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When men go to urinate, they typically take out their penis, retract the foreskin, and relieve themselves. If retracting your foreskin is difficult or impossible, you might belong to the group of men affected by a foreskin tightness condition known as phimosis. This article explains what phimosis is and what you can do about it.
Natural Phimosis in Newborns and Young Children
The penis consists of the shaft and the glans, with the foreskin encasing the sensitive glans to protect it. For most male newborns (around 96 out of 100) and young children, it’s entirely normal for the foreskin not to be retractable. This natural tightness or adhesion of the foreskin and glans prevents excessive friction, drying out, and infections from viruses or bacteria during the early years of life. Parents should not attempt to forcibly retract the foreskin. Over time, the foreskin usually detaches and stretches naturally.
Foreskin Tightness During Puberty
The situation becomes more complicated if phimosis has not resolved by puberty. The reasons why this natural resolution doesn’t occur in about 1 in 100 adolescents remain unclear. Treatment is often necessary, as this is the age when individuals begin exploring their bodies, and masturbation becomes significant. If, for example, the foreskin cannot be retracted or only with pain during masturbation, the experience becomes far less enjoyable. Issues can also arise when an adolescent has an erection during sleep and the foreskin cannot retract over the glans. The same applies to sexual activity with a partner.
However, discussing such an intimate issue with parents can be challenging for adolescents. Therefore, if parents learn about their son’s phimosis, they should approach the topic openly and consider treatment options for what is called primary phimosis.
Secondary Phimosis
Foreskin tightness isn’t limited to children or adolescents. Adults can also develop a foreskin constriction, known as secondary phimosis. This can occur due to inflammation, various skin conditions, or injuries. These injuries often appear as small tears when attempting to retract a tight foreskin during childhood. Scarring from such injuries can lead to phimosis.
Potential Issues with Foreskin Tightness
Proper hygiene involves washing the penis, including the glans. However, with phimosis, cleaning the area between the foreskin and glans can become difficult. Unfortunately, this creates the perfect environment for bacteria or fungi, which can lead to infections in this sensitive region.
Some individuals attempt to forcibly retract the foreskin, which is counterproductive and can cause small injuries or tears. These can scar and worsen the phimosis.
Even if you manage to retract the foreskin despite the tightness, a new problem can arise: paraphimosis, also called “Spanish collar.” This happens when the overly tight foreskin gets stuck behind the glans and cannot be pulled back over it. In this position, the foreskin might restrict blood flow, causing the glans and foreskin to swell. If this occurs, the restricted tissue could die. If this happens, you should immediately see a doctor or visit an emergency room, as it is a genuine medical emergency.
Another complication can arise if phimosis leads to urine retention. This rare issue occurs when the foreskin swells, often due to inflammation, blocking the proper flow of urine. In severe cases, urine may back up to the kidneys, potentially causing damage.
What to Do About Foreskin Tightness
If your phimosis hasn’t resolved on its own, treatment may be beneficial. Many adolescents are treated with conservative methods, such as applying corticosteroid creams or ointments for several weeks.
If creams or ointments don’t resolve the issue, a minor surgical procedure may help. This surgery, called circumcision or circumcision, is recommended if there are recurrent foreskin infections, paraphimosis, or scarring-related phimosis. A complete circumcision involves the full removal of the foreskin.
If the tight area of the foreskin is limited to the tip, the doctor may remove only the narrowed section, performing a partial circumcision. In both cases, the incision is stitched. If scarring and phimosis recur, the foreskin can be completely removed in a second operation.
It’s also possible to preserve the foreskin by widening it surgically. This involves making two or three longitudinal cuts in the foreskin and stitching them transversely. These procedures are done under general anesthesia in children, while local anesthesia is typically sufficient for adults. Circumcisions are usually performed by pediatric surgeons or urologists.
The Foreskin as a Source of Arousal?
For some men, their own foreskin or that of a partner is a source of sexual arousal. Losing it due to circumcision may feel significant, but it’s not the end of the world. There are countless other sources of arousal that can excite us. After circumcision, take the time to rediscover your penis—after all surgical wounds have fully healed. This can be done manually or with various sex toys like masturbators or electro-sex toys.
After circumcision, the glans may initially become overly sensitive since it is no longer shielded by the foreskin. If you experience this, moisturize your fingers with baby oil (or almond or sunflower oil) and gently stroke the glans daily. Over a few weeks, you’ll likely notice a decrease in sensitivity. Incorporating this into your masturbation routine can help.
Does Sex Improve or Worsen After Circumcision for Phimosis?
There are few scientific studies on whether sex improves or worsens after phimosis treatment via circumcision. Some men report a decline in their sexual experiences post-surgery. However, this perception is often due to insecurity rather than the procedure itself, which can negatively affect arousal. A Swiss study (EKSG – Swiss Commission for Sexual Health, 2015) found no significant differences in sexual experiences or functionality between circumcised and uncircumcised men.
Many men who underwent circumcision due to phimosis reported improved sex lives afterward. They cited pain-free sex as a significant factor. If you’re affected by phimosis, consider treatment. Surgery on such an intimate area can be a private and perhaps intimidating matter, but it can help you overcome the limitations caused by phimosis, allowing you to urinate and enjoy pain-free sex once again.
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