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I am 42 years old, married, normal sex life and never had an issue prior to this. My foreskin seems to have shrunk after a day of masturbating 3-4 times. A typically unusual amount but the mood hit me that day. Since then, my foreskin is extremely tight around my penis when I am erect and the skin is pulled back, it actually is constricting it somewhat. I do not want to be circumcised under any circumstances unless this condition threatens the use of it. Can you give me some advice please?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 23 Doctors Online

Hello and thankyou for approaching DoctorSpring with your query.
From what you have described you seem to probably have developed a condition called paraphimosis.
In this condition the retracted foreskin cannot be returned to normal position.
This is a urologic emergency as the retracted foreskin will develop venous and lymphatic congestion, resulting in swelling and further constriction on the penis which blocks blood flow to the tip of the penis.

Patient usually complains of swelling of the penis and pain in the penis, retracted foreskin which cannot be put back into the normal position, pain while passing urine, or decreased urine flow. With time if ischemia sets in, there will be change in skin color from the normal pink to blue or black.

If you have the above symptoms or you are experiencing what I have described above, I would advise you to visit the ER immediately and get examined to rule out paraphimosis and to prevent complications.
The physician will do a reduction. Depending on the severity the doctor will give you a topical or local anesthesia and digitally manipulate and reduce the condition.
If this does not help, minimally invasive techniques will be used for reduction.
Depending on the severity of your condition the doctor will decide which method will be best suited.

Please visit the ER immediately if the foreskin is retracted and is not going back to its normal position.

I hope this has helped. You can get back to me after visiting your physician.

Patient replied :

Thank you for your prompt reply, it isn't that serious, I can return it to it's normal position, no difficulty in urinating. Why would it just shrink?

Hello, thankyou for your reply. If it can be pushed back to it's normal position, it is a good thing.
It has not shrunk.
The foreskin tends to get trapped behind the coronal sulcus (circumference at the base of the glans penis) which blocks the lymphatic and venous blood flow resulting in swelling of the glans penis.
It occur in case of sexual activity due to forceful retraction of the foreskin which can trap it in the coronal sulcus. Can also occur if one forgets to replace the foreskin after cleaning, urinating or after a sexual activity.
Males who's preputial opening are narrower than usual are more prone to it.
It addition the foreskin may be retracted and difficult to return to normal position if there is an inflammation of the glans penis due to infection resulting in slight swelling of the glans.

For now if you are able to pull the foreskin right up to its normal position, you need not worry.
You can clean the penis gently and apply the OTC hydrocortisone 1% cream on the penis twice a day.
However make sure you are careful and bring the foreskin back to its normal position.

Like I said earlier if the foreskin is retracted and does not return to its normal position, you will have to get it examined immediately.
I hope this has helped.

Patient replied :

Thanks again for your time and advice.

Take care.
Wishing you good health.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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