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Phimosis

1,089 bytes added, 14:21, 1 November 2019
Add no treatment option.
Even though the data from Jakob Øster's studies (see above) have been known for 51 years, some check lists for school doctors‘ examinations still erroneously refer to physiological phimosis as an abnormality.
 
====No treatment====
Non-retractile or tight foreskin is a condition, not a disease. It is not life threatening. One may elect to remain as one is, without treatment.
 
Many men can have sex, father children, and live happily with a non-retractile foreskin.<ref>{{REFweb
|url=http://www.circumstitions.com/Restric/adult-non-retr.html#adult
|title=Adult non-retracting foreskin ("Phimosis")
|trans-title=
|language=
|last=Young
|first=Hugh
|author-link=
|publisher=Circumstitions
|website=
|date=
|accessdate=2019-11-01
|format=
|quote=The foreskin never retracts, and nor does it cause any kind of problem while having intercourse or masturbating. I have been enjoing a very healthy sex life with my girlfriend since the last two years.
}}</ref>
==== Manual stretching ====
The growth and hormonal surge during puberty alter both the size and size ratio of the penis and penile skin significantly. Also, the first masturbations aid in the process of stretching of the skin and detachment of any remaining childhood fusion.
If, after that, the foreskin still remains too tight, resulting in pain during sexual activities, and making genital hygiene difficult, treatment is indicated. The boy himself should engage in stretching exercises, if needed with the aid of corticosteroid cream. Depending on the active substances, success rates of 80-90% have been documented.<ref>{{REFjournal
|accessdate=2019-09-25
}}</ref>
Manual stretching preserves the foreskin and its many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| physiologial functions]].
Should those therapies not yield the desired outcomes, there is a surgical option, namely a preputioplasty.
==== Preputioplasty ====
 
This surgical method preserves the foreskin. A good cosmetic result and total preservation of the foreskin are achieved. The basic principle of most of those methods consists of making one or more small longitudinal incisions, and then suturing the wound or wounds transversely.
There are several different methods:
 
* Dorsal slit with transverse suturing: this technique places a single lengthwise cut into the stenotic ring which is then closed transversely.
* Lateral preputioplasty: this is a refinement of the dorsal slit with transverse suturing. It consists of two lateral, longitudinal incisions sutured transversely.
* Triple incision: this is a method of foreskin widening. It typically consists of three incisions across the tight ring. They are closed from side to side, thereby increasing the circumference of the tight ring relative to the length of the cuts. From an aesthetic view, it has results far superior to those of a dorsal slit, and usually yields a good cosmetic result.
 
Preputioplasty also preserves the foreskin and its many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| physiologial functions]]
If after a failed attempt to stretch the foreskin with corticosteroid cream a surgical intervention is necessary, a preputioplasty is always to be preferred over classic circumcision, due to its lower morbidity, lower rate of complications and lower costs.
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