and Addressing Excessive Foreskin Issues in Men

Prepuce issue (able to retract the foreskin to the coronal sulcus)

I previously had phimosis, and after successfully retracting the foreskin to expose the glans, I discovered that there was still a condition of foreskin adhesion (where debris caused part of the foreskin to stick to the glans).
I endured the pain and managed to separate it myself, and after the wound healed, I am left with the following issues:
1.
It seems that I have some degree of redundant foreskin.
When erect, there is a lot of skin bunching at the coronal sulcus.
I can pull it down, but it feels tight.
2.
Additionally, when I pull down that excess skin during an erection, there is a noticeable ring constricting, specifically at the glans > coronal sulcus > a short distance afterward, where there is a tight band > normal base of the penis.

What options do I have to address this?

Niming, 10~19 year old female. Ask Date: 2015/08/16

Dr. Xu Weikai reply Urology

Hello,
1.
It is recommended to seek medical attention to determine if there is a condition of phimosis (tight foreskin).
2.
It may be a case of stenosis.
If it is severe, surgical intervention may be necessary.
If you have any concerns, you can visit a nearby medical facility for relevant examinations.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be considered as references; it is essential to consult a medical institution when necessary.

Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/08/16

More Info

Excessive foreskin issues, particularly in men who have experienced phimosis or other related conditions, can be both physically uncomfortable and psychologically distressing. It’s important to address these concerns with a comprehensive understanding of the anatomy involved, potential complications, and available treatment options.

Understanding the Condition
1. Phimosis: This condition occurs when the foreskin cannot be easily retracted over the glans (the head of the penis). It can be physiological in infants and young boys but may persist into adulthood, leading to discomfort or pain during erections.

2. Foreskin Adhesions: As you mentioned, adhesions can occur when the foreskin remains attached to the glans due to a buildup of smegma (a combination of dead skin cells and oils). This can lead to discomfort and complications if not addressed.

3. Excessive Foreskin: In some cases, men may have an excess of foreskin that can bunch up during an erection, leading to a constricting sensation. This can be uncomfortable and may cause pain or even issues with blood flow if the constriction is severe.

Symptoms and Concerns
- Discomfort During Erection: The sensation of tightness or constriction around the corona (the ridge of the glans) can be alarming. This may lead to pain during sexual activity or even during normal daily activities.

- Hygiene Issues: Excess foreskin can make it more difficult to maintain proper hygiene, potentially leading to infections or other complications.

Treatment Options
1. Topical Treatments: In some cases, topical corticosteroids can help reduce inflammation and may assist in retracting the foreskin more easily. However, this is typically more effective for mild cases of phimosis.

2. Manual Retraction: If you are comfortable and it is not causing significant pain, gently attempting to retract the foreskin can help. However, this should be done with caution to avoid tearing or causing further injury.

3. Surgical Options:
- Circumcision: This is the most definitive treatment for excessive foreskin and phimosis. It involves the surgical removal of the foreskin, which can alleviate all associated symptoms and prevent future complications.

- Preputioplasty: This is a less invasive procedure that involves widening the opening of the foreskin without complete removal. It may be suitable for those who do not wish to undergo circumcision but still need relief from tightness.

4. Consultation with a Urologist: Given your symptoms, it is advisable to consult with a urologist. They can provide a thorough examination and discuss the best course of action tailored to your specific situation. They can also rule out any other underlying conditions that may be contributing to your symptoms.

Preventive Measures
- Hygiene: Maintaining good hygiene is crucial. Regular cleaning under the foreskin can help prevent smegma buildup and reduce the risk of infections.

- Gentle Stretching: If comfortable, gentle stretching of the foreskin over time may help increase elasticity and reduce tightness.

Conclusion
Excessive foreskin issues can lead to discomfort and potential complications if left unaddressed. It’s essential to approach this condition with care, considering both conservative and surgical options. Consulting with a healthcare professional, particularly a urologist, will provide you with the best guidance tailored to your needs. They can help you navigate the options available and ensure that you can achieve a comfortable and healthy outcome.

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