Dr. Reed, Have serious phimosis. Unable to retract my foreskin over my head. I am 24 and worried. What is the best ways to manage this and any alternatives? I am very nervous. Kent
Phimosis is a normal situation for newborns and by the time a man reaches 18 years of age, only 3% still have phimosis. The others can retract fully without difficulty. The best treatment for phimosis is adult circumcision. Others will mention steroid creams which may work temporarily but the phimotic tendency will return again and again. With each stretching event the elastic fibers of your foreskin are replaced with scar fibers, which only when stretched and broken reform with more scar.
If you wish to maintain semblance of a foreskin, you need at least to have the scarred portion removed. Another procedure called a preputioplastycould be considered, but if you look at the medical illustrations, I can’t imagine you’ll be happy with that.
Please see before and after phimosis pictures on our web-site adult-male-circumcision.com/photographic-examples/ Start at Phimosis Example: 10/1 – 10/3 and scroll down.
Here’s an article re: preputioplasty on children. Note this was written in 2003 and from the UK J R Soc Med. 2003 Sep; 96(9): 452–453.
23 boys (mean age 5 years; range 1–10) underwent preputioplasty as a day case under the care of two consultant urologists in the course of 3 years. The procedure was offered to those who had a problematic irretractable prepuce with a clear tight band and no evidence of balanitis xerotica obliterans (lichen planus et atrophicus). Under general anaesthesia, a dorsal longitudinal incision is made through the tight preputial band. After haemostasis, the wound is closed horizontally with a 4/0 Vicryl Rapide suture (Figure 1). Parents were asked to begin retraction of the foreskin the next day, placing 2% lidocaine gel behind it, and to continue for three days. The questionnaire (available from the authors) asked parents to address nine questions concerning the outcome and their satisfaction.
The Reed Centre for Cosmetic Circumcision | Miami