Stretching

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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.[1]

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 and tissue expansion to occur. We all know this from the skin which covers e.g. the human stomach or the breast area.

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. It does not work without stretching. Betamethasone valerate[2] is the most commonly recommended active ingredient. A cream with 0.05% betamethasone appears effective in treating phimosis in boys,[3] and often averts the need for circumcision.[4][5][6] It has replaced circumcision as the preferred treatment method for some physicians in the British National Health Service.[7][8]

Other recommended ingredients include Mometasone furoate 0.1%,[9] and Clobetasone 0,05%.[10]

Manual stretching should continue until the foreskin will 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 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 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.[11]

The traditional way of addressing this issue was to consult a urologist and get a 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 circumcision.

Fingers

Where the phimosis is very mild it may be possible to stretch the foreskin by pulling it back tightly against the head of the erect penis. One should pull the foreskin back until one feels tension in the foreskin and hold that for perhaps five minutes. Do that twice a day. Do not force retraction and do not cause yourself pain.

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.[12] [13]

Devices

There are various medical devices available on the market which promise to help stretching the tight foreskin.

See also

External links

References

  1. REFjournal Dunn HP. Non-surgical management of phimosis.. Aust N Z J Surg. December 1989; 59(12): 963. PMID. DOI. Retrieved 20 September 2022.
  2. REFweb Betamethasone, Wikipedia. Retrieved 21 December 2020.
  3. REFjournal Moreno G, Corbalán J, Peñaloza B, Pantoja T. Topical corticosteroids for treating phimosis in boys. The Cochrane Database of Systematic Reviews. 2 September 2014; 9(9): [CD008973]. PMID.
  4. REFjournal Van Howe RS. Cost-effective treatment of phimosis PDF. Pediatrics. 1998; 102(4): [E43]. PMID. DOI.
  5. REFjournal Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A. Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. World Journal of Urology. April 2008; 26(2): 187–90. PMID. DOI.
  6. REFjournal Zampieri N, Corroppolo M, Zuin V, Bianchi S, Camoglio FS. Phimosis and topical steroids: new clinical findings PDF. Pediatr Surg Int. April 2007; 23(4): 331–5. PMID. DOI.
  7. REFjournal Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C. Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int. 2001; 87(3): 239–44. PMID. DOI.
  8. REFjournal Chu CC, Chen KC, Diau GY. Topical steroid treatment of phimosis in boys. J Urol. 1999; 162(3 Pt 1): 861–3. PMID. DOI.
  9. REFweb Mometasone, Wikipedia. Retrieved 21 December 2020.
  10. REFweb Clobetasone, Wikipedia. Retrieved 21 December 2020.
  11. REFjournal Beaugé Michel. The causes of adolescent phimosis. Br J Sex Med. 1997; (September/October): 26. Retrieved 21 April 2021.
  12. REFweb How can I cure phimosis?. Retrieved 21 December 2020.
  13. REFweb (2021). Phimosis Stretching: Helpful illustrated guide (with examples). Retrieved 29 July 2021.
  14. REFweb Foreskin Stretching with Phimosis Rings. Retrieved 21 December 2020.