This site discusses phimosis in its specific forms of phimotic ring, frenulum breve, adhesions or skinbridges. During erection these conditions inhibit the relationship between foreskin and glans. This functionally restricts the erection, and thus has an effect on the sexuality. With our culture's attitudes on health care, it would be appropriate to monitor boys before puberty and encourage early prevention.

2012 : note from author: My previous idea of monitoring boys before puberty is impractical, unecessary and now only of historical interest. please see Postscript.

updates and supporting education on new site : Phimosis.cloud

ELASTIC BANDS and PHIMOTIC RINGS

Hi there everybody
Sorry I've been keeping so quiet lately, but I've been reading through the various comments on wearing the foreskin retracted, phimosis and adhesions with interest.

I've been giving some thought to the nature of the preputial ring, phimotic or otherwise. During the discussions on retracting the foreskin, someone suggested that a mild degree of phimosis may be necessary to keep the skin back behind the glans when flaccid. I do not agree with this view as it is merely the elastic nature of the skin, trying to return the preputial orifice to its 'natural' size, which holds it there. This elasticity will vary betwen individuals, and in some it may not be enough to hold the foreskin retracted, but it must exist otherwise eveyone's foreskin opening would be the same as the glans diameter, and would gape wide open when the foreskin was forward.

Thinking back to my own childhood, before my phimosis developed, my foreskin would stay back while flaccid, and I think most other boys' foreskins would. I would think that foreskins get looser with age, or with repeated retractions, so the adult is perhaps less likely to be able to stay permanently retracted.

These thoughts on foreskin elasticity got me thinking about balloons (the party type, not the hot air type). A balloon which has not been blown up before can be very difficult to blow up, but if it is then deflated it is much easier to blow up the second time, and becomes easier at each successive inflation. If foreskins behaved the same way, this could explain so-called 'childhood phimosis', where the skin is too tight to allow it to be pulled back without pain or discomfort. Repeated stretching, caused by erections and gentle manipulation, will gradually allow the skin to be stretched more easily and eventually allow retraction.

This analogy with balloons did not explain phimosis satisfactorily, but I then thought of something that might - an elastic band.

Any elastic band can have three physical characteristics described:
1. natural length
2. elasticity
3. maximum length

To explain these in a bit more detail:
1. natural length - fairly obvious, the length when no force is applied.
2. elasticity - the extension produced by a given force. One particular elastic band may double in length when a given force is applied, and another, more elastic one, may triple its length when the same force is applied.
3. maximum length - when stretching an elastic band, there comes a point where the resistance to further extension suddenly becomes very much greater, and a much greater force is required. Only a small amount of further extension is possible before the band breaks.

Now, how does this relate to foreskins, specifically the opening?

1. natural size - the size of the opening with the penis flaccid and the skin fully forward.
2. elasticity - the increase in size of opening produced by a given force.
3. maximum size - the size beyond which a much larger force is required to cause a further increase in size. Any further stretching will cause pain and/or damage to the tissue.

The concept of a maximum size of opening lends itself to a very neat definition of phimosis. That is, phimosis exists when the maximum size of the preputial orifice is less than the maximum diameter of the glans on erection.

My own phimosis was very severe, and the maximum size of the opening was not much more than its natural size. However, when pulling back on the skin, it felt very much as though it had reached a definite limit of extendibility, just like an elastic band. While on the subject of my own phimosis, Peter's description of his 'rounded triangle of gristly skin' fitted my own foreskin perfectly. I would say that the constriction was in the inner foreskin immediately behind the opening.

Would any other phimosis sufferers care to comment on this?

It would be interesting to debate how the three characteristics I have mentioned develop in time from childhood through to adulthood. My own hypothesis is that in most young boys, the natural size of the opening is small, and the elasticity is low (i.e. the foreskin is tight), and these two characteristics may prevent retraction. Now, as the boy grows, do the natural orifice size and elasticity increase of their own accord, or is some manual assistance required to do this, i.e regular retraction (or attempts at retraction)? Thinking of the balloon analogy, I am tempted to think that assistance is required. I am also reminded of Øster, who found that retractibility increased with age, but was it his own previous attempts at retraction (and the boys' own subsequent attempts at retraction, having learnt that the skin should pull back) which resulted in the retractibility at a later age?

Does the maximum orifice size increase with age as the boy is growing? Does repeated retraction cause the maximum orifice size to increase? If we speculate that retraction *is* necessary to increase the maximum orifice size, we could have the situation where a boy's maximum orifice is sufficient to enable retraction before puberty, but would not be large enough to allow retraction over the enlarged glans after puberty. If he regularly retracts before puberty, this may increase the maximum size of the opening and prepare it for the larger expansion required after puberty. In other words, in some boys, if they do not retract, or attempt to retract, before puberty, they may find themselves suffering from phimosis after puberty, which would have been avoided if they had retracted from an earlier age.

This is all speculation of course, and the actual behaviour of the foreskin will be determined by the cellular structure of the skin (about which I know nothing), just as the characteristics of an elastic band are determined by its molecular structure.

Anyway, it's food for thought.
John