Phimosis: Concerns, Care, and Circumcision Options

Foreskin~~~~etc?

Hello, doctor.
Recently, I was chatting with a friend about the issue of the foreskin, and I realized that I might have a foreskin issue as well.
My friend said that if the skin cannot retract to the area behind the glans when it is erect, it indicates that I have a foreskin.
Even when my glans is erect, I still cannot retract it, and the skin covers the glans, leaving only a small opening.
My friend also mentioned that I need to wash the glans regularly to prevent infection.
When I asked how to wash it, he said I just need to clean the exposed part.
However, I explained that my skin covers the entire area, so I asked how to wash it.
He advised me to push the skin back with my hand before it becomes erect, and the glans would naturally become exposed.
I tried this while showering today, and indeed, the glans came out, but it was very painful.
Additionally, when the skin was pushed back, I noticed a white powdery substance on the glans.
My classmate said that I need to clean that off.
I want to ask the doctor if I should wash off that substance.
At that moment, I was very nervous and quickly rinsed it off, but when the water touched the glans where the white powder was, it caused some mild pain.
Afterward, when I was no longer erect, the skin was all bunched up, and I had to manually adjust it.
Is this the correct way to do it? Could it be that not cleaning it properly is worse than not washing it at all and could lead to infection? Do I definitely need to undergo a circumcision? When you perform circumcision, are there female nurses present? How long does the surgery take? How long do I need to rest afterward? Also, what are the costs involved?

Danxin de ren, 10~19 year old female. Ask Date: 2001/03/03

Dr. Liu Jianting reply Urology

Wow! Your description is very vivid.
It seems that you are experiencing phimosis, which is the condition where the foreskin cannot be easily retracted behind the glans.
When erect, if the foreskin is retracted, it may feel tight and uncomfortable.
Due to the constant covering of the glans, there may be smegma (a white, powdery substance) that is difficult to clean, and sometimes there may be an odor.
I recommend that you consult a urologist for an examination and further management.

Reply Date: 2001/03/03

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 various concerns, including hygiene issues, discomfort, and potential complications such as infections or inflammation. Your description suggests that you may be experiencing phimosis, especially since you mentioned difficulty retracting the foreskin even when erect, and the presence of discomfort and white powdery substances.

Understanding Phimosis
1. Symptoms and Concerns:
- Difficulty retracting the foreskin, especially when the penis is erect.

- Pain during attempts to retract the foreskin.

- Presence of white discharge, which could be smegma—a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin.

- Increased risk of infections if proper hygiene is not maintained.

2. Hygiene:
- It is essential to maintain good hygiene to prevent infections. If you cannot retract the foreskin, cleaning the area can be challenging. It is generally recommended to wash the external genital area with mild soap and water. If you can retract the foreskin without pain, gently cleaning the area underneath is advisable. However, if this causes significant discomfort, it’s best to consult a healthcare professional for guidance.

3. Pain and Discomfort:
- Experiencing pain when attempting to retract the foreskin is a common symptom of phimosis. It’s crucial to avoid forcing the foreskin back, as this can lead to tears, bleeding, or further complications.

Treatment Options
1. Non-Surgical Approaches:
- In some cases, topical corticosteroids can be prescribed to help loosen the foreskin, making it easier to retract over time.

- Gentle stretching exercises may also be recommended, but these should be done cautiously and under the guidance of a healthcare provider.

2. Surgical Options:
- If non-surgical treatments are ineffective, circumcision may be recommended. This procedure involves the surgical removal of the foreskin and is typically performed under local or general anesthesia.

- Circumcision can resolve phimosis and prevent future complications.

Surgical Procedure and Recovery
1. Procedure Details:
- Circumcision is usually performed in a surgical setting, and the duration can vary but typically lasts about 30 minutes to an hour.

- The presence of medical staff, including nurses, is standard during the procedure, and there may be both male and female staff present.

2. Recovery:
- Recovery time varies, but most individuals can return to normal activities within a week or two. However, it’s essential to follow post-operative care instructions provided by your surgeon to ensure proper healing.

3. Costs:
- The cost of circumcision can vary widely based on location, healthcare provider, and whether the procedure is covered by insurance. It’s advisable to check with your healthcare provider or insurance company for specific details.

Conclusion
If you suspect you have phimosis, it’s essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment options. Avoid attempting to forcefully retract the foreskin, as this can lead to injury. Proper hygiene is crucial, but if you experience pain or discomfort, seeking medical advice is the best course of action. Remember, you are not alone in this, and many men experience similar issues. A healthcare provider can offer support and guidance tailored to your specific situation.

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