Phimosis: Non-Surgical Options for Tight Foreskin

excuse me?

I was born in 2005, and I am currently 19 years old.
Since childhood, I have never retracted my foreskin and have not experienced any infections.
Two years ago, when I was 18, I managed to retract my foreskin while in a non-erect state, and I found some smegma inside.
After cleaning, I can normally retract my foreskin when not erect.
However, when I am erect, I cannot retract it as it feels tight.
Does this mean I have a long foreskin? I can retract it when not erect, but it still feels tight when erect.
Do I definitely need a circumcision? Are there other options or treatments available? Some doctors prescribe steroid ointments that can be applied to the glans and foreskin, suggesting that after 4-6 weeks, the foreskin may become looser.
I am about to enlist in the military and hope to find an answer.
I am actually afraid of undergoing surgery due to potential complications.
Is there a way to treat the tight foreskin without surgery? Can steroid ointments help with this issue, allowing the foreskin to retract normally? If so, where can I obtain such ointments?

Xiao Wen, 10~19 year old female. Ask Date: 2005/01/10

Dr. Lin Wenxu reply Urology

Hello, Xiao Wen.
Thank you for your letter.
In fact, every child is born with issues of phimosis and excessive foreskin.
Surgical circumcision is only necessary when phimosis is severe enough to cause recurrent infections or persists into puberty.
Regarding the application of topical corticosteroids, there are indeed some articles suggesting they may be somewhat helpful, so it is recommended to try that first; if ineffective, then consider surgery.
Based on your description, it seems you are experiencing excessive foreskin but not complete phimosis.
I suggest that you gently retract the foreskin daily and clean the area.
Generally, with time, the foreskin will become more pliable, so there is no need to be overly anxious.

Reply Date: 2005/01/10

More Info

Phimosis, the condition where the foreskin cannot be easily retracted over the glans (head) of the penis, can be a source of concern for many young men, particularly when it affects hygiene or sexual function. In your case, it seems that you can retract the foreskin when not erect, but experience tightness during an erection. This is a common scenario and does not necessarily mean that you have an excessively long foreskin; rather, it may indicate a degree of phimosis.

Non-Surgical Options for Managing Phimosis
1. Topical Steroid Creams: One of the most common non-surgical treatments for phimosis is the application of topical steroid creams. These creams, such as betamethasone or hydrocortisone, can help to soften and stretch the foreskin over time. The typical regimen involves applying a small amount of the cream to the tight area of the foreskin once or twice daily for about 4 to 6 weeks. Many studies have shown that this method can be effective in reducing phimosis without the need for surgery. However, it is essential to follow your healthcare provider's instructions regarding the use of these medications.

2. Gentle Stretching Exercises: In conjunction with topical steroids, gentle stretching of the foreskin can also be beneficial. This involves gradually pulling back the foreskin over time, which can help to increase its elasticity. It is crucial to be gentle and not force the foreskin back, as this can cause pain or injury.

3. Hygiene Practices: Maintaining good hygiene is essential, especially if you have difficulty retracting the foreskin. Regular cleaning with mild soap and water can help prevent the buildup of smegma (a combination of dead skin cells and oils) under the foreskin, which can lead to irritation or infection.

4. Consultation with a Urologist: If you are hesitant about surgery, it is advisable to consult a urologist who can provide a thorough evaluation of your condition. They can discuss the potential benefits and risks of both surgical and non-surgical options, helping you make an informed decision.

Surgical Options
If non-surgical methods do not yield satisfactory results, circumcision (the surgical removal of the foreskin) is a definitive treatment for phimosis. However, many young men are understandably apprehensive about surgery due to potential complications, recovery time, and the psychological impact. It is important to weigh these factors against the benefits of resolving the condition.

Conclusion
In summary, while circumcision is a common solution for phimosis, there are effective non-surgical alternatives available. Topical steroid creams and gentle stretching exercises can often alleviate the tightness of the foreskin. It is essential to consult with a healthcare provider to determine the best course of action for your specific situation. If you are considering using steroid creams, they are typically available by prescription, so you will need to visit a healthcare provider to obtain them. Remember, addressing this issue is important for your overall health and comfort, especially as you prepare for military service.

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