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Where the [[phimosis]] It is very mild it may be possible to stretch the [[foreskin]] by pulling it back tightly against the head [[glans]] of the erect [[penis]]. One should pull the [[foreskin]] back until one feels non-painful tension in the tight part of the foreskin and hold that for perhaps five minutes. Do that twice two or more times a day. <u>'''Do not force retraction and do not cause yourself pain'''</u>. One should gradually see the narrow tip widen and become more retractable.
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'''Stretching''' of the tight [[foreskin]] is a well-known and the recommended treatment of [[phimosis]] and [[paraphimosis]]. Dunn (1989) reported successful treating of phimosis by manual stretching.<ref name="dunn1989">{{REFjournal |last=Dunn |first= |init=HP |author-link= |etal=no |title=Non-surgical management of phimosis. |trans-title= |language= |journal=Aust N Z J Surg |location= |date=1989-12 |season= |volume=59 |issue=12 |article= |page=963 |pages= |url=http://www.cirp.org/library/treatment/phimosis/dunn1/ |archived= |quote= |pubmedID=2597103 |pubmedCID= |DOI=10.1111/j.1445-2197.1989.tb07640.x |accessdate=2022-09-20}}</ref> Foreskin stretchers should take care to avoid [[paraphimosis]]. === A word to intact teens === Boys are born with a [[foreskin]] that is non-retractable for reasons of [[Immunological_and_protective_function_of_the_foreskin#The_protective_and_hygienic_function_of_the_foreskin| protection]]. The inner surface is fused with the [[glans penis]] by a [[synechia]] (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the foreskin is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider, so the foreskin gradually becomes [[Retraction of the foreskin| retractable]]. A survey carried out in [[Denmark]] found that the mean age of first foreskin retraction is 10.4 years.<ref name="Thorvaldsen">{{REFjournal |last=Thorvaldsen |init=MA |last2=Meyhoff |init2=H |title=Patologisk eller fysiologisk fimose? |trans-title=Pathological or physiological phimosis? |language=Danish |journal=Ugeskr Læger |volume=167 |issue=17 |pages=1858-1862 |url=http://www.cirp.org/library/normal/thorvaldsen1/ |quote= |pubmedID= |pubmedCID= |DOI= |date=2005 |accessdate=2023-12-09}}</ref> This means that 1/2 of boys become retractable earlier and 1/2 of boys become retractable later. a few [[intact]] boys go through puberty but find that their [[foreskin]] is still too narrow to permit retraction. Beaugé (1997) reported that boys, who [[masturbation| masturbate]] by pulling their [[foreskin]] away from the body, will not stretch the tight part of the foreskin so non-retractile foreskin will persist. He advised changing the method of [[masturbation]] to the more conventional method of pulling the foreskin toward the body so that the narrow orifice gets stretched.<ref name="beauge1997">{{REFjournal |last=Beaugé |init=Michel |author-link= |last2= |init2= |author2-link= |url=http://www.cirp.org/library/treatment/phimosis/beauge2/ |title=The causes of adolescent phimosis |journal=Br J Sex Med |date=1997 |volume= |issue=September/October |pages=26 |accessdate=2021-04-21}}</ref> The traditional way of addressing this issue was to consult a [[Issues_with_American_urologists_and_the_practice_of_male_circumcision#Issues_with_care_of_adult_intact_males| urologist]] and get a [[Adolescent and adult circumcision| circumcision]], however we now understand that in the vast majority of cases, manual [[stretching]] over a few months will widen the narrow [[foreskin]] by [[tissue expansion]], make the foreskin retractable and eliminate the need for a destructive and harmful [[Adolescent and adult circumcision| circumcision]]. One should continue to stretch until one gets satisfactory [[gliding action]].
== Methods ==
Human [[skin]] can be stretched and normally returns to its normal size and position. But when stretching is done over a longer period of time, chances are that this stretching causes new [[skin]] cells to grow ([[mitosis]]) and [[tissue expansion]] to occur. We all know this from the [[skin]] which covers e.g. the human stomach or the breast area.=== Topical steroid cream for stretching ===Basically, all curative or constructive stretching of human [[skin]] should be accompanied by applying a steroid cream or lotion to the [[skin]]. The steroid thins the skin and makes stretching easier. Topical steroid treatment is also useful to hasten foreskin retraction in boys with nonretractile foreskins. A number of steroid preparations have been used, including [[stretchinghttps://www.webmd.com/drugs/2/drug-4897-722/betamethasone-valerate-topical/betamethasone-valerate-topical/details Betamethasone Valerate]] easier0.05% to 0.1%, triamcinolone 0.1% and mometasone furoate 0.1%.<ref name="cps2015">{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=AL |author3-link= |etal=yes |title=Newborn male circumcision |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/ |quote= |pubmedID=26435672 |pubmedCID=4578472 |DOI=10.1093/pch/20.6. 311 |accessdate=2023-06-15}}</ref> It does not work without stretching. Betamethasone valerate<ref>{{REFweb
|url=https://en.wikipedia.org/wiki/Betamethasone
|title=Betamethasone
|website=Wikipedia
|accessdate=2020-12-21
}}</ref> is the most commonly recommended active ingredient. A cream with 0.05% betamethasone appears effective in treating [[phimosis ]] in boys,<ref>{{REFjournal
|last=Moreno
|init=G
|DOI10.1002/14651858.CD008973.pub2
|pubmedID=25180668
}}</ref> and often averts the need for [[Adolescent and adult circumcision| circumcision]].<ref>{{REFjournal
|last=Van Howe
|init=RS
}}</ref>
Manual [[stretching]] should continue until the [[foreskin]] will [[Gliding action| glide smoothly]] back and forth while the [[penis]] is erect. ====A word to intact teens==== Boys are born with a [[foreskin]] that is non-retractable for reasons of [[Immunological_and_protective_function_of_the_foreskin#The_protective_and_hygienic_function_of_the_foreskin| protection]]. The inner surface is fused with the [[glans penis]] by a [[synechia]] (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the foreskin is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider as a boy ages, so the foreskin gradually becomes [[Retraction of the foreskin| retractable]]. Some boys go through puberty but find that their [[foreskin]] is still too narrow to permit retraction. Beaugé (1997) reported that boys, who masturbate by pulling their [[foreskin]] away from the body, will not stretch the tight part of the foreskin so non-retractile foreskin will persist. He advised changing the method of [[masturbation]] to the more conventional method of pulling the foreskin toward the body so that the narrow orifice gets stretched.<ref name="beauge1997">{{REFjournal |last=Beaugé |init=Michel |author-link= |last2= |init2= |author2-link= |url=http://www.cirp.org/library/treatment/phimosis/beauge2/ |title=The causes of adolescent phimosis |journal=Br J Sex Med |date=1997 |volume= |issue=September/October |pages=26 |accessdate=2021-04-21}}</ref> The traditional way of addressing this issue was to consult a urologist and get a [[Adolescent and adult circumcision| circumcision]], however we now understand that in the vast majority of cases, manual stretching over a few months will widen the foreskin by [[tissue expansion]], make the foreskin retractable and eliminate the need for a destructive [[Adolescent and adult circumcision| circumcision]].
=== Fingers ===
Or the fingers can be inserted into the opening and used to stretch the foreskin. If the foreskin is only slightly tight, a minor case of phimosis, then the stretching can be accomplished using fingers inserted into the opening in the foreskin and applying outward pressure.<ref name="glansie">{{REFweb
}}</ref>
* [... more to be added ...]
==Video==
<br>
<b>Tips for a tight foreskin</b>
<youtube>v=LoyZ_ur1IqI</youtube>
<br>
<b>4 common treatments for phimosis</b>
<youtube>v=NPwFMSZjiII</youtube>
{{SEEALSO}}
* [[Acroposthion]]
* [[Development of retractable foreskin]]
* [[Frenulum breve]]
* [[Gliding action]]
* [[American urologists and the practice of male circumcision]]
* [[Mitosis]]
* [[Retraction of the foreskinParaphimosis]]* [[Preputial sac]]* [[Preputioplasty]]
* [[Tissue expansion]]
[[Category:Foreskin anatomy]]
[[Category:Genital]]
[[Category:Penile function]]
[[Category:Physiology]]