[ ARC forum 2 ]
Written by Paul B. at 09 Jan 2002 12:01:23: Phimosis: what is effective
As an answer to: Re: Phimosis: what is effective written by halfclip at 07 Jan 2002 11:50:15:
> You still used wording to imply that your solution is garanteed to work, and that is what I was against.
Yes, I daresay you are. But that's just how it is. Some things are just like that. If you drive a car into a brick wall at 30 mph, the car doesn't come out looking brand new. There are certain physical laws that govern our existence, and I was just describing one. (;-)
> I have no problem with someone who wishes to retain his foreskin.
Glad to hear it.
> I though it was a given that steroid creams alone would not magically solve the problem
Indeed.
> i have a problem with the suggestion that all foreskin problems can be solved by stretching/ creams.
Well, all foreskin problems might be a long shot, but basically, all problems insofar as they relate to a tight foreskin, will to that extent be sorted by stretching it.
> There are conditions where ... the foreskin will eventuall become tight again due to scarring
Scars have a life cycle, the latter part of which is known as "consolidation" or "stabilisation". If stretching is continued through this stage, then the scar will stabilise at the desired dimension. This is most certainly the principle of the body suit used for burns and such. But the "scar flattening" films operate after this stage of course.
> or lichen sclerosis for instance.
Well, that ("BXO", uncommon), and chronic (diabetic, regrettably not so uncommon) candidiasis are certainly conditions where the scarring process continues, so in these cases there would need to be persistence of the stretching process until the condition goes into remission with the help of steroids in the case of BXO, or by stabilisation and the persistent application of antifungals or Jim's diet trial in the case of diabetes.
What particularly interests me about the "device" concept is that something such as the film canister could be so easy and effective that one could wear it for months or years to "wait out" the disease, removing it of course as necessary. (:-^)
> you have not seen the person's foreskin, so you should not be able to garantee that your solution will work.
No, but to the extent that they identify the problem as due to tightness, and quantify the degree, then we can give them the appropriate suggestion for that degree of tightness. If they have mis-interpreted the deformity, that may be a problem. It remains their responsibility to describe the situation accurately so far as "remote control" advice goes.
> You should only suggest to start with stretching for X period of time and if ... then consider surgical solution.
Again, I am sorry, but you obviously have a rather simplistic approach to medicine. Many conditions are difficult to work with and there is no straightforward "cure" - diabetes and hypertension are good examples. Impatience is an impediment to management. These conditions are particularly illustrative because (long-term) drug treatment is only one approach. Becoming fit and losing weight are extremely effective managements which cure many sufferers, not infrequently to the extent of complete resolution and perhaps for a lifetime - until and unless the weight is regained and fitness lost.
It is a big ask and sure, many people can't do it, so go on the drugs instead. But that doesn't mean the conservative interventions don't work. I think this business of stretching is uncannily similar.