Phimosis and Its Symptoms: When to Seek Medical Help

Phimosis??

Hello, doctor: I have some questions to ask you.
Normally, my foreskin covers the glans, but when I have an erection, the glans still does not naturally expose itself.
Is this a case of phimosis or just a long foreskin? Additionally, when I try to retract the foreskin with my hand, I can only pull it back to halfway down the glans and cannot push it further.
Sometimes, I notice a smell that resembles urine; could this be smegma? I do try to clean it daily, but as I mentioned, I can only pull it back to halfway down the glans, and I am hesitant to clean too vigorously because it feels somewhat… I’m not sure if it’s pain or just sensitivity.
What should I do? Is surgery absolutely necessary? Should I see a doctor for an examination first? The last time I saw a doctor, he only looked at how far I could retract the foreskin and suggested that surgery would be better.
Should I go see another doctor? Also, sometimes when I touch my testicles, they feel equal in size, but after masturbation, I sometimes feel pain, and it seems like the left testicle feels a bit strange?

Taiyang Shen, 20~29 year old female. Ask Date: 2004/02/08

Dr. Lai Ronghao reply Urology

Director Zhang Jianghu respectfully responds.

Reply Date: 2004/02/08

More Info

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). It can be classified into two types: physiological phimosis, which is common in infants and usually resolves naturally as they grow, and pathological phimosis, which occurs when the foreskin becomes too tight due to scarring or inflammation.
From your description, it seems that you may be experiencing symptoms of pathological phimosis. The fact that your foreskin covers the glans even during an erection and that you can only retract it partially suggests that the foreskin is indeed too tight. The presence of a foul odor, which you mentioned resembles urine, could indicate the accumulation of smegma, a combination of dead skin cells, oils, and moisture that can build up under the foreskin if it cannot be retracted fully for cleaning. This accumulation can lead to irritation and infection if not addressed.

It is important to seek medical help in your situation. A healthcare professional, preferably a urologist, can provide a thorough examination and determine the best course of action. They may recommend conservative treatments, such as topical steroid creams that can help loosen the foreskin, or they may suggest surgical options like circumcision or preputioplasty if the condition is severe.
Surgery is not always necessary, and many cases of phimosis can be managed with non-invasive treatments. However, if your symptoms are causing pain, discomfort, or recurrent infections, surgery may be the most effective solution.
Regarding your concerns about your testicles, it is not uncommon for one testicle to feel different from the other, especially after ejaculation. However, if you are experiencing persistent pain or noticeable changes in size or shape, it is crucial to have this evaluated by a doctor. Testicular pain can arise from various conditions, including infections, torsion, or even hernias, and should not be ignored.

In summary, I recommend the following steps:
1. Schedule an appointment with a urologist: They can provide a comprehensive evaluation of your phimosis and any concerns regarding your testicles.

2. Discuss your symptoms openly: Be honest about the pain, sensitivity, and any odors you are experiencing. This information will help the doctor make an informed diagnosis.

3. Follow medical advice: Depending on the diagnosis, follow the recommended treatment plan, whether it involves topical treatments, surgical options, or further evaluations.

4. Maintain hygiene: Continue to clean the area gently, but avoid forcing the foreskin back if it causes pain. Proper hygiene can help prevent infections and manage any unpleasant odors.

5. Monitor your symptoms: Keep track of any changes in your condition, including pain levels, changes in the appearance of the foreskin or testicles, and any new symptoms that may arise.

Taking these steps will help you address your concerns effectively and ensure that you receive the appropriate care for your condition.

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