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Pain, swelling, redness in foreskin, problem with retracting. Uncircumcised, diabetic. Can I go for circumcision ?

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General & Family Physician
Practicing since : 2005
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Hi, I am male, 31. About 2 years back I was diagnosed with diabetes and I have been on medication ever since. I take Metformin (1 gm twice a day) and Gliclazide (120 mg twice a day) as prescribed by my doctor. I am uncircumcised and very active sexually. I always had a problem in pulling my foreskin back, especially with an erection but never really had much of a pain or discomfort. But lately I have been experiencing a lot of pain , swelling and redness in my foreskin. It has become so tight that I can't pull it back at all. Also, from whatever I can see of my penis's glans, it looks red with white flaky patches. During urination and when I try to clean my penis, these white stuff comes out. This has happened 3 times in the past 4 months or so. Each time I have suffered pain, discomfort and itchiness for about 12-15 days. I am not sure if this is related to my blood sugar levels. But I am seriously considering getting circumcised. Will it be advisable for a diabetic male of 31 years to get circumcised?
Posted Fri, 13 Jul 2012 in Penis Problems
Answered by Dr. Prasad 8 hours later


Thanks for the query.

I appreciate your efforts to seek medical help online on this forum. I have gone through the details provided by you with diligence and my opinion is as follows:

1. Smegma is a collection of exfoliated skin and genital secretions. This gets collected under the foreskin in some men. The collection appears as white and flaky debris. As such this is a harmless condition, however when left uncleaned it can be site of microbial activity results in balanitis (inflammation of foreskin and glans).
Since you are uncircumcised and sexually active, what you have is smegma collection that is getting infected.

Uncontrolled diabetes is a factor increasing chances of infection.

2. Untreated infection can result in swelling, adhesion and tight foreskin. Your inability to retract the foreskin could probably be due to unattended infection.

What you need now?
1. Smegma can be easily cleaned with running water. So clean them up every day. Make sure you maintain this hygiene. You will be able to prevent worsening of this problem.
2. Current infection can be treated with topical antibiotic preparation. 2% Mupirocin and 1% clindamycin ointments are available over the counter. You may use them.
3. Visit your urologist for clinical examination. Perhaps swab test if there are any discharge might be helpful. You may also start on oral antibiotics under the supervision of the urosurgeon for better treatment of balanitis.
4. Manage your sugars properly with regular medications and lifestyle changes. Monitoring glycosylated hemoglobin (Hba1c) levels once every 3 months will give you a better idea of sugar control. Your target should be keeping Hba1c level under 6.5
5. I feel your condition can be treated conservatively with only medications. You may plan circumcision if the tightness is severe and doesn't get better following cure of balanitis.

Hope I was able to address all your current concerns. Let me know if you need more information.
If all your concerns are addressed, please close this discussion. Your feed backs are appreciated.

Warm Regards
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