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Manual stretching preserves the foreskin and its many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| physiologial functions]].
==== Preputioplasty ====
=== Pathological phimosis ===
=== Short frenulum (frenulum breve) ===
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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.
==Treatment options==
====No treatment====
|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.
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This option preserves the foreskin, it appearance, and most of the protective, immunological, sensory, and sexual functions, but does not make the foreskin retractable.
==== Manual stretching ====
|accessdate=2019-09-25
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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.
==== Preputioplasty ====
Should those therapies not yield the desired outcomes, there is a surgical option, namely a 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.
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.
In pathological phimosis, the foreskin cannot be retracted over the glans without injury, due to a lack of elasticity caused by scarring or hardening.
A circumcision is 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.
If the frenulum is too short, it can hinder or even prohibit retraction of the foreskin. Since the underside of the glans is attached to the inner foreskin by the frenulum, it can be bent downwards due to the resulting tension when the foreskin is retracted. If the mechanical strain is too great, the frenulum can tear or rip apart. If the frenular artery, which runs within, is damaged in the process, it can lead to considerable and prolonged bleeding. When only small tears appear, it may heal spontaneously.
{{SEEALSO}}
* [[Retraction of the foreskin]]
* [[Foreskin#Physiological_Phimosis|Physiological Phimosis]], described in the [[Circumpendium]]
* [[Foreskin#Pathological_Phimosis|Pathological Phimosis]], described in the [[Circumpendium]]
{{REF}}
[[Category:From Intactipedia]]
[[Category:Medicine]]
[[Category:Penile disorders]]
[[de:Phimose]]