an erection is excessive.
Personally, I believe that the length of the foreskin is not important; what matters is: (1) the ability to maintain cleanliness, and (2) whether it interferes with sexual intercourse.
As for male actors in adult films, many may have undergone surgery or screening, which is why their appearance is more aesthetically pleasing.

2.
When is surgery necessary? A.
Recurrent sexual infections B.
Presence of a tight band of foreskin C.
Difficulty in maintaining cleanliness D.
Fibrosis of the foreskin E.
Suspected malignant changes.

3.
Not undergoing circumcision does not have an absolute impact on sexual function or fertility.

Reply Date: 2003/07/17

More Info

Phimosis is a condition characterized by the inability to retract the foreskin over the glans (the head of the penis). It can be classified into two types: physiological phimosis, which is common in infants and young boys and usually resolves naturally as they grow older, and pathological phimosis, which occurs when the foreskin becomes tight due to scarring or inflammation.

To determine whether your foreskin is considered "too long," it is essential to understand the anatomy and function of the foreskin. In a healthy male, the foreskin should be able to retract fully over the glans when the penis is erect. If the foreskin does not retract and causes discomfort or pain, especially during sexual activity or when attempting to clean the area, it may indicate a problem.

In your case, if you can only expose the tip of the glans when the penis is erect and experience pain when attempting to retract the foreskin, this could be a sign of phimosis. The pain you describe when trying to pull back the foreskin is particularly concerning, as it suggests that there may be an underlying issue, such as inflammation or scarring.

Regarding your concerns about sexual function and fertility, phimosis can potentially impact both. If the foreskin is too tight, it may lead to discomfort during intercourse, which can affect sexual performance and satisfaction. Additionally, if proper hygiene is not maintained due to difficulty retracting the foreskin, it could increase the risk of infections, which might indirectly affect fertility.

In terms of treatment, circumcision is one option that many consider when phimosis causes significant problems. However, it is not the only solution. Some men may benefit from topical steroid creams that can help loosen the foreskin, allowing for easier retraction. Stretching exercises may also be recommended to gradually increase the foreskin's elasticity.
If you are experiencing pain or discomfort, it is crucial to consult a healthcare professional, such as a urologist. They can provide a thorough examination and discuss the best treatment options tailored to your specific situation. It is essential not to self-diagnose or self-treat, as this could lead to complications or worsening of the condition.

In summary, phimosis is defined by the inability to retract the foreskin, and whether it is considered "too long" depends on the ability to expose the glans without pain. If you are experiencing discomfort, it is advisable to seek medical advice to explore your options and ensure your sexual health and overall well-being are maintained.

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