Painful Foreskin Retraction: Urological Concerns

Retracting the foreskin can be painful?

Hello doctor, my glans can normally be exposed during an erection and masturbation is also fine.
However, when I try to pull down the foreskin, it feels like the sides are stuck, causing pain when I pull it down.
If I continue to pull, it results in a painful sensation similar to a skin tear.
This pain also occurs during intercourse.
Is there any treatment needed for this? Additionally, I notice that there is often smegma on both sides of the frenulum, which only comes out when I squeeze it.

Niming, 20~29 year old female. Ask Date: 2012/10/10

Dr. Xu Weikai reply Urology

Hello, based on your symptoms, surgery should be considered for correction.
However, after reviewing the photos, there doesn't seem to be a reason for surgery.
Strengthening your cleaning routine should suffice.
If there are any unclear points, feel free to ask again for further discussion and research.
Please note that online responses should only be used as a reference; it is essential to seek medical attention at a healthcare facility if necessary.
This message is from Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2012/10/10

More Info

Painful foreskin retraction can be a concerning issue, and it is essential to understand the underlying urological concerns that may be contributing to your symptoms. Based on your description, it seems that you are experiencing discomfort when retracting the foreskin, which could be indicative of a condition known as phimosis or possibly a related issue such as balanitis or a tight frenulum.

Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). This can lead to discomfort during retraction, especially if there is any scarring or adhesions present. In your case, the sensation of the foreskin being "stuck" and the pain associated with pulling it back could suggest that there is some degree of phimosis. This condition can be physiological (normal in younger boys) or pathological, resulting from scarring or inflammation.

Balanitis, which is inflammation of the glans, can also lead to discomfort and pain during retraction of the foreskin. This condition can be caused by poor hygiene, infections, or skin conditions such as eczema or psoriasis. If you notice any redness, swelling, or discharge, it may be worth consulting a healthcare professional for an evaluation.

The mention of "urine residue" or "smegma" accumulating around the frenulum could indicate that proper hygiene is not being maintained in that area. Smegma is a natural substance that can accumulate under the foreskin, and if not cleaned regularly, it can lead to irritation or infection. It is crucial to practice good hygiene by gently retracting the foreskin during bathing to clean the area thoroughly.

Given your symptoms, it is advisable to seek a consultation with a urologist. They can perform a physical examination to assess the condition of your foreskin and glans, evaluate for any signs of infection or inflammation, and discuss potential treatment options. Treatment may range from conservative measures, such as improved hygiene practices and topical treatments, to more invasive options like circumcision or preputioplasty if phimosis is diagnosed.

In the meantime, avoid forcing the foreskin back if it causes pain, as this could lead to further injury or complications. If you experience any severe pain, bleeding, or signs of infection (such as fever or discharge), seek medical attention promptly.

In summary, while your symptoms may be manageable, they warrant a professional evaluation to rule out any underlying conditions and to determine the best course of action for your specific situation. Remember, maintaining good hygiene and being aware of any changes in your genital health is crucial for preventing complications.

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