Foreskin Issues: Pain and Mobility Concerns Explained

Foreskin issues

Hello, my foreskin can normally be retracted for cleaning, but during an erection, it does not retract naturally.
There is only a small opening through which I can see the glans, and I have to pull it down hard, which causes some pain.
Once I reach the coronal sulcus, the pain subsides, but all the foreskin is bunched up at the sulcus, making it impossible to pull it down further.
Therefore, I cannot move freely up and down during masturbation.
To enlarge the opening of the foreskin, I sometimes pull it back when I am not erect, but it quickly retracts on its own, and it often gets caught in the hair.
What should I do?

Aguai, 10~19 year old female. Ask Date: 2008/07/15

Dr. Xu Weikai reply Urology

Hello, your condition seems to be a case of phimosis.
There are two treatment options:
1.
Conservative treatment: Regularly retracting the foreskin can help gradually relax and widen the narrow area using the width of the glans.
You can apply some topical corticosteroid ointment to the tight area, which can soften the tissue and make it easier to stretch.
The downside of conservative treatment is that it takes a long time to see results, so patience is required.
2.
Surgical treatment: This involves surgery to incise or remove the narrow area, which provides quicker results.
The downside is that it can be more painful.
If you have any further questions or need more details, feel free to ask, and we can discuss it further.
Sincerely,
Dr.
Hsu Wei-Kai
Department of Urology
Taitung Hospital, Ministry of Health and Welfare

Reply Date: 2008/07/15

More Info

It sounds like you are experiencing a condition known as phimosis, which is when the foreskin cannot be easily retracted over the glans (the head of the penis). This can lead to discomfort during erections and may also affect sexual activity, including masturbation. Phimosis can be a common condition, especially in younger males, but it can persist into adulthood for some individuals.

Understanding Phimosis
Phimosis can be classified into two types:
1. Physiological Phimosis: This is common in infants and young boys, where the foreskin is naturally non-retractable. As they grow, the foreskin usually becomes more retractable.

2. Pathological Phimosis: This occurs when the foreskin becomes tight due to scarring, inflammation, or infection, making it difficult or painful to retract.

Symptoms and Concerns
From your description, it seems that you are experiencing pain when attempting to retract the foreskin, especially during an erection. The pain subsides once you reach the corona (the ridge of the glans), but the inability to fully retract the foreskin can lead to discomfort during sexual activities. Additionally, the foreskin's tendency to revert back to its original position after being retracted can be frustrating and may lead to hygiene issues, as it can trap moisture and bacteria.

Potential Solutions
1. Gentle Stretching: Some individuals find that gently stretching the foreskin over time can help increase its elasticity. This should be done carefully to avoid pain or injury. You might consider doing this during a warm bath when the skin is more pliable.

2. Topical Treatments: Over-the-counter topical corticosteroids can sometimes help reduce inflammation and promote stretching of the foreskin. However, it is essential to consult with a healthcare provider before starting any treatment.

3. Consult a Urologist: Given your symptoms, it would be wise to consult a urologist. They can provide a thorough examination and discuss treatment options, which may include:
- Circumcision: This is a surgical procedure to remove the foreskin entirely. It is often recommended for severe cases of phimosis.

- Preputioplasty: This is a less invasive surgical option that involves widening the opening of the foreskin without removing it.

4. Hygiene Practices: Maintaining good hygiene is crucial, especially if the foreskin is difficult to retract. Ensure that you clean the area gently to prevent infections.

5. Avoiding Irritation: If you find that the foreskin gets caught in hair or clothing, consider trimming pubic hair or wearing looser-fitting underwear to minimize discomfort.

Psychological Impact
It’s also important to address any psychological concerns that may arise from this condition. Feelings of embarrassment or anxiety about sexual performance can be common. Speaking with a mental health professional or a counselor can help you navigate these feelings and provide coping strategies.

Conclusion
In summary, while phimosis can be uncomfortable and may lead to complications if not addressed, there are various treatment options available. Consulting with a healthcare professional is the best course of action to determine the most appropriate treatment for your specific situation. Remember, you are not alone in this, and many men experience similar issues. Seeking help is a positive step toward improving your comfort and overall sexual health.

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