What is Phimosis?
pronounced ‘Fi Moze Is” is a state in which the male foreskin is unable to retract properly from the head of the penis (or glans). This is due to an unusually tight foreskin. The causes of a tight foreskin can vary, but most commonly it is simply because males are born with it that way. Usually the condition resolves as the male develops into adult-hood. However, a proportion of men can have phimosis persist into later years, with a spectrum of presentations. Also, over time it can also be exacerbated by tearing of the opening of the foreskin, which leaves little scars. This can leave a fairly right rim of scar tissue. Incidence of Phimosis varies, but it is thought to be as high as 1-5% of the male non-circumcised population. The absolute incidence is much higher in Japan, which has never had a cultural practice of circumcision. (reference1)
What are your treatment options?
Do you have a very tight foreskin that causes you regular problems?
Only a medical device or surgery can help. Do not be fooled by books or websites that promise home cure unless the device is listed on a medical device register approved by a Government Health Authority. Our surveys show that only the NOVOGLAN Gentle Foreskin Stretcher meets high levels of customer satisfaction, and that is consistent with the fact that the NOVOGLAN product is the only product approved on the register of therapeutic goods to treat phimosis. We have studied several other types of devices including two devices, a two pronged and three pronged caliper or skin retractor that claim to work to stretch a tight foreskin. These devices look promising, however, they use a technique that has been shown to cause more harm than good. They were first developed in the 1840s. Whilst you can stretch skin quickly to get a quick result, the actual outcome will be that the skin will tighten and the risk of micro tears and scarring could leave the user far worse of than prior to use. There is no shortcut to stretching skin – only slow, regular, gentle, even, pressure in the absence of inflamed skin is the proven way to stretch skin and that includes foreskin. The bottom line is this – if you have a tight foreskin, phimosis, and want to keep it – then be prepared to spend 2 to 4 weeks to stretch the skin slowly. We used to think that it was “Sometimes” good to use a steroid cream or properly formulated foreskin stretching cream prior to stretching. Now we have data that shows that you get the best results when you prepare the foreskin for stretching by using the foreskin stretching cream or steroid.
Can you sometimes pull your foreskin back (flaccid or erect) but have pain or persistent discomfort with your tight foreskin?
If this reflects your condition, Doctors will recommend a gentle stretching device. These devices have a very good track record and are widely accepted as providing the ideal means to widen your foreskin. Most Doctors would always recommend a steroid cream or foreskin stretching cream in conjunction with such a device. You do not always have to use a cream or steroid and if good progress is made then steroids will not be prescribed. If you have little foreskin widening, then a steroid will usually be prescribed
When would you use finger stretching for a tight foreskin?
The use of fingers would only be useful and safe for those men with very very mild tightness of their foreskin. That is, they can usually retract the foreskin without problem, most of the time. They have no pain or discomfort, and have not had infections or irritation. Fingers and the foreskin and penis must be clean and warm. The use of fingers have been shown in some cases to cause infection, especially where nails inadvertently tear or rip the sensitive skin.
What are the only proven treatment options?
- Stretching (stretching of the foreskin can be achieved by a metal calliper or a balloon device
- Steroid Cream (Betamethasone has been proven to assist with making the foreskin stretch and should be used more often especially in combination with the balloon for optimal results)
- Stretch Plus Steroid Cream (This combination should be used as often as clinically indicated and will give the best non surgical outcomes and results should be long term)
- Surgery (Any form of surgery should be used as a last option. Surgery is generally effective, however, any form of surgery has well known risk of side effects and complications)
What are the treatment steps?
Step 1 – use a device designed for stretching a tight foreskin. This should be done over two weeks (or longer), in line with the skins ability to stretch gently and slowly. Stretching should only be done for a few minutes once per day initially. Once the skin responds well to initial stretching, you can increase the level of stretch to however long you are comfortable. Just be sure to apply gentle, even, regular pressure, for at least few minutes over a few weeks. This has been scientifically proven. Some users report using the NOVOGLAN device for up to three hours per day for two weeks and claim to get very good results
Step 2 – if stretching is not progressing well after around 10 days, ask your doctor for a prescription of a steroid cream. Apply this to the foreskin in the morning if stretching at nighttime or in the evening if stretching in the morning.
Step 3 – Ideally, after one week of good results, you can increase the pressure if your stretch within your own comfort zone. The majority of men using gentle stretching devices designed to loosen a tight foreskin, will get very good long lasting results. A few men, will need a referral to a urologist or surgeon with expertise in foreskin surgery. Several options are available. We would suggest that for men who don’t get good results with device, they make sure they use one in combination with steroid and try it for at least 4 weeks. Most men will get their foreskin back to a normal level of function within two to four weeks on average. However, do not despair if it takes longer. We are now reviewing data, that tends to indicate that the longer the foreskin has been tight, the longer it will need to stretch. This data needs to be verified, however, it stands to reason that a long standing problem will take time to fix.
What can your Doctor offer (for uncomplicated phimosis)?
- advice on caring for your foreskin options on stretching with either the metal calliper tool or the more gentler and effective balloon device
- prescription for steroid and counselling on use, side effects etc.
- follow up consultation to review treatment and encourage continued use if progress is slow but positive
- Surgical options if failure or if complications. Always follow your doctor’s advice.
- Do not rely on books or websites promising a home cure that is not listed on Government Medical Device Register. Doctors tell us the only thing you should spend your money on is either a device for stretching foreskins or a doctors appointment for either a steroid prescription or referral for surgery.
More information from the web.
A full review on the topic of phimosis reveals many different approaches to defining phimosis. We have provided the most up to date definitions from reputable websites.
- a constriction of the opening of the foreskin so that it cannot be drawn back over the tip of the penis. ymghealthinfo.org/content.asp
- A condition in which the foreskin of the penis becomes constricted and difficult to retract. www.thehardnessfactor.com/exclusives/glossary.html
- The inability to retract the foreskin beyond the first 2-3 years of life is usually associated with abnormal scarring of the foreskin or phimosis. Steroid cream may be used to promote healing and softening of the foreskin. In cases where the scar may be too severe to permit foreskin retraction, a circumcision is performed. www.choa.org/default.aspx
- tightness of the foreskin, which prevents it from being moved back over the head of the penis www.american-depot.com/services/resources_gl_p.asp
- an abnormal tightness of the foreskin preventing retraction over the glans wordnet.princeton.edu/perl/webwn
- Phimosis is a medical condition in which the foreskin of the penis of an uncircumcised male cannot be fully retracted. Phimosis is a Greek term meaning muzzled. The term is confusing because it is used to denote both a physiological stage of development (i.e., not a disease), and a pathologic condition (i.e., a condition that causes problems for a person). Elasticity and ambiguity of definition are especially common when referring to infants. en.wikipedia.org/wiki/Phimosis
- 1Phimosis(pronounced ‘Fi Moze Is” is a state in which the male foreskin is unable to retract properly from the head of the penis (or glans). This is due to an unusually tight foreskin. The causes of a tight foreskin can vary, but most commonly it is simply because males are born with it that way. Usually the condition resolves as the male develops into adult-hood. However, a proportion of men can have phimosis persist into later years, with a spectrum of presentations. Also, over time it can also be exacerbated by tearing of the opening of the foreskin, which leaves little scars. This can leave a fairly right rim of scar tissue. Incidence of Phimosis varies, but it is thought to be as high as 1-5% of the male non-circumcised population. The absolute incidence is much higher in Japan, which has never had a cultural practice of circumcision. http://store.platigosolutions.com/pages/Phimosis.html This is the site for the Gentle Foreskin Stretcher, “Novoglan Gentle Foreskin Stretcher” Platigo Solution; http://store.platigosolutions.com
GFS “This was supported by a grant from The Sate of NSW (Australia) Government Department of State & Regional Development. “