Phimosis: Difference between revisions

'''Phimosis''' (''fɪˈmoʊsɨs'' or ''faɪˈmoʊsɨs'', from the Greek ''phimos'' (φῑμός "muzzle"), in adults is a natural variant of the [[penis]] in which the [[foreskin]] cannot be fully retracted over the [[glans penis]] to uncover and expose the [[glans penis]] that occurs in up to ten percent of [[foreskinned]] adult males. A medical dictionary defines phimosis as "Tightness of the foreskin (prepuce) of such degree as to prevent retraction. This may be congenital or the result of inflammation. Severe phimosis that interferes with [[urination]] is an indication for circumcision. From the Greek <i>phmoun</i>, to gag or muzzle."<ref>{REFweb

[[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 <i>had</i> to have a circumcision</b>," it is usually a lie.

}}</ref> According to Beaugé, the condition may be treated by changing one's method of [[masturbation]].

[[Physiological phimosis]] is a normal, healthy stage of development in children and young people that does not require treatment.

Manual [[stretching]] preserves the [[foreskin]] and its many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| physiological functions]], and renders the foreskin retractable, but may take some months to achieve.<ref>{{REFweb

Carilli et al. (2021) tested the PhimoStop device which gradually dilates the [[foreskin]] over an extended period of time. Phimosed men were treated for sixty days. The treatment helped 52.1 percent of the men to resolve their phimosis.<ref>{{REFjournal

Men who consult a [[urologist]] regarding non-retractile [[foreskin]] will usually receive a recommendation for [[adult circumcision]] because that surgery produces the [[Financial incentive| highest profit]] for the urologist. Circumcision (partial penile [[amputation]]) once was the classic treatment for phimosis, but has many disadvantages and drawbacks. [[Neurotomy]] is an unavoidable feature of every [[adult circumcision| circumcision]] and causes severe loss of [[erogenous sensation of the foreskin]]. [[Adolescent and adult circumcision| Circumcision]] is less performed today, because it is becoming outmoded by newer and better treatments.<ref name="shahid2012" />

* Circumcision permanently and irreversibly amputates the [[Foreskin sensitivity| highly innervated]], erogenous [[foreskin]], so its [[Foreskin#Physiological_functions| multiple protective, immunological, sensory, and sexual physiological functions]] are destroyed and has many [[risks and complications]]. The sensitive head of the [[penis]] will be permanently exposed, so newly [[circumcised]] men find it very painful when the [[glans penis]] is touched or rubs against clothing. The pain will persist until [[keratinization]] occurs.

* Circumcision has a long, painful, and difficult recovery. Erections are painful. Post-circumcision [[lymphoedema]] caused swelling can last for many months. Recovery time is placed at six weeks. Erections may cause sutures to pull out, thus opening the surgical wound, causing [[wound dehiscence]]. Sexual and [[Psychological issues of male circumcision| psychological]] issues abound. As with other surgery, complications are surgical misadventure, [[bleeding]], and [[infection]]. Loss of the [[penis]] and [[death]] are known.<ref name="shahid2012" /> <ref name="williams-kapila1993">{{REFjournal

* Circumcision is irreverible [[amputation]]. Circumcision cannot be undone. [[Regret men]] are common.

Many men would prefer to live with phimosis in preference to losing one's [[foreskin]] to an [[adult circumcision]]. Phimosis is a condition, not a disease. Circumcision is usually an elective surgical [[amputation]]. Men who elect to be [[circumcised]] can only blame themselves, if they do not like the results. [[Regret men]] are common.

[[Frenulum breve]] is frequently confused with phimosis. To make a differential diagnosis, one may attempt to retract the foreskin when the penis is erect. Since the underside of the glans is attached to the inner foreskin by the [[frenulum]], if frenulum breve is present, the head of the penis will bend downwards due to the resulting tension when the [[foreskin]] is retracted.

To help the healing, lukewarm camomile baths or cremes containing panthenol can be applied. With a very short ]]frenulum]] and previous large tears, surgical treatment is advised.

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 harm| harmful]] [[circumcision]] to an unwary patient.