Foreskin Issues: When to Consider Circumcision?

Q: Foreskin Issues: When to Consider Circumcision?

Hello： According to the description, surgery is not necessary unless cleanliness and dryness cannot be maintained. <br>Circumcision may facilitate better hygiene. <br>Areas that cannot be cleaned properly can be soaked in warm water; if that still does not help, it is advisable t

Issues related to the foreskin?

I would like to ask the doctor, my foreskin can be manually retracted, but the glans does not emerge during an erection.
I want to know if this situation requires a circumcision.
Also, since I didn't have much knowledge about this, I only started retracting it for cleaning in my first year of high school, and it has become much cleaner since then.
However, there is still a white residue at the tip that I can't seem to wash away.
I've tried pushing it with my fingers, but it's still difficult to remove.
Do you have any suggested methods?

K, 10~19 year old female. Ask Date: 2023/07/17

Dr. Du Shixi reply Urology

Hello: According to the description, surgery is not necessary unless cleanliness and dryness cannot be maintained.
Circumcision may facilitate better hygiene.
Areas that cannot be cleaned properly can be soaked in warm water; if that still does not help, it is advisable to seek medical attention.
It is important to keep the area dry.
Wishing you good health.

Reply Date: 2023/07/17

More Info

When it comes to foreskin issues, particularly regarding whether circumcision is necessary, there are several factors to consider. Your situation, where the foreskin can be manually retracted but does not fully retract during an erection, is known as a condition called phimosis. Phimosis can be physiological (normal in young boys) or pathological (caused by scarring or other issues).
In your case, since you are able to retract the foreskin manually, it suggests that you do not have a complete phimosis. However, if the foreskin does not retract during an erection, it could lead to discomfort or complications such as pain during intercourse, inflammation, or infections. The presence of a white substance that is difficult to clean could indicate smegma, which is a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin. While some accumulation is normal, excessive smegma can lead to hygiene issues and potential infections.

Here are some recommendations:
1. Hygiene Practices: It’s essential to maintain good hygiene. Gently retract the foreskin during bathing to clean the area with mild soap and water. Avoid using harsh soaps or scrubbing too hard, as this can irritate the sensitive skin.

2. Consult a Urologist: If you continue to experience difficulty with retraction during an erection or if you have persistent issues with smegma, it would be wise to consult a urologist. They can assess whether there are any underlying conditions that need to be addressed.

3. Consider Circumcision: Circumcision is a surgical procedure that removes the foreskin. It is typically considered when there are recurrent infections, significant phimosis that causes pain or discomfort, or if the individual prefers the procedure for personal or cultural reasons. A urologist can help you weigh the pros and cons based on your specific situation.

4. Non-Surgical Options: In some cases, topical steroid creams can help loosen the foreskin and allow for easier retraction. This is usually a less invasive option compared to circumcision and can be discussed with your healthcare provider.

5. Monitoring Symptoms: Keep an eye on any symptoms such as pain, swelling, or recurrent infections. If you experience these, it’s essential to seek medical advice promptly.

In summary, while your ability to retract the foreskin manually is a positive sign, the inability to do so during an erection and the presence of smegma warrant further evaluation. Consulting with a urologist will provide you with tailored advice and help determine whether circumcision or other treatments are appropriate for your situation. Remember, maintaining good hygiene and monitoring your symptoms are crucial steps in managing foreskin issues effectively.

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