Phimosis: When the Glans Can't Expose the Coronal Ridge

Erection only allows the glans to emerge without exposing the coronal ridge?

Dear Dr.
Hsu, I would like to ask about a situation where the glans cannot be exposed during an erection, but it can be pushed to the coronal sulcus with my hand.
The foreskin seems to be tight at the coronal sulcus, similar to wearing a ring, but there is no discomfort or signs of paraphimosis.
Does this indicate that I have phimosis and need a circumcision? Thank you.

edifier, 20~29 year old female. Ask Date: 2014/08/13

Dr. Xu Weikai reply Urology

Hello, in this situation, it depends on whether the individual feels it affects their daily life.
If there is no interference, surgery is generally not necessary.
If there are any unclear aspects, feel free to ask again, and we can discuss and research further.
Answers found online should only be used as a reference; if necessary, it is best to seek medical attention at a healthcare facility.
This response is from Dr.
Hsu Wei-Kai, Director of the Urology Department, Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2014/08/13

More Info

Phimosis is a condition where the foreskin cannot be retracted fully over the glans (the head of the penis). It can be classified into two types: physiological phimosis, which is common in infants and young boys and typically resolves on its own as they grow, and pathological phimosis, which occurs due to scarring, inflammation, or other medical conditions.
In your case, it seems that you are experiencing a tightness of the foreskin that prevents it from retracting fully over the glans, especially during an erection. The fact that you can manually push the foreskin back to the coronal ridge but feel some tightness suggests that you may have a mild form of phimosis. However, since you mentioned that there is no discomfort or pain, and you do not experience any symptoms of paraphimosis (where the foreskin becomes trapped behind the glans), it may not be an urgent medical issue.

When to Consider Treatment
1. Symptoms: If you are not experiencing pain, discomfort, or recurrent infections, treatment may not be necessary. However, if you start to experience symptoms such as pain during erections, difficulty with hygiene, or recurrent urinary tract infections, it would be advisable to seek medical advice.

2. Hygiene: Maintaining proper hygiene is crucial. If you find it difficult to clean the area effectively due to the tight foreskin, this could lead to infections or other complications.

3. Sexual Function: If the condition begins to interfere with sexual activity or causes anxiety about sexual performance, it may be worth discussing treatment options with a healthcare provider.

Treatment Options
1. Topical Steroids: In some cases, a healthcare provider may recommend the use of topical corticosteroids to help loosen the foreskin. This can be effective in mild cases of phimosis.

2. Stretching Exercises: Gentle manual stretching of the foreskin can sometimes help improve the situation over time. However, this should be done carefully to avoid injury.

3. Surgical Options: If phimosis is severe or causes significant problems, circumcision (removal of the foreskin) or a less invasive procedure called preputioplasty (which involves widening the opening of the foreskin) may be recommended.

Conclusion
In summary, while you may have a form of phimosis, the absence of discomfort or complications suggests that immediate intervention may not be necessary. However, it is essential to monitor the situation and consult with a healthcare provider if symptoms change or worsen. They can provide personalized advice and treatment options based on your specific condition and needs. Regular check-ups can also help ensure that any potential issues are addressed early on.

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