Sexual Health Q&A

Q&A
Male Sexual Health Penile Surgery
What are ways to loosen a tight foreskin?

A tight foreskin should always be treated under the care of a qualified medical professional.

The medical term for a foreskin that cannot be pulled back is phimosis. The medical term for a foreskin that has been pulled back but then cannot be replaced is paraphimosis.

Young boys are born with physiologic phimosis. Their foreskin stays in place naturally at first. As the natural adhesions between the inner surface of the foreskin and the head of the penis dissolve over time, boys learn to retract the foreskin and pull it forward again as they explore their genitals. Usually, they are able to do so by age 7, but some boys need more time.

Pathologic phimosis happens in teenage boys and adult men. It can be caused by a naturally tight ring at the tip of the foreskin, poor hygiene, infection, or inflammation.

Sometimes, paraphimosis occurs.  This is similar to phimosis, except the foreskin cannot be pulled forward once it has been retracted.

To treat phimosis, a doctor might prescribe a steroid cream that softens the foreskin and makes it easier to move back and forth. The cream is typically applied to the tip of the foreskin. After a couple of weeks, gentle stretching exercises may begin. These exercises should be taught to patients (or parents/guardians) so they can be performed properly.

More serious cases of phimosis may require circumcision, a procedure in which part or all of the foreskin is surgically removed. If only part of the foreskin is removed, recurrence of phimosis is possible.

To learn more about circumcision, please see these links:

How common is circumcision around the world?
Why might an adult male be circumcised?
What are some benefits of circumcision?
What are some potential complications of circumcision?
How might circumcision affect a partner’s sexual pleasure?

Another surgical option is preputioplasty or dorsal slit, in which an incision is made to widen the foreskin, thus loosening it. No part of the foreskin is removed, but it should be easier to retract and pull forward.

Paraphimosis, when the foreskin cannot be pulled forward from a retracted position, might be treated manually. Usually the doctor numbs the area with a local anesthetic before pulling the foreskin forward with his or her hands.  (Note: This should be done only by a qualified healthcare provider.)  If the paraphimosis is severe, surgery might be necessary.

Paraphimosis is an emergency and needs immediate medical attention to avoid further problems, like tissue death.

Please note: This is a revised article and involves clarifications from a prior post that discussed treatment for a tight foreskin. Please note that men should not treat this condition on their own at home and should always see their doctor if they have trouble retracting the foreskin or pulling it forward.   

Resources

PubMed Health

“What are the treatment options for phimosis?”
(October 7, 2015)
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079408/

International Society for Sexual Medicine

“What is phimosis?”
http://www.issm.info/sexual-health-qa/what-is-phimosis/

MedicineNet.com

Jerry R. Balentine, DO, FACEP
“Phimosis vs. Paraphimosis: Symptoms, Causes, and Treatments”
(Reviewed: May 10, 2017)
https://www.medicinenet.com/phimosis_and_paraphimosis_penis_disorders/article.htm#what_causes_phimosis

WebMD

“2 Penis Disorders: Phimosis and Paraphimosis”
(Reviewed: October 30, 2017)
https://www.webmd.com/men/phimosis-paraphimosis#1-2

ISRN Urology

Shahid, Sukhbir Kaur
“Phimosis in Children”
(Published online: March 5, 2012)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329654/

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