Phimosis vs. Excessive Foreskin: Symptoms and Treatments

Phimosis?

Hello doctor, when my penis is not erect, only one-third of the glans is exposed, but I can retract the foreskin to reveal the entire glans and shaft.
When erect, the entire glans is exposed, but I cannot retract the foreskin further to reveal the coronal sulcus, and it causes pain.
May I ask: do I have phimosis or a long foreskin? What treatment options are available?

Xiao Ye, 20~29 year old female. Ask Date: 2015/11/16

Dr. Xu Weikai reply Urology

Hello, when there is no erection, the glans should be visible and it shouldn't be too long.
As for whether there is a narrowing, it depends on whether the foreskin is tight during an erection.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Answers from the internet should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/11/16

More Info

Phimosis and excessive foreskin are two conditions that can cause discomfort and complications for individuals. Understanding the differences between them, as well as their symptoms and treatment options, is crucial for effective management.

Phimosis is a condition where the foreskin cannot be retracted fully over the glans (the head of the penis). This can be due to a variety of reasons, including congenital factors, scarring from infections, or inflammation. In your case, since you mentioned that you can retract the foreskin when not erect but experience pain and an inability to fully retract it during an erection, it suggests that you may be experiencing a form of phimosis. The pain you feel when trying to retract the foreskin further during an erection indicates that there might be tightness or constriction at the opening of the foreskin, which is characteristic of phimosis.

On the other hand, excessive foreskin refers to having more foreskin than what is typically considered normal, which may not necessarily cause any functional issues. Individuals with excessive foreskin may not experience pain or difficulty retracting it, but they might have hygiene concerns or aesthetic preferences that lead them to seek treatment.

Symptoms of Phimosis:
1. Inability to retract the foreskin: This is the hallmark symptom. If you cannot retract the foreskin fully, especially during an erection, it may indicate phimosis.

2. Pain or discomfort: Pain during erections or when attempting to retract the foreskin is a common symptom.

3. Swelling or redness: In some cases, there may be signs of inflammation or infection.

4. Recurrent infections: Phimosis can lead to recurrent urinary tract infections or balanitis (inflammation of the glans).

Treatment Options:
1. Topical Steroids: In mild cases of phimosis, applying a topical steroid cream can help soften the foreskin and make it easier to retract. This treatment is often effective and non-invasive.

2. Gentle Stretching: Gradual stretching of the foreskin can also help. This should be done carefully to avoid pain or injury.

3. Circumcision: In more severe cases, or if conservative treatments fail, circumcision (surgical removal of the foreskin) may be recommended. This is a definitive treatment for phimosis and can alleviate symptoms permanently.

4. Preputioplasty: This is a less invasive surgical option that involves widening the opening of the foreskin without complete removal. It can be a suitable option for those who wish to retain their foreskin.

Recommendations:
Given your symptoms, it would be advisable to consult a urologist for a thorough examination. They can confirm whether you have phimosis or excessive foreskin and recommend the most appropriate treatment based on your specific situation. Avoid any forceful retraction of the foreskin, as this can lead to further injury or complications.

In conclusion, while you may be experiencing symptoms consistent with phimosis, a professional evaluation is essential for accurate diagnosis and treatment planning. Early intervention can help prevent complications and improve your comfort and quality of life.

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