[ ARC forum 2 ]

Phimosis, Steroid ointment and such.

Written by Paul B. at 27 Dec 2001 10:44:21:

As an answer to: Steroid cremes on phimosis written by Halfclip at 27 Dec 2001 05:31:42:

> they say that the foreskin must be partially retracted when applying the ointment

Hey! I must be saying the right things - you mentioned "ointment"!

> ... ensure that the phimotic ring must be exposed fully in order to apply the ointment to it. (which makes sense).

Indeed it does.

Take a look at this picture again:

It certainly doesn't look healthy to me. Anyway, note that the effect of pulling back the foreskin against the glans, is to increase the pressure under the foreskin so that the inside part actually extrudes through the tight part, flipping it to the outside and making it accessible for application of the ointment. Note that the part showing at the tip is pleated - it is not tight.

In general, as long as you firmly pull the foreskin back "on the stretch" you will be bringing the tight part to the outside. As it stretches, it will of course come right back toward the corona and at the tip will be only the inside (not tight) layer of foreskin.

> This has interesting implications.

Mmmm.

> If you have a tight phimosis ... you cannot apply the ointment to the full surface of the tight ring of skin.

But as you go on to say, as long as you do it on the stretch, you will expose the tightest part, and most of it.

> in the case of a pinhole phimosis, ... I guess one could apply it only to whatever you can and hope

You no longer have one to experiment on, (;-) but that's the general idea.

> that would make the stretching much more lenghty.

Good pun.

I have come to the conclusion that the use of a dilator worn all, or at least the majority of the time, is probably a much more potent "secret weapon" than the steroid ointment. I think any reasonably sensible adult can manage this for himself, but it may be a bit fiddly to use on boys.

I foresee the possibility of commercial manufacture of dilators - plastic (silicone?), properly designed in a "grommet" format similar to (albeit far larger and using a fully smoothed shape) those used with myringotomy for many years now. The central hole would allow urination without removal.

I have even mused on producing such a thing myself (theoretically, it is my field of expertise after all ;-) but it would be unlikely to be profitable - I think it would have to be marketed via the 'net at least for starters, though who knows, it could end up a big seller? There are also regulatory (legal) considerations involved in "medical" appliances.


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