Phimosis: Difference between revisions
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Phimosis is classed as [[physiological phimosis]] or [[pathological phimosis]]. The physiological phimosis condition in adults is a natural variant, not a disease, so it does not threaten health. Men may elect to treat it or not treat it. Some men live their entire lives with a non-retractile foreskin. [[Sex with phimosis| They are able to have sexual intercourse and father children]]. | Phimosis is classed as [[physiological phimosis]] or [[pathological phimosis]]. The physiological phimosis condition in adults is a natural variant, not a disease, so it does not threaten health. Men may elect to treat it or not treat it. Some men live their entire lives with a non-retractile foreskin. [[Sex with phimosis| They are able to have sexual intercourse and father children]]. | ||
[[Adult circumcision]] is an <i>elective</i> surgical [[amputation]]. One choses to be [[circumcised]] and must first grant [[informed consent]]. When a man states, "<b>I had to have a circumcision</b>," it is usually a lie. | |||
==Positive aspects of phimosis== | ==Positive aspects of phimosis== | ||
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* <b>Alternative Intimacy Experiences:</b> Individuals with phimosis sometimes develop unique approaches to intimacy that focus on broader sensual experiences rather than conventional techniques. | * <b>Alternative Intimacy Experiences:</b> Individuals with phimosis sometimes develop unique approaches to intimacy that focus on broader sensual experiences rather than conventional techniques. | ||
Some men state that they prefer non-retractable foreskin over retractable foreskin. | |||
==Physiologic phimosis== | ==Physiologic phimosis== | ||
[[Michel Beaugé| Beaugé]] (1997) states that adult phimosis persists when the individual uses unusual methods of [[masturbation]] that fail to stretch the narrow foreskin of [[Foreskin#Foreskin_in_infancy_and_childhood| childhood]].<ref name="beauge1997">{{REFjournal | [[Michel Beaugé| Beaugé]] (1997) states that adult phimosis persists when the individual uses unusual methods of [[masturbation]] that fail to stretch the narrow foreskin of [[Foreskin#Foreskin_in_infancy_and_childhood| childhood]].<ref name="beauge1997">{{REFjournal | ||
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From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters [[puberty]]. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point. | From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters [[puberty]]. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point. | ||
Even though the data from [[Jakob Øster]]'s studies have been known for more than half a century,<ref name="Øster1968">{{OesterJ 1968}}</ref> some check lists for school doctors‘ examinations still erroneously refer to [[physiological phimosis]] as an abnormality. | Even though the data from [[Jakob Øster]]'s studies have been known for more than half a century,<ref name="Øster1968">{{OesterJ 1968}}</ref> some check lists for school doctors‘ examinations still erroneously refer to normal, healthy [[physiological phimosis]] as an abnormality. | ||
In most cases, only watchful waiting is necessary, not surgery or other treatment. Parental reassurance is the only treatment required.<ref name="shahid2012" /> | In most cases, only watchful waiting is necessary, not surgery or other treatment. Parental reassurance is the only treatment required.<ref name="shahid2012" /> | ||
By age 10.4 years, about 50 percent of [[intact]] boys have a retractable [[foreskin]].<ref name="Øster1968"/><ref name-"thorvaldsen2005">{{REFjournal | By age 10.4 years, about 50 percent of [[intact]] boys have a retractable [[foreskin]] and about 50 percent do not have a retractable foreskin.<ref name="Øster1968"/><ref name-"thorvaldsen2005">{{REFjournal | ||
|last=Thorvaldsen | |last=Thorvaldsen | ||
|init=MA | |init=MA | ||
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A [[Adolescent and adult circumcision| circumcision]] may be indicated in severe cases of pathological phimosis, where neither non-surgical methods with corticosteroid cream nor foreskin-preserving [[preputioplasty]] are promising (for example with chronic [[balanitis xerotica obliterans]]) or have failed in previous attempts. | A [[Adolescent and adult circumcision| circumcision]] may be indicated in severe cases of pathological phimosis, where neither non-surgical methods with corticosteroid cream nor foreskin-preserving [[preputioplasty]] are promising (for example with chronic [[balanitis xerotica obliterans]]) or have failed in previous attempts. | ||
==Pathological phimosis== | ==Pathological phimosis== | ||
Pathologic phimosis is phimosis caused by lichen sclerosis et atrophicrus (LSA), formerly known as [[balanitis xerotica obliterans]] (BXO), on the [[foreskin]].<ref name="rickwood1980">{{REFjournal | Pathologic phimosis is phimosis caused by lichen sclerosis et atrophicrus (LSA), formerly known as [[balanitis xerotica obliterans]] (BXO), on the [[foreskin]].<ref name="milos2022-09-19">{{REFweb | ||
|url=https://intactamerica.org/ask-marilyn-can-a-tight-foreskin-be-treated-without-circumcision/ | |||
|title=Ask Marilyn—Can a Tight Foreskin be Treated without Circumcision? | |||
|last=Milos | |||
|first= | |||
|init=MF | |||
|author-link=Marilyn Fayre Milos | |||
|publisher=Intact America | |||
|date=2022-09-19 | |||
|accessdate=2024-10-24 | |||
}}</ref> <ref name="rickwood1980">{{REFjournal | |||
|last=Rickwood | |last=Rickwood | ||
|first= | |first= | ||
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|doi= | |doi= | ||
|accessdate=2024-01-13 | |accessdate=2024-01-13 | ||
}}</ref> | }}</ref> | ||
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* Elongation of the frenulum with a [[skin]] graft. | * Elongation of the frenulum with a [[skin]] graft. | ||
Circumcision is not appropriate or necessary to treat [[frenulum breve]]. Patients must be careful when consulting a urologist, because urologists earn an attractive fee from performing | Circumcision is not appropriate or necessary to treat [[frenulum breve]]. Patients must be careful when consulting a urologist, because urologists earn an attractive fee from performing an [[adult circumcision]], so may be quick to recommend inappropriate and unnecessary injurious [[circumcision]] to an unwary patient. | ||
==Hygiene== | |||
The normal non-retractable [[foreskin]] may be easily flushed out with warm water and a [https://www.amazon.com/Syringe-Removing-Syringing-Medi-Grade/dp/B0842B1XMR?sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1 rubber-bulb type ear syringe]. Excessive washing and the use of soap should be avoided.<ref name="Birley1991">{{REFjournal | |||
|last=Birley | |||
|init=HDL | |||
|author-link= | |||
|last2=Wasker | |||
|init2=MM | |||
|last3=Luzzi | |||
|init3=GA | |||
|etal=yes | |||
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing | |||
|journal=Genitourin Med | |||
|date=1993-10-01 | |||
|volume=69 | |||
|issue=5 | |||
|pages=400-3 | |||
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf | |||
|quote= | |||
|pubmedID=8244363 | |||
|pubmedCID=1195128 | |||
|DOI=10.1136/sti.69.5.400 | |||
|accessdate=2025-12-05 | |||
}}</ref> | |||
==Video== | ==Video== | ||
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|accessdate=2025-11-23 | |accessdate=2025-11-23 | ||
}} | }} | ||
* {{REFweb | |||
|url=https://www.reddit.com/r/Intactivists/comments/1nwbfkw/belgium_drops_coverage_for_circumcisions_for/ | |||
|title=Belgium drops coverage for circumcisions for phimosis | |||
|last=Anonymous | |||
|first= | |||
|init= | |||
|author-link= | |||
|publisher=REDDIT | |||
|date=2025-10 | |||
|accessdate=2026-01-07 | |||
}} | |||
The following link contains graphic images and is only for those who are 18 years of age and older. | |||
* {{NSFW}} {{REFweb | |||
|url=https://www.reddit.com/r/Phimosisappreciation/ | |||
|title=Phimosis appreciation | |||
|last=Anonymous | |||
|publisher=Reddit | |||
|accessdate=2026-03-11 | |||
}} | |||
{{REF}} | {{REF}} | ||