SELF DIAGNOSIS

Only accurate diagnosis can ensure individual problem related treatment.

There is a simpler special guide on how parents could check children. This page is intended to help the enquiring adult to diagnose his own complaint.

Please first read the summary on phimosis

The important point about self diagnosis is that YOU understand your condition, - to make it worth a doctor discussing treatment with you in an intelligent manner, instead of simply recommending something, with you left clueless.

What have you got? Does it need surgery or could it respond to conservative treatment?

THINK: If you want the best surgery you go to a surgeon - if you want conservative treatment (betamethasone or some other skin ointment) then best would be a dermatologist (skin specialist). Please read: how to make life easy for you and the medical profession

SELFDIAGNOSIS

Introductory Remarks for Self Diagnosis
Please read the Summary of The Conditions
If you`re totally new to the subject then the following may help.

To a man who has never retracted his foreskin, it appears to be made from one thick layer of skin, similar to the tongue or an ear lobe. This is not the case. There is no join between the outer and inner surfaces of the foreskin, the inner and outer foreskin are one continuous layer or sheet of skin which is folded back on itself. What is meant by retracting the foreskin, is that one pulls back on the outer foreskin. The inner surface of a healthy foreskin, will roll out from underneath and spread back evenly over the shaft.

In order to start a self diagnosis: - WHEN FLACCID slowly and gently start retracting the foreskin.

Very rarely infant adhesions can still be bonded in early adulthood, they usually release last in the area around the frenulum.

Occasionally among uncircumcised boys skin bridges usually take the form of a single strip or string of skin between the foreskin and the glans, (these often occur directly beneath the urinary opening, thus may easily be confused with an extremely short frenulum - see later).

When attempting retraction - The most common conditions are phimotic ring and frenulum breve - and these often occur together so that "it`s difficult to see where the one starts and the other ends" - one will usually predominate.

With a normal foreskin as the outer skin pulls back, the inner foreskin turns inside out and rolls back unfolding freely.
If you can get it back "so far"
The phimotic ring lies just inside the join between inner and outer foreskin and this is most evident on the top side of the penis, so looking from above, with phimotic ring as the outer pulls back, only a small strip of the inner turns over and at the foremost edge of the inner foreskin a fine line of the white (or occasionally red(?)) band of a phimotic ring will be visible.

If you have a loose phimotic ring, which seems undetectable when flaccid, try this: insert two clean little fingers, (or even one finger and a q.tip) in the end of the foreskin and pull (gently) sidewards, you will feel very clearly most of the skin is elastic except for a thin ring, so thin that you feel if it was wire it would cut you, this is the phimotic ring.

With frenulum the restriction is underneath the glans, so as the outer foreskin is pulled back a good centimeter or more of inner foreskin turns over above, but now look underneath and you see the restriction staring to pull the glans downwards.

MORE DETAILS for those who are still unsure

PHIMOTIC RING
The phimotic ring or noose is a thin line or contour of rigid skin on the inner foreskin, just behind the tip of the foreskin on the upper side of the foreskin, however on the lower side of the foreskin there is a flap of skin which you can flip away downwards quite freely.

Retracting gently, if there is any degree of difficulty in retraction, do not use any force, there is a danger of paraphimosis or ripping etc.. Would the foreskin retract when flaccid - with lubrication? If you can retract without any difficulty, there is often a clearly visible hourglass effect around the shaft. .(see Phimosis Research).

Mysterious Conditions
Many men call what they have: phimosis, but they describe sensations which I`ve learnt to recognise as symptoms for frenulum breve: the foreskin always slides forward again; too much foreskin; can retract esasily when flaccid but not at all when erect; or: discomfort, tightness or pain following intercourse. The point is that when there`s just a mysterious, indistinct discomfort; tightness, pain its very often a symptom for frenulum breve.

FRENULUM BREVE
When flaccid or erect, if you hold the foreskin in the retracted position and look sideways, you will be able to see if the glans bends downwards. When the foreskin is retracted as far as possible even minor degrees of frenulum breve will bend the glans at a obviously distorted angle to the shaft of the phallus. There is some doubt in my mind as to how the surgeon defines which degree indicates a frenulum which is too short. Therefore the best test is: the frenulum is too short if, when erect, it causes the retracted foreskin to slide forward again and recover the glans.

You and the medical profession
Parents Diagnosis