As an answer to: Phimosis written by Gilford at 21 Jun 2005 15:08:33:
Hi there,
You start by saying that you have not been able to retract your foreskin since you were a very young boy but that you can retract it now when flaccid for cleaning etc.. Are you saying that even when flaccid you cannot retract it fully over the glans? Generally Phimosis does does not hurt although causes difficulty during intercourse. The fact that you experience a little pain when having intercourse without a condom suggests to me that the 'pain' is probably due to the hypersensitivity of the glans which are rarely exposed. Would you agree with that? Or does the pain seem to be caused by the forceful retraction of your foreskin? I ask these questions because phimosis is often present along with another condition called Frenulum Breve which is known to cause pain rather than difficulty as with Phimosis. When your foreskin is flaccid and you retract it does it seem to want to spring forward? This is another indicator of Frenulum Breve.
It sounds to me as though you have Phimosis alone although it is important to identify the full extent of your problems before we can begin to identify your best option for treatment. If I am correct and phimosis is the full extent of your condition then there are two principal options for you to consider both which you already appear aware of. Firstly there is a temporary and sometimes unsuccessful option of regularly and indefinitely stretching the foreskin. I must advise you not to consider using any 'tools' you have seen available, they are most certainly all a con and some of them could cause further damage. The recommended technique is to stretch daily using an appropriate steroid cream which should be available from your G.P, betamethasone.05 is generally prescribed for this purpose. No 'tools' are required, just patience and persistence.
The second and most appropriate option is surgery. I sense your anxiety about this and I can wholly sympathise since I opted for surgery myself. A full circumcision however is not necessary and indeed not appropriate to treat your condition. You would be well advised to seek information on having a partial circumcision which is the only permanent treatment for Phimosis. Your first port of call should be your G.P who will refer you to a Urologist. Be aware that some Urologists will try to recommend a full circumcision to treat Phimosis simply because this is a more widely practised and routine operation. You should press your surgeon to carry out a partial circumcision which would leave you with some foreskin. This is considered the correct approach.
I will advise you not to consider 'forcing' your foreskin behind your glans when erect since this can be dangerous and may cause permanent damage if the foreskin is lodged behind the glans exerting undue pressure of delicate nerves. This is called paraphimosis and should be avoided at all costs. Additionally you should refrain from leaving your foreskin lodged behind the glans when sleeping and in the event that your foreskin is lodged behind the glans when erect you should endeavour to bring it back forward again as soon as possible.
I hope this information helps. If you need to know anything else feel free to contact me.
