Hi XXXXXXX

Thanks for your query.

Inability to retract the foreskin is known as phimosis, resulting due to adhesions between the layers of the penile foreskin.

Poor hygeine, frequent balanitis(inflamation of foreskin), causes scarring of the tissues and hence the retraction gets difficult with time. Forceful retractions will cause minute tears which further increasing scarring.

Phimosis if left untreated will develop into paraphimosis, a condition where forekin is forcibly retracted past the glans and the person fails to replace it back after retraction.This gradually may need to obstruction in lymphatic flow as well as venous flow.Venous engorgements and swelling may eventually develop.Sometimes even the arterial supply gets reduced leading to necrosis or gangrene, which may need amputation of the penis.

Since you have this problem form 3 years, I suggest you to visit a General Surgeon/UROLOGISTfor the same .There is nothing to feel shy, many people have this problem and have got it corrected without difficulties.

An examination along with routine blood and urine work up would be necessary.The treatment is preferably surgery, circumcision is widely done .Other methods would be application of steroid preparations to strecth the skin and remove adhesions, but results may vary.

Circumcision is a simple procedure. It requires local anesthesia, you will be observed for a couple of hours after the procedure and discharged on the same day.After care with dressings may be needed for 10 days. The wound is expected to heal by 2 weeks .After this, no treatment needs to be followed other than good hygiene.

The chances of complications are very rare. Wound infection,bleeding and slow healing are a few to list.One can surely resume normal sexual activities after the wound has healed.

WWW.WWWW.WW please contact the doctor on this link.Please tell him that you were referred from WWW.WWWW.WW
Hope this answers your query.I am available for follow ups as well.

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Hi XXXXXXX

Thanks for the query.

Here are the answers for your questions.

1."i wanted to know that how long can i delay this surgery if needed": It is better you do not delay the surgery as you have had this problem since 3 years, though not an emergency, delaying would lead to more scarring and may need an extensive procedure.

2."Is there acute risk of cancer" : recurrent phimosis can increase the risk of cancer penis.

3."after circumcision what changes will be there with my penis as they remove my foreskin" : Circumcision will have benefits in the form of preventing collection of secretions which pave way for infection, reduced chances of adhesions, reduce risk of developing cancer and good penile hygiene.The only possible problem would be reduced sensitiveness of the penis during sexual activity .This may not be a concern and improves over the time.

The alternative to circumcision would be medical treatment with application of steroid creams to remove scarring and help in retracting the foreskin. Dorsal slit is also a surgical procedure requiring a small incision. Partial circumcision too is a surgical procedure. You can discuss these options with the surgeon you prefer to get examined from.

Hope this answers your query.

Wish you good health.

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Hi XXXXXXX

I understand that you are worried about the condition and have read through regarding what could this be. I appreciate your prompt response to try and see the doctor on this .

Balanitis xerotica obliterans is a condition involving the foreskin of penis,associated with scarring and strictures.It has known to be associated with phimosis and paraphimosis as well.This presents with scarring,pain retention of urine , pain and sexual discomfort.The cause could be an autoimmune disease or even an infection.

This could be best treated by circumcision , however, steroids , antibiotics, laser therapy and testosterone creams are other options.

Collection of too much of smegma would lead to infection due to long standing accumulation, a sign of poor hygiene as well . Circumcision would help in dealing with this problem.

Since you have got an appointment with the doctor,I suggest you not to worry much and wait for an examination.The doctor will guide you on what your condition is and further treatment options.

Hope this answers your queries .

Wish you good health

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Hello Shaurya,

Before you mentioned it, I had figured out that you have BXO (balanitis xerotica obliterans) and advanced from of lichen sclerosus.

Before you go for circumcision, I would prefer you to use a very potent steroid like clobetasol instead of FUCIDIN, twice daily for atleast a month.

Check if there is any softening of skin and if you are able to retract your foreskin. If there is any improvement then you can continue the treatment further.

If not then go for circumcission as it is curative.

Thanks

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