Dr. Harold Reed Blog

Category Archives: Preputioplasty

Best treatment for phimosis

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.  Roger

Dear Roger,

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 preputioplasty could be considered, but if you look at the medical illustrations, I can’t imagine you’ll be happy with that.

Please see pictures of phimosis on our web-site  penisdoctor.com/before-after-adult-circumcision  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.

Image result for image preputioplasty

Preputioplasty with dorsal incision
Cordially,
Harold M. Reed, M.D.
The Reed Centre for Cosmetic Circumcision | Miami
1-305-865-2000
Phimosis picture
 
Phimosis picture
 
Phimosis picture with inflammation and micro-tears
 
Picture of phimosis treated with adult circumcision
 

Phimosis and adult circumcision

(taken from Wikipedia) Phimosis is a condition in which the foreskin of the penis cannot be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In teenagers and adults, it may result in pain during an erection, but is otherwise not painful. Those affected are at greater risk of…Continue Reading

Unable to retract my foreskin for about 1 year

Dr. Reed,  Believe I have phimosis. Unable to retract my foreskin for about 1 year.  What are the options? My wife is favoring as circumcision.  Gary Dear Gary, While some doctors treat phimosis with steroid creams, the likelihood of permanent cure is nil. Another option is so called preputioplasty, often called a dorsal slit with…Continue Reading

Preputioplasty

Dr. Reed, Seeking a Preputioplasty or tightening of the preputial ring.  I am an uncircumcised UK male. My foreskin has become very slack stretched in the opening, which i find aesthetically displeasing and my wife dislikes as it doesn’t stay forward when erect. I have heard that it is possible to have a V shaped…Continue Reading