[ ARC forum 2 ]

Problems and appropriate advice.

Written by Paul B. at 22 Dec 2001 14:26:26:

As an answer to: Re: I need some advice, Please Help Me ! written by Halfclip at 22 Dec 2001 07:50:16:

> It is my understanding that the medical community agrees that the stretching and creams
> do not solve all phimosis problems,

Well, that may indeed be your understanding and it is, letter-for-letter, quite true, because you used the participle "do" rather than "can". It is however in that respect, deliberately misleading.

I would say that the medical community agrees that people "do what they do". What actually happens in medicine, is that doctors offer treatments and procedures, and people utilise these to degrees varying from moment to moment. A surgical procedure has a fairly unique characteristic - between the beginning and the end, the patient has in general no involvement; cannot vary the process or the outcome, certainly not if general anaesthesia is used. Even when local anaesthetic is employed, there is a "point of no return" where the alternative to continuing the procedure to its unique conclusion is so unacceptable, that he is compelled to see it through.

So on the one hand, this shortens the treatment (after care similarly, follows irrevocably from the surgery and allows no alternatives of significance) and on the other, reduces the options.

The point of this is that the medical community only experiences the consequence of the treatments which it superintends. If the patient chooses a "non-medical" line of management, in the vast majority of cases, and particularly with respect to surgeons and other specialists, they are lost to follow-up. There are no studies on the efficacy of stretching because men would have to come to doctors and report on their success or otherwise, and do so with sufficient reliability to be studied.

In fact, those who choose stretching are 1} unlikely to present themselves to the doctor in the first place, because except for the steroid cream if they choose to use that, they have no need and therefore little reason to see the doctor to embark on the stretching, and are 2} even less likely to report to the doctor when the approach is successful.

Obviously therefore, only those who have given up on stretching, or indeed never considered it, will put themselves in a position to be studied and yes, amongst them, the success of stretching is very low indeed!

> (regarding stretching) ... and that in some cases, it does not garantee re-occurance of phimosis.

... when it is ceased. However, having been initially successful, there would be little reason not to employ it again, perhaps with modification as I have elsewhere mentioned, as well as treating the cause of the recurrence.

> It also does not remove scarred tissue.

Neither does the use of "pressure suits" or "dermal films" ("silastic"). Nevertheless, these recent, but now routine medical techniques are able to re-shape scar tissue into the desired resemblance of non-scarred tissue, so the existence of scar tissue is relatively moot.

> If one has a fairly severe case of phimosis, or scarred foreskin, is it fair to suggest the non surgical treatment?

You beg the question that these cases are somehow qualitatively different when in fact, it is quantitative. There's no contest that the more you have to stretch, and the tougher the tissue, the more effort (not in terms of force, but rather, persistence and/ or a more effective method,) will be involved. That does not however invalidate the approach.

> As far as the "quick fix" issue. Quick fix does not imply quick decision.

Not the point. As Jim carefully pointed out, it is the decision to choose something which appears to achieve a given objective quickly and with little dedication, putting short term gratification ahead of long-term durability.

> If ... getting the foreskin shortened will provide him with a better outcome than stretching it,

But by "better", you only mean "faster" outcome anyway.

> and as a side effect, will give him a fully functioning penis faster,
> is there anything wrong with this?

Yes, indeed. Again, the use of the term "fully functioning" is deliberately misleading. This begs the question that the foreskin has neither sensory nor mechanical function.

Those who have had a major operation, such as abdominal surgery, will be aware that when you cut nerves, regeneration is somewhat idiosyncratic, and feeling on the side of the scar away from where the nerves originate is diminished and paradoxical - touch felt as heat and such. Unlike a dorsal slit which is parallel to the lie, and thus tends to avoid interruption, of the nerves, a "partial" circumcision just as a "complete", transects all the nerves passing through. How then does this reconcile with the concept of "fully functioning"?

> we can argue on the benefits/ disadvantages of having a short or long foreskin

Certainly. What disadvantage, presuming as you say that it moves properly, and that it has if necessary been manipulated to do so, might there be in having a long foreskin? There are obvious advantages in the ease of both masturbation and intercourse.

> because in the end,

Slight pun.

> a choice: stretch and retain long foreskin, or get a partial circ and get a short foreskin.

Again, you seem to be drifting from the topic. Given that a long one works, what is so glorious about a short foreskin? Why did this enter the discussion?

> We are talking about a small cosmetic circumcision that shortens the foreskin
> to a more cosmetically pleasing length and in doing so removes the phimosis.

Why is it "cosmetically" necessary for you to have a short foreskin? Is it in fact the case, that this peccadillo is the real basis for your interest?

> If ... the person likes the idea very much, is there anything wrong with this?

Quite likely. See under in respect of general body mutilation.

> But these people should understand that some people have no problems with having the body improved surgically,

I think that the desire to "improve" the body surgically (or by using drugs such as anabolic steroids) is a substantial problem.

> especially if that solves a nagging problem.

I'd call that two separate problems.

> Do poeple who oppose so vehemently circumcision also oppose piercings and tatoos

And augmentation mammaplasty?

For sure. It's most appropriate that you mention this because there is a clear connection between such self-abusive behaviours. By and large, these behaviours indicate one or both of an intellectual deficit, or a history of abuse. It is not at all surprising that the military has traditionally had a combined tradition of tattooing and ritualised abuse ("bastardisation") and is of course, despite the vigorous advertising otherwise, a substantial repository for those who are academically unsuited to find an alternate job.

> or weird hairstyles/ hair colouring?

These do not trouble me nearly as much as it is obvious that they are with varying degrees of convenience, reversible. It is pretty inappropriate to group these with tattoos or circumcision.

> we are discussing about an adult choosing cosmetic surgery ... with informed decision making method.

Interesting that you are. I was on the other hand, originally limiting myself to discussion of achieving optimum foreskin function in regard to sexuality.


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