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PHIMOSIS without pain, trouble passing urine. Is sex difficult?

Resolved Question:

Hi Doc,

I believe I am suffering from severe Phimosis i.e. tight penis foreskin which cannot be retracted in flaccid or erect state. It is painless and I have never faced any trouble in passing urine or masturbating, however, I am worried that sex may be painful as the foreskin will be forced back during penetration.

Do I need to treat this ? Is it possible to have painless sex with Phimosis ? If I have to treat it then please suggest some non-surgical treatments. Attaching pictures.

Thanks,

Nikhil Sharma
24 years old patientold, male,


Category: Urologist

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Rajiv Goel is online now

Expert:  Dr. Rajiv Goel replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com

You seem to be having severe phimosis. In all probability you will not have any trouble in having sex.
The only possible treatment appears to be surgery and you should undergo it. Secretions are getting collected under the prepuce and long term to these secretions can lead to development to penile cancer in later life. Surgery is highly recommended. Unfortunately, there is no medical treatment for this.
Feel free to discuss further,

Take care
Sincerely
Rajiv Goel


Patient replied :

Thank you doctor. You consider my case to be a severe case of phimosis and that secretions are getting collected under the prepuce , do you say that on the basis of the pictures I have attached ?
Also doctor, you say that I will not have any problems in having sex , but can you explain how? will my foreskin not be forced back during penetration ?
I have read that there are stretching techniques which can resolve Phimosis. Can I not use any of those methods ? Also besides circumcision what other surgical treatment is there ?
Regards.


Expert:  Dr. Rajiv Goel replied 3 Days.

Hello,
On the basis of pictures you have severe phimosis. Secretions get collected for people who have no phimosis but don't clean on regular basis. Hence secretions are certainly getting collected.
You shall not have any problem during sex as your skin is too tight and shall not get pulled back.
Stretching exercises may help but likelihood of success is less and it may actually bring you to ascudd stage where having sex shall become problematic.
Besides circumcision you can undergo dorsal slit. A small cut is made on the top of foreskin so that the ring opens up and it becomes possible to retract the foreskin.
Feel free to discuss further,

Take care
Sincerely
Rajiv Goel


Patient replied :

Thank you doctor. Since I am a working male, could you please tell me how long this dorsal slit procedure lasts and how long does it take to heal fully? Would you recommend this procedure over circumcision personally ? and which are the best hospitals from where I can get it done and what is the general cost range ? I reside in South Delhi.
Besides , if I wish to use stretching techniques, kindly suggest the best method for a severe case like mine. Thank you doctor. I need answers to these questions so as to enable me to make a sound choice. Also doctor Please tell me about Preputioplasty procedure.
Many regards.


Expert:  Dr. Rajiv Goel replied 2 Days.

Hello,
One is back to work immediately after dorsal slit and usually requires rest of 3-4 days post circumcision.
Dorsal slit is much less invasive and can be done even in a clinic and should cost not more than 5000 rupees.
Personally I shall still prefer circumcision over dorsal slit.
You can keep on pulling on to the foreskin every day to stretch it slowly and slowly and also apply fucibet cream on the skin to thin out the skin.
Please feel free to discuss further,

Take care
Sincerely
Rajiv Goel


Patient replied :

Thanks for all the help doctor. Just one final consultation - Why do you suggest Circumcision over Dorsal slit ? Also I have read about a treatment called Preputioplasty. Kindly inform me about it and the pros and cons of it if possible. I would like the least complex surgical treatment and retain my foreskin if possible. Also, this Fucibet cream, is it available over the counter from a chemist or do I need a doctor's prescription for it ? Thanks Doc.


Expert:  Dr. Rajiv Goel replied 1 Day.

Hello,

I preferred circumcision over dorsal slit just for the reason that there are chances of recurrence with dorsal slit and it may not be very pleasant to look at.
Preputioplasty is an option but your phimosis seems too tight for it.
Fucibet does not need prescription.

Take care
Sincerely,
Dr. Rajiv Goel


Dr. Rajiv Goel
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MCh(urology) Medical Council of India
Fellow, Laparoscopic urology, Germany
Fellow, Urooncology and Robotic urology, Australia
DNB - NBE
Felloship - MCH, Urology/Genito-Urinary Surgery, AIIMS, 2004
Residency - MS, Master of Surgery, AIIMS, 2001
Medical School - MBBS, Bachelor of Medicine and Bachelor of Surgery, AIIMS, 1998
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