Tight foreskin/Phimosis, requiring Circumcision
Symptoms of Tight Foreskin
- Tight/sore frenulum (banjo string)
- Difficulty retracting the foreskin to clean the head of the penis
- Difficulty bringing the foreskin back over the glans if it’s pulled back
- Painful foreskin when the penis is erect
- Sore/itchy/red foreskin or glans penis
- White discolouration of foreskin
- Cracking or fissuring of foreskin which can bleed after sex
Treatments for Tight Foreskin
- Steroid creams (Dermovate for short periods)
- If above fails or pathological phimosis
- Consider surgery (Frenuloplasty or circumcision)
Frenuloplasty
Simple operation that can be performed under local or general anaesthetic
A horizontal incision across the frenulum which is closed vertically
Risks of surgery:Bleeding
- Infection
- Altered sensation (rarely numbness or increased sensitivity)
- Scar formation
- Failure to resolve the tight foreskin requiring circumcision
Circumcision (removal of foreskin)
Can be performed under local or general anaesthetic.
Day case surgery which takes 30-45 minutes.
Abnormal foreskin is removed.
The wound on the penis is closed with absorbable stitches.
Risks of surgery:
- Bleeding
- Infection
- Meatal stenosis (rarely the external urethral opening can become scarred)
- Altered sensation
- 1% poor cosmesis requiring further revision surgery
- Rarely urethral injury
- Removing too much skin resulting in skin tightness during an erection
Post circumcision care:
- Most men take 1 week off work after surgery
- Can shower as normal but avoid soaking in the bath
- After drying apply Vaseline to the head of the penis and wound unless given an antibiotic cream instead
- Avoid sex for 4-6 weeks (until wounds healed)
- Expect the penis to be swollen and bruised for at least a week