[ ARC forum 2 ]
Written by Paul B. at 16 Aug 2002 01:32:17: Phimosis & BXO
As an answer to: Phimosis / BXO written by trotter at 15 Aug 2002 19:18:26:
> Anyone care to offer any advice?
Keep looking for a competent doc?
I mean, the first doctor was not competent at all- you state that yourself - he didn't even examine you. At least the second one looked at it, but since you realise the first one wasn't competent, that gives you the hint that the second one (particularly if this is in America - I know it seems farcical, but America really is the land where money talks loudest) can't entirely be believed either.
> Small white dots developed. The skin around them became harder and less sensistive. Now my foreskin tingles slightly sometimes. My inner foreskin has a few red blotches on it.
Now that description certainly could indicate BXO to be sure. However, two things should be borne in mind. One is that BXO is actually relatively rare, so you are more likely to be suffering persistent candidal infection, which has exactly that same appearance (white and red spots). There are two options in this regard, and you probably should pursue both: You should have a biopsy (a small sacrifice for the potential of a functioning foreskin) to find out what it really is, and you should have maximal treatment for candida - which means fluconazole (moderately expensive but ...) over at least 2 months.
Second matter to remember - circumcision is a surgeon's treatment for BXO, a doctor's treatment for it is steroids either applied on the affected skin, or injected into the area. So, to have proper treatment for this (including the biopsy), you would need to find a skin specialist; a dermatologist. Don't trust the $urgeon$!
Note also that steroids increase your susceptibility to Candidal infection also, so even if BXO is diagnosed, an anti-fungal such as fluconazole should be used in addition, which is why I suggest it could be used at the same time as the biopsy.
> Now another doctor has visually diagnosed BXO and recommended a partial circ.
"Partial" circ is a euphemism.
> At the same time as all this has been going on, peeing has become harder. A cystoscopy (camera into my urethra through to the bladder) diagnosed bladder neck problems. I've been told I should get the bladder neck musscle cut.
To my knowledge, there is no "easy" alternative to this, and it is as appropriate as any other approach (there are two drug treatments, but they are not stunningly effective and the problem tends to build up eventually). There may be side effects on your sexual function of course, and you may be heading for a full prostatectomy in time. Sad, but this is a bit of a "black magic" area of medicine still.
So when you go for the bladder neck resection, make sure you add to the consent form, clearly printed, the clause that under no circumstances may any form of circumcision be performed. I'm not joking. Otherwise, it may well be "decided" when you are "under". I presume the cystoscopy was an office procedure, by the way?