Understanding and treating tight foreskin in adults

Tight foreskin, a condition known as phimosis, is a prevalent concern among adult males, raising questions about its causes, associated risks, and potential impact on sexual health. In his latest online article, Mr Edward Calleja explores the various factors contributing to a tight foreskin, ranging from inflammation and inadequate hygiene to more severe conditions like lichen sclerosus.

What causes tight foreskin in adult males, and is it a common condition?

Usual causes of a tight foreskin include frequent inflammation of the head of the penis (balanitis), which can lead to scarring and foreskin tightness. Additionally, lack of cleaning can result in the buildup of a pale substance known as smegma, leading to infections and eventual scarring. Inflammatory skin conditions, such as lichen sclerosus, may cause a hardened ring at the tip of the foreskin, impeding its ability to retract. Forcefully retracting the foreskin or experiencing trauma might also result in scarring and tightness. Phimosis is a frequently observed condition in young children but is expected to resolve; by the age of 16-18, only 1% of men will experience phimosis.

What are the potential complications or risks associated with adult male tight foreskin?

Tight foreskin can lead to several complications if not addressed:

1. Difficulty in retracting the foreskin can lead to pain during sexual activities or while urinating.

2. Increased risk of infections.

3. In severe cases can cause difficulty in peeing, leading to urinary retention.

4. It can lead to paraphimosis, where the foreskin gets stuck behind the head of the penis and cannot return to its original position, causing painful swelling and restricting blood flow. One needs to seek immediate medical treatment.

Can tight foreskin impact sexual health, and what are the implications for sexual activity?

Tight foreskin can significantly impact sexual health and activity in various ways. Difficulty in retracting the foreskin can lead to pain and discomfort during sexual activity. The psychological stress resulting from the fear of pain or the physical discomfort itself can lead to erectile issues. Some men may experience decreased sensitivity post-circumcision, as the glans becomes less protected. Issues with sexual performance or appearance can lead to anxiety, stress, or decreased self-esteem.

Are there non-surgical treatments or exercises to address tight foreskin in adults?

1. Corticosteroid creams can be applied to the foreskin to reduce inflammation and encourage gentle stretching.

2. Regular gentle stretching exercises, especially after a warm shower, can gradually increase the foreskin's elasticity. Performing these exercises regularly and carefully is crucial to avoid tears and scarring.  There are innovative devices that use custom-moulded balloons to induce gradual skin remodelling and dilatation of the prepuce.

3. Good hygiene practices: Maintaining cleanliness can prevent infections and reduce the risk of the foreskin becoming tighter.

What is the process of adult male circumcision, and how effective is it in treating tight foreskin?

Circumcision is a day-case surgical procedure that is performed under general or local anaesthesia. Following a meticulous separation of the foreskin from the glans penis, a predetermined quantity of foreskin is surgically removed. The edges are sutured together with a dissolvable stitch. A sterile dressing is applied to the affected area to promote a safe recovery and prevent infection.

Circumcision is highly effective in treating phimosis and preventing its recurrence. It also reduces the risk of certain infections and conditions associated with a tight foreskin.

Mr Edward Calleja is an esteemed urologist with over 20 years of experience. You can schedule an appointment with Mr Calleja on his Top Doctors profile.