"A 56-year-old uncircumcised man presented with complete erectile failure for 11 years. After discussion of treatment options he expressed the wish to consider a vacuum tumescence device. While demonstrating on him how to use such a device, he quickly developed a reasonable erection. The foreskin had not been retracted. He then suddenly declared some discomfort and the device became splattered with blood. On removal of the device it became apparent he had split a
phimosis of which he had previously been unaware."

Full Text:

W.D. ALEXANDER
Phimosis and Treatment for Erectile Failure
Letter to Editor: Diabetic Medicine 1993 Oct; 10(8): 782

Patients with erectile failure may have had the problem for many years prior to seeking and obtaining treatments. Such patients may also have had, yet be unaware of a mild but significant phimosis. The foreskin should always therefore be retracted prior to treatments being used.

In my experience, when instructing uncircumcised patients on the technique of self injection with vaso-active drugs, it is important for them to retract the foreskin and stretch the penis to one side while holding it by the glans. This gives a better view and therefore makes it easier to avoid trauma to veins and subsequent bruising. There is another reason. A 56-year-old uncircumcised man presented with complete erectile failure for 11 years. After discussion of treatment options he expressed the wish to consider a vacuum tumescence device. While demonstrating on him how to use such a device, he quickly developed a reasonable erection. The foreskin had not been retracted. He then suddenly declared some discomfort and the device became splattered with blood. On removal of the device it became apparent he had split a phimosis of which he had previously been unaware.

W. D. Alexander
Queen Mary's Hospital
Sidcup, Kent, DA14 6LT, UK
(C) 1993 by W.D. Alexander