Phimosis and Smegma: Key Insights for Young Men - Urology

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Phimosis and smegma?


Dear Dr.
Hsu Wei-Kai,
I hope you can take some time to answer my questions.
I am really worried this winter break.
I am 18 years old, and due to a lack of knowledge, I did not know that the foreskin needed to be retracted for cleaning.
It was only during this winter break that I learned about this from online resources.
I attempted to retract my foreskin but found that if I forcefully pulled it down, it might get stuck at the coronal sulcus, potentially causing necrosis of the glans tissue, so I did not continue.
In elementary school, I had a few instances of inflammation, and I consulted a nearby hospital.
The doctor advised me that because I have phimosis, I should avoid inflammation and clean my penis daily, similar to squeezing toothpaste.
I followed this advice, but I hardly expelled anything.
Since then, I have not experienced any inflammation, so I did not pay much attention to this reminder.
Now, as a college freshman, I believe I have phimosis.
I do not have difficulty urinating, and when I touch my penis, I do not feel any lumps.
I also have not had any inflammation recently, but I am considering undergoing a circumcision.
After researching, I learned about smegma and its potential link to penile cancer, as well as its negative implications for my partner.
1.
What are the different types of circumcision procedures, and which one is recommended?
2.
Is it okay to undergo the procedure during the summer break?
3.
If I have never retracted my foreskin to clean smegma, will the long-standing smegma be removable later? Could the presence of old smegma complicate the surgery or lead to infection?
4.
If I do not feel any lumps when I touch my penis, does that indicate that there are currently no serious issues, even though I have never retracted my foreskin to clean smegma?
5.
After undergoing circumcision, will the doctor or nurse clean my smegma?
Thank you for your time and assistance.

Niming, 10~19 year old female. Ask Date: 2015/02/02

Dr. Xu Weikai reply Urology


Anonymous: Hello.
1.
There are many types of circumcision procedures, each with its own advantages and disadvantages.
2.
It can be performed during the summer vacation.
3.
Inadequate disinfection before the surgery can lead to infections.
4.
A diagnosis can only be made after assessing the current condition.
5.
Generally, cleaning is done before the surgery to prevent post-operative infections.
Note: Circumcision usually requires out-of-pocket expenses.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; it is essential to seek medical care at a healthcare facility if necessary.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/02/02

More Info


Understanding phimosis and smegma is crucial for young men, especially as they navigate their sexual health and hygiene. Phimosis refers to a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). This condition can be physiological (normal in young boys) or pathological (due to scarring or infection). Smegma, on the other hand, is a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin if proper hygiene is not maintained.

1. Types of Circumcision: When considering circumcision, there are various techniques available, including the traditional surgical method and newer methods such as the use of a clamp or laser. The choice of method often depends on the surgeon's expertise, the patient's specific condition, and personal preference. It's essential to consult with a urologist who can provide guidance based on your individual case and recommend the best approach.

2. Timing for Surgery: Scheduling the circumcision during the summer break is generally acceptable, provided you allow sufficient time for recovery before returning to activities that may involve physical exertion. Typically, recovery from circumcision takes about one to two weeks, during which time you should avoid strenuous activities and follow your doctor's post-operative care instructions closely.

3. Cleaning Smegma: If you have not been able to retract your foreskin to clean underneath, it is possible that smegma has accumulated. However, once the foreskin is retracted (either naturally or post-surgery), you can clean the area effectively. Chronic accumulation of smegma may lead to irritation or infection, but it does not necessarily complicate the surgical procedure. Your surgeon will be able to address any concerns regarding the presence of smegma during the operation.

4. Current Condition: The absence of hard lumps or painful sensations when touching your penis is a positive sign. It suggests that you may not have any immediate issues such as infections or significant scarring. However, it is still essential to maintain proper hygiene moving forward to prevent any future complications.

5. Post-Surgery Care: After circumcision, healthcare providers will typically clean the area as part of the surgical procedure. They will also provide you with detailed instructions on how to care for the surgical site during recovery. This includes how to clean the area gently and what signs of infection to watch for.

In summary, it is crucial to maintain good hygiene practices, especially if you have a longer foreskin. Regular cleaning can prevent infections and complications associated with phimosis and smegma. If you are considering circumcision, consult with a qualified urologist who can provide personalized advice and ensure that you are making an informed decision based on your health needs. Remember, taking care of your sexual health is an important aspect of overall well-being, and seeking professional guidance is always a wise choice.

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