Phimosis: When Is Circumcision Necessary for Urinary Issues?

Prepuce

According to the payment standards set by the Health Insurance Bureau, the indications for circumcision due to phimosis are as follows: 1.
Paraphimosis 2.
History of recurrent balanitis 3.
Scarring of the foreskin affecting urination or penile erection 4.
Foreskin excision required for pathological examination due to lesions 5.
Foreskin excision necessary for other surgical procedures.

Dr.
Hsu, if the foreskin balloons up like a balloon during urination, would that qualify as affecting urination under point 3?

123, 20~29 year old female. Ask Date: 2008/03/01

Dr. Xu Weikai reply Urology

Hello, this point depends on the clinical judgment of the physician.
Generally, to meet the third criterion, the clinician will find a hard lump on the patient's foreskin, which is scar tissue that appears whiter and is usually not painful.
Your situation still needs to be evaluated in person, but you can provide the above information (from the National Health Insurance Administration) to your physician for reference, and they will make an appropriate diagnosis.
Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2008/03/01

More Info

Phimosis, or the inability to retract the foreskin over the glans of the penis, can lead to various urinary issues and discomfort. In your case, where you experience the foreskin ballooning during urination, it may indeed indicate that the condition is affecting your ability to urinate normally. This symptom aligns with the criteria for circumcision under point 3 of the health insurance bureau's guidelines, which states that circumcision may be necessary if the foreskin causes scarring that affects urination or penile erection.

When considering circumcision for phimosis, it is essential to evaluate the severity of the condition and its impact on your quality of life. If the ballooning of the foreskin during urination is causing pain, discomfort, or recurrent urinary tract infections, it may be a strong indication for surgical intervention. Additionally, if you have experienced recurrent balanitis (inflammation of the glans) or other complications related to phimosis, these factors further support the need for circumcision.

Circumcision is generally considered a safe procedure, and it can provide significant relief from the symptoms associated with phimosis. However, it is crucial to discuss your specific situation with a qualified urologist. They can perform a thorough examination, assess the degree of phimosis, and determine whether circumcision is the most appropriate treatment option for you. In some cases, conservative treatments such as topical steroid creams may help alleviate symptoms and allow for retraction of the foreskin without the need for surgery.

In terms of the potential risks and benefits of circumcision, it is important to weigh the advantages of resolving urinary issues and preventing future complications against the risks associated with any surgical procedure, such as infection or bleeding. Most patients who undergo circumcision report significant improvements in their symptoms and overall satisfaction with the outcome.

If you are experiencing significant discomfort or urinary issues due to phimosis, it is advisable to seek medical advice promptly. A urologist can provide you with the necessary information and guidance to make an informed decision about your treatment options. Remember that addressing urinary issues early can prevent complications and improve your quality of life.

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