Do I Need Circumcision for My Phimosis? the Risks and Solutions

Circumcision issues?

Hello! I have a problem with phimosis.
When I am erect, only 1/4 of the glans is exposed, and I feel pain when trying to retract the foreskin.
When I retract the foreskin when not erect, I notice that part of the foreskin is connected to the glans.
Do I definitely need a circumcision? Will there be any issues during vaginal intercourse? Could the foreskin cause pain that prevents penetration? Thanks.

hihi nǐ hǎo, 10~19 year old female. Ask Date: 2004/02/12

Dr. Cai Bingkun reply Urology

Phimosis, also known as excessive foreskin, occurs when the foreskin completely covers the glans and cannot be retracted beyond the coronal sulcus, exposing the glans.
In cases of incomplete phimosis, the foreskin can be retracted, and as long as personal hygiene is maintained daily, surgical intervention is not necessary.
However, if you experience pain and are unable to retract the foreskin, this indicates complete phimosis, and a circumcision is recommended.
The decision to undergo surgery does not affect sexual activity, but it is a matter of personal hygiene for both the individual and their sexual partner.

Reply Date: 2004/02/12

More Info

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). This can lead to discomfort, pain during erections, and potential complications during sexual activity. Your description indicates that you are experiencing pain when attempting to retract the foreskin, especially during an erection, and that part of the foreskin is adherent to the glans. This situation can indeed raise concerns regarding sexual function and overall penile health.

Do You Need Circumcision?
Circumcision is one of the treatment options for phimosis, especially when it causes significant discomfort or functional issues. However, it is not the only option. Here are some considerations:
1. Severity of Symptoms: If your phimosis is causing pain during erections or interfering with sexual activity, circumcision may be recommended. Pain during erections can indicate that the condition is severe enough to warrant surgical intervention.

2. Non-Surgical Options: Before considering circumcision, there are non-surgical treatments available. These may include:
- Topical Steroid Creams: Applying a steroid cream to the foreskin can help reduce inflammation and allow for easier retraction over time.

- Gentle Stretching Exercises: Gradually stretching the foreskin can sometimes alleviate the tightness. This should be done carefully to avoid pain or injury.

3. Adhesions: The fact that part of your foreskin is adherent to the glans (a condition known as synechia) can complicate phimosis. In some cases, these adhesions can be treated without circumcision. A healthcare provider can assess whether these adhesions can be separated safely.

4. Sexual Activity: Regarding your concern about sexual intercourse, if the foreskin is too tight, it may lead to pain during penetration. If you are unable to retract the foreskin, this could potentially cause discomfort or pain during intercourse. It is essential to address this issue, as painful intercourse can lead to anxiety and avoidance of sexual activity.

Risks of Not Treating Phimosis
If left untreated, phimosis can lead to several complications:
- Infections: Difficulty in cleaning the area under the foreskin can lead to infections, such as balanitis (inflammation of the glans).

- Painful Erections: As you have experienced, the inability to retract the foreskin can lead to pain during erections.

- Sexual Dysfunction: Pain during intercourse can affect sexual relationships and overall quality of life.

Conclusion
In summary, whether you need circumcision for your phimosis depends on the severity of your symptoms and the impact on your quality of life. It is crucial to consult with a urologist or healthcare provider who can evaluate your specific situation, discuss the potential benefits and risks of circumcision versus conservative management, and help you make an informed decision. If you are experiencing significant pain or functional limitations, seeking treatment sooner rather than later is advisable.
Remember, open communication with your healthcare provider is key to finding the best solution for your condition.

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