Phimosis: Symptoms, Treatment, and Care Tips

Circumcision?

Hello, Doctor: When I am not erect, I can easily retract the foreskin back behind the glans, but when I am erect, only a quarter of the glans is exposed.
If I push with my hand, I can expose up to three-quarters, but it becomes painful.
Is this considered phimosis? Do I need a circumcision? I clean the area daily.
I've also heard that I can repeatedly push it back to stretch the opening, but it hurts and retracts.
Is that okay? Additionally, when not erect, my penis feels very short, but when erect, it seems normal.
Could this be because the foreskin has been covering the glans for a long time? I am relatively slim.

Yo Hoo Hoo, 10~19 year old female. Ask Date: 2012/02/24

Dr. Xu Weikai reply Urology

Hello, you may be experiencing incomplete phimosis.
It can be stretched, but the effectiveness is limited.
Generally, it is more effective in children under the age of 2.
It is still important to seek medical advice to determine if surgery is necessary.

Reply Date: 2012/02/24

More Info

Phimosis is a condition characterized by the inability to retract the foreskin over the glans (head) of the penis, particularly when the penis is erect. Your description indicates that while you can retract the foreskin easily when flaccid, you experience difficulty and pain when attempting to do so during an erection. This suggests that you may indeed be experiencing a form of phimosis, particularly if the foreskin does not retract fully and causes discomfort.

Symptoms of Phimosis
The primary symptoms of phimosis include:
1. Inability to Retract Foreskin: As you've described, the foreskin can be retracted when flaccid but not when erect.

2. Pain or Discomfort: Pain during attempts to retract the foreskin, especially during an erection, is a common symptom.

3. Swelling or Inflammation: In some cases, the area may become swollen or inflamed.

4. Difficulty with Hygiene: If the foreskin cannot be retracted, it may lead to difficulties in maintaining proper hygiene, which can increase the risk of infections.

Treatment Options
1. Conservative Management: In mild cases, gentle stretching exercises may help. This involves gradually and gently pulling back the foreskin over time to increase its elasticity. However, this should be done cautiously to avoid pain or injury.

2. Topical Steroid Creams: Some doctors may prescribe topical steroid creams to help soften the foreskin and make it easier to retract.

3. Surgical Options: If conservative measures fail or if there are recurrent infections or significant discomfort, circumcision (removal of the foreskin) may be recommended. This is a common procedure and can be done under local anesthesia.

4. Preputioplasty: This is a less invasive surgical option that involves widening the opening of the foreskin without complete removal.

Care Tips
- Hygiene: Continue to maintain good hygiene by cleaning the area gently. This is crucial to prevent infections, especially if the foreskin cannot be retracted fully.

- Avoid Forceful Retraction: Do not forcefully retract the foreskin, as this can lead to pain, tearing, or scarring.

- Consult a Specialist: If you experience persistent pain, difficulty, or any other concerning symptoms, it is essential to consult a urologist or healthcare provider. They can provide a proper diagnosis and recommend the best treatment options for your specific situation.

Psychological Considerations
It's also worth noting that concerns about the appearance of the penis, such as feeling that it looks shorter when flaccid, can be common among men with phimosis. This perception may be influenced by the foreskin covering the glans. However, it’s important to understand that penis size varies widely among individuals, and the presence of phimosis does not necessarily correlate with size.

Conclusion
In summary, based on your description, it seems you may have a mild case of phimosis. While gentle stretching may help, it is crucial to avoid any painful attempts to retract the foreskin. Consulting with a healthcare provider is the best course of action to explore your options and ensure that you receive appropriate care. They can provide guidance tailored to your specific needs and help alleviate any concerns you may have regarding this condition.

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