What is phimosis? How do I know I have phimosis? How is it solved?

There is talk of phimosis when the skin (foreskin) that covers the glans (tip of the penis) is tight and cannot be easily lowered to leave the glans uncovered.

Why does it occur?

It is common that at birth the foreskin cannot be lowered because the skin is stuck to the glans (adhesions) or because it forms a narrow ring (phimosis) through which the glans does not pass. This is physiological phimosis , that is normal. You should not force to lower the skin at this age. Gradually, with development, the foreskin detaches from the glans and that “narrow ring at the end of the foreskin” becomes more elastic. About 2/3 of 11-15 year olds and more than 95% of 16-17 year olds can pull down their foreskin without difficulty.

Sometimes phimosis does not resolve spontaneously because the ring is not elastic or because it hardens. Other times the foreskin does not go down well, because it is still attached to the glans (preputial adhesions). Phimosis or adhesions can persist due to inflammation or infections in the area ( balanitis ), poor hygiene or unknown causes. Only 0.8-1.5% of boys who have not been treated before cannot pull down their foreskin well in adolescence.

What problems can I have if I have phimosis? Why should I treat it?

The foreskin serves to wrap the glans and protect it. It is important that you have good daily hygiene by lowering it and cleaning the area with soap and water. If you don’t do it or you can’t do it because of your phimosis, the accumulation of skin scales (smegma) and dirt can cause urine infections, balanitis and penile cancer.

Depending on whether the foreskin is more or less narrow, there are different degrees of phimosis:

• The worst situation is that the foreskin is so tight that you cannot urinate, or the foreskin swells “like a balloon” when urinating. It’s the weirdest.
• More often, you urinate well but you can’t completely uncover the glans.
• You may only be able to pull the foreskin down if the penis is not erect.
• Other times the skin of the foreskin goes down with difficulty and then it is also difficult to raise it again. One risk of this situation is that by leaving the foreskin retracted for a while, it tightens like a ring and causes the glans area to swell. It’s paraphimosis. You will need an urgent medical consultation.

Sometimes, regardless of the degree, phimosis can make it difficult for you to have pleasurable sexual intercourse.

When should I worry? Does it fix itself? When should I consult the doctor?

Phimosis is unlikely to resolve itself by adolescence. It’s best to see your doctor if you think you have phimosis.

What is the treatment of phimosis? Circumcision? Are there other alternatives without operating?

There are two types of treatment: medical and surgery.

The first treatment is usually medical. It consists of putting a corticosteroid cream on the foreskin and glans, twice a day for 1-3 months, and gently and progressively stretching the foreskin. It does not matter that you have done this treatment before, you can repeat it. This manages to solve the problem in many cases. In any case, your doctor will tell you which treatment is the most suitable for you.

When the above fails, the solution is surgery with local anesthesia. The techniques are varied. Removing all the skin from the foreskin so that the glans is uncovered is the classic circumcision. Today there are also techniques that remove only the part of the skin that forms the phimosis ring. Sometimes urologists widen-cut the ring without removing skin.

DOUBTS, FEARS OR FALSE MYTHS

– I have a lot of skin that covers the glans. Is that phimosis?

– The skin does not cover my glans completely. Do I have phimosis?

If the skin falls well with the erect penis, you do not have phimosis. A long or short foreskin does not change anything in terms of comfort, hygiene or sexual relations.

–  When under the skin of the penis it bothers me at the bottom. Do I have phimosis or is it a frenulum?

Just below the urine outlet (meatus), the foreskin is fixed in a narrow area (it is the frenulum). That’s not phimosis. Sometimes the frenulum is shorter and pulls a little on erection or when lowering the foreskin. If it bothers, the surgeon or urologist can cut it under local anesthesia. Sometimes it can tear itself during sexual activity and bleed. Do not be scared if this happens to you, you should squeeze a few minutes in that area until the bleeding stops.

–  If I have surgery for phimosis, does it hurt a lot after the surgery?

Circumcision and other surgical techniques can cause discomfort for the first few days, especially if there are erections. In these cases, the discomfort itself causes the erection to go down. Some surgeons advise, before an erection, to get up and put your feet on the cold floor or put ice on the lower abdomen. You can also take medication if you have pain.

– If I have surgery for phimosis, when will I be able to have sexual intercourse? When will I be able to masturbate again ?

Healing begins in the first few weeks, but the skin wound will not be completely closed for at least 6 weeks. It is advised not to have any type of sexual activity at least during this time.

– If I have surgery for phimosis, how will the appearance of my penis change?

It depends on the type of surgery. In the classic circumcision, the glans will be completely exposed. In all other cases, the skin will cover part of the glans. You will see the stitch marks on a circular scar line. You shouldn’t worry. You can lead a completely normal life.

–  Circumcision, does it worsen the erection? Does it impair sexual function or sensitivity?

You shouldn’t worry. There are no differences in sexual activity and pleasure between circumcised men and those not operated on for phimosis. Sometimes circumcision is done for cultural or religious reasons .

–  If I have phimosis, will my penis grow less? Will it grow more after surgery?

The penis grows whether or not you have phimosis. The surgery does not affect the growth of the penis or the glans. You should know that the normal size of the penis is very variable. With the same penis size, it may seem smaller if you are obese or have a lot of fat in the lower abdomen. The size of the penis does not influence the enjoyment of sexuality either. Sexual pleasure depends above all on the glans in men, and on the introitus and first part of the vagina in women.

PHIMOSIS (TOTAL CIRCUMCISION)

Next I am going to talk about my testimony and experience as a boy operated on for phimosis, since I am operated on it.

They operated on me when I was 4 years old, after having two inguinal hernias and having seen the pediatrician who had a little phimosis, the pediatrician together with my parents, decided to operate on me for phimosis, to prevent having to do it when I was older.

I had a total circumcision, in which the entire foreskin was completely removed and the frenulum left.

I remember that to my parents in the postoperative period I told them: they “cut” me “la cuca” , since when I peed, the jet came out like a sprinkler and everything was different from before; but it was a few days.

At first, as a child, after being circumcised, I saw myself differently from the other classmates, since in the locker room the other classmates hadn’t had surgery and I had, and they made comments among some saying “look, he’s missing a piece” .

The aspect of when they perform the total circumcision is that the glans is always completely exposed, and the foreskin will never cover it again.

As a circumcised boy, I can say that both from a hygienic and aesthetic point of view, it is a change for the better, since it is an important change.

I think that total circumcision is much better than partial circumcision, since I understand that partial circumcision usually causes problems.

In my case, they did not remove my brace, but I have spoken with many boys who have undergone surgery and have had the total done and all of them also had their braces removed.

The scar that remains is a circular shape just before the beginning of the glans (if you have had a loose style), as in my case, the skin is not tight. If the scar is a little further from the glans (it is the tense style), and the skin is tighter. I have left the marks where I had the points in a circular shape.

In my opinion, I believe that the only reason to have a phimosis operation (circumcision) is for medical reasons, although it is well known that other cultures always do it and it is completely respectable. Currently this surgery is also performed for purely aesthetic reasons.

In my case, in terms of sensitivity, I have normal sensitivity in the glans; since it is usually commented that boys who have had circumcision lose sensitivity in the glans, and I think that is not true.

I was looking for information about circumcision and some time ago I was seeing several newspaper articles that comment that boys who have undergone circumcision surgery before the first sexual relationship reduce the risk of prostate cancer by 15%, according to a study by the “Fred Hutchinson” Cancer Research Center (USA).

It is also often said that circumcision increases the size of the penis, and I think that is not true at all, although visually it may seem a little larger, since not having a foreskin, it can lead to a more liberated appearance and visibly a little older.

If you suffer from phimosis, I think you have to consult your doctor and find a solution, the surgery is simple and after it, it is important to be careful with the cures and follow the medical recommendations, and I am sure that you will be much happier and happy, since you will have removed a problem that at first seems taboo, and occurs more often than we think, and there is no need to be afraid of surgery.

I participate in a forum in which there is a thread on the subject of phimosis, in which many guys who are going to have phimosis surgery write, and the words after surgery in the vast majority of cases are: “ yes I know , I would have had surgery before, what a change!”