Sep 26, 2022
By Marilyn Milos, RN
Sometimes the retractable foreskin of an adult male will close down; this condition is called “pathological phimosis.” Too often, when men who have developed pathological phimosis consult with a urologist or other physician, they are told that the only cure is circumcision. This is incorrect in most cases.
The word phimosis means muzzling, to indicate that the glans (head of the penis) is muzzled by the foreskin. At birth, most babies have “physiological phimosis,” a normal condition because the glans and foreskin have not yet separated. The foreskin separates from the glans over time, usually by adolescence.
But even after the foreskin becomes mobile and retractable, it is possible that a man will one day begin to have trouble retracting it, and be diagnosed with pathological phimosis.
Here are a few possible causes for pathological phimosis, along with cures that you can pursue in order to avoid the loss of your foreskin.
1. Yeast imbalance. Exposure to soap, shampoos, and chlorinated water in swimming pools or hot tubs can kill normal, beneficial bacteria on the foreskin. This can result in yeast overgrowth, inflammation, itching, and stinging with urination; it can also make the foreskin close down. A yeast imbalance can be corrected by eliminating soap and shampoo, or by using a barrier cream on the foreskin before swimming. To help the healing process. Liquid Acidophilus culture purchased from the health food store or pharmacy can also be applied to the foreskin by pouring some of the liquid into the palm of the hand, dipping the foreskin into the solution, and letting it drip dry; do this six times a day for 3 or 4 days.
2. Vigorous sexual activity. Sometimes the foreskin will close down if a male has been too vigorous sexually, which can cause small tears in the foreskin. The opening will become tight while the tissue heals. Time and gentleness are the cure for this.
3. “Lichen sclerosus” (formerly called “BXO”), is another condition that can cause the foreskin to become too tight. Lichen sclerosus is characterized by the presence of small, shiny, and smooth white patches on the foreskin. These patches may become larger, and the skin may become itchy, thin, and wrinkled, and may tear easily and bleed. A dermatologist can diagnose lichen sclerosus, which is commonly treated with two creams, Clotrimazole and hydrocortisone, both available over the counter at your local pharmacy, or by prescription, depending upon the desired strength.
If none of these conditions is present, and your foreskin is simply too tight for comfortable retraction, before considering circumcision, ask your urologist about a Y-V- or Z-plasty. These are surgical techniques in which small slits are cut in the foreskin, and then sewn together in a way that widens the opening. This surgery saves the foreskin and its specialized nerve endings that allow for full sexual sensations and enjoyment.
As you can see, finding the reason for your phimosis is a critical step to solving the problem and avoiding the loss of your foreskin.
If you have questions not covered here about problems with your foreskin, you may write to us at: [email protected].
Sep 26, 2022
During my Obstetrics and Gynecology Residency, I had the opportunity to learn newborn circumcision. Because of the frequency of the procedure, I agreed to the training. Yes, the Siren on the rocks of “cultural normalcy” called me.
Immediately prior to the training, I remember a blond-haired resident giddy with excitement at being able to learn the procedure, and vividly recall her saying: “Have the nursing staff line the boys up. Go Chop! Chop! Chop! Think of all the RVUs you can make??” RVU stands for Relative Value Unit, which is a figure used for compensation. Obviously, her main concern was the amount of money that could be generated by sexually maiming newborn boys in the name of profit.
The white Circumstraint board was on a procedure table. The baby was brought into the room. The mother’s written “consent” had been verified.
There were three of us. My assigned job was to put the safety pin through the foreskin.
The naked baby was then placed in four-point restraint and immediately began crying uncontrollably. Someone prepped the skin. Another Resident placed the local anesthetic which resulted in further crying. Those who have children or work with newborns know that babies do “talk” in their own ways. There are cries of hunger. Cries of frustration, and cries of absolute fear and pain. Perhaps I am blocking out the other parts of the procedure that the other two doctor trainees performed.
It came time for me to place the safety pin, so I was standing directly over the baby. The screaming was just awful. I can remember starting to place the safety pin in the foreskin and small dot of blood appeared where the pin would be placed. At this point, I almost walked out of the room. Seeing a naked restrained human screaming in pain, with his head rocking back, spittle flying from his little mouth was too much. I wondered, “Now why are we doing this? Why are we violating this human being? I finished my part and stepped aside. As the shrieks of the restrained baby intensified, the third resident severed the baby’s foreskin along the edge of the clamp and placed the circular bloody specimen on side of the Circumstraint.
I will never forget the shrieks of that baby.
The episode left me with the knowledge that I had violated my own morals as well as the code of medical ethics. Indisputably, we had done harm to the baby that day. The baby’s normal genital anatomy at birth had been forever changed, leaving him physically altered as well as neurologically ruined. Unquestionably, it is impossible for a newborn baby to give consent for such a procedure. I still hear the screams from time-to-time.
And we call ourselves healers?
I have never performed or taken part in another circumcision.
— James F. Verrees, M.D., FACOG
Las Vegas, Nevada
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Sep 26, 2022
Dear Marilyn,
My almost 5 year old keeps having erections and is complaining that it’s hurting. Is that normal for an intact kiddo? My oldest is circed as is hubby so this is new to me and hubby. What can I do to help him?
—Emily in Indiana
Dear Emily,
How does your son’s penis look? Are there any changes in his foreskin? Is it red or swollen? If not, then your son’s painful erections may need to be directly addressed. Erections are normal and begin in babies in utero. If your son’s erections are painful, then the development of his penis needs to be explained to him. When he understands that at birth the foreskin is usually non-retractile because the foreskin and glans (head of the penis) are attached when they develop. These two structures will separate over time. Once the foreskin and glans separate, the foreskin becomes retractable. As the foreskin becomes retractable, erections may cause sensations as the foreskin separates from the glans or because the opening of the foreskin is not yet large enough to accommodate retraction of the glans. Discussion of these aspects of his penile development should help determine where the pain is coming from so that your son can consider and accept the sensations as a part of the developmental process or something that needs to be addressed.
—Marilyn
Sep 19, 2022
Dear Marilyn:
I’m a 35-year-old man. I have been having trouble with a very tight foreskin. My doctor says it’s phimosis, and the only treatment is circumcision. Is there any other remedy? I’d really like to keep my foreskin.
—Harold, New Orleans, LA
Dear Harold:
The word phimosis means muzzled, to indicate that the glans (head of the penis) is muzzled by the foreskin. At birth, most babies have “physiological phimosis,” a normal condition because the glans and foreskin have not yet separated. The foreskin separates from the glans over time, usually by adolescence.
Sometimes a retractable foreskin of an adult male will close down; this condition is called “pathological phimosis.” From your letter, I cannot determine why your foreskin has closed down, so I will suggest a number of possible causes and cures.
- Exposure to soap, shampoos, and chlorinated water in swimming pools or hot tubs can kill normal, beneficial bacteria on the foreskin, which can result in yeast overgrowth, inflammation, itching, and stinging with urination; it can also make the foreskin close down. This condition can be corrected by eliminating soap and shampoo, or by using barriers creams on the foreskin before swimming. To help the healing process. liquid Acidophilus culture purchased from the health food store or pharmacy can also be applied to the foreskin by pouring some of the liquid into the palm of the hand, dipping the foreskin into the solution, and letting it drip dry; do this six times a day for 3 or 4 days.
- Sometimes the foreskin will close down if a male has been too vigorous sexually, which can cause small tears in the foreskin. The opening will become tight while the tissue heals. Time and gentleness are the cure for this.
- Pathological phimosis can result from a condition called “lichen sclerosus” (formerly called “BXO”), characterized by the presence of small, shiny, and smooth white patches on the foreskin. These patches may become larger, and the skin may become itchy, thin, and wrinkled, and may tear easily and bleed. A dermatologist can diagnose lichen sclerosus, which is commonly treated with two creams, Clotrimazole and hydrocortisone, both available over-the-counter at your local pharmacy or by prescription, depending upon the desired strength.
- Finally, before considering circumcision, ask your urologist about a Y-V- or Z-plasty—a surgery in which small slits are cut in the foreskin, and then they are sewn together in a way that widens the opening. This surgery saves the foreskin and its specialized nerve endings that allow for full sexual sensations and enjoyment.
So, you can see, Harold, that finding the reason for your phimosis is a critical step to solving the problem and avoiding the loss of your foreskin.
—Marilyn
Sep 12, 2022
Dear Marilyn:
I have hair going up the shaft of my penis. Is this normal?
—Daniel F., Tulsa, OK
Dear Daniel:
Hair on human bodies varies by individual. Penile shaft hair is rare but most frequently it is the result of circumcision, which pulls scrotal skin onto the shaft. Men with this problem sometimes manually remove the hairs one-by-one with a tweezer, or resort to electrolysis to eradicate unwanted hair growth on the shaft. If we stop doing circumcisions, this problem will end.
—Marilyn
Sep 5, 2022
Dear Marilyn,
The doctor cut off only a little bit of foreskin—way less than I’ve noticed in other circumcised babies his age (4 months)—when she circumcised my son. Should I take him for a second circumcision? Should I do it now or wait until he is older? How old?
—Sophia
Dear Sophia,
Many doctors are beginning to understand that the extreme removal of foreskin tissue also removes the ability to have a normal, full erection. Without that tissue, men suffer from tight and painful erections. The foreskin is meant to cover and protect the glans (head of the penis) and the urinary meatus (opening). The tissue at the opening of the foreskin contains thousands of nerve endings that provide a male with the ability to ride the wave to orgasm the same way women do. These are cut off with circumcision. This is what doctors should tell parents as part of an “informed” consent, but they often do not understand the protective, immunological, sensitive, and sexual benefits of the foreskin because they themselves are likely circumcised or their spouse is. Hopefully your son’s remaining foreskin will protect enough of his glans to maintain its sensitivity. Many circumcised males are using stretching techniques to re-cover the glans to regain sensitivity and, when your son grows up, should he want to do that, he’ll have a head start.
—Marilyn
