Foreskin tightening in adults?
Although foreskin tightening in adulthood is rare, it cannot be ruled out and should not be underestimated. Those affected find that the foreskin can only be pulled back with pain or not at all.
Phimosis: What is foreskin tightening?
„Phimosis“ is the medical term for foreskin tightness. In uncircumcised men, the glans is covered by the foreskin, which can be easily retracted when necessary. However, if it is not possible to retract the foreskin, this is referred to as phimosis. This is often associated with discomfort when urinating or pain during erection.
There are two types of foreskin tightness: incomplete and complete. In the case of incomplete phimosis, the foreskin cannot be pulled back when the penis is erect. In the case of complete foreskin tightness, the foreskin cannot be pulled back over the glans even when the penis is flaccid.
Those affected should not pull back their foreskin forcefully under any circumstances, as this can worsen the foreskin tightening and thus also complicate treatment.
If you cannot pull back your foreskin over the glans without pain or if you experience severe pain during an erection, discuss the problem with a urologist.
How does phimosis develop, what types are there, and what are the symptoms?
A distinction is made between congenital phimosis, which is primary, and phimosis acquired during the course of life, which is secondary.
Congenital “primary” phimosis
Primary phimosis is present from birth. This must be distinguished from natural phimosis, also known as foreskin adhesion. Foreskin adhesion and the associated symptoms of foreskin narrowing resolve on their own in the first few years of life. In true primary phimosis, however, the symptoms of foreskin narrowing persist unless treated.
Acquired, secondary phimosis
Secondary, acquired phimosis is when the symptoms only appear later in life. The reasons for such phimosis in adulthood can vary: the most common causes include injuries and inflammation in the area of the glans and foreskin. However, impaired sugar metabolism (diabetes mellitus) or the rare skin disease “lichen sclerosus” can also lead to foreskin narrowing in adult men.
Occurrence of phimosis
It is estimated that approximately 96 out of 100 male newborns are born with natural phimosis. However, this natural narrowing recedes in the majority of cases during the first few years of life. By puberty, very few boys still have phimosis. At the age of 16, only one in 100 still has foreskin narrowing. Even in adults, foreskin tightness is pretty rare.
It’s possible that phimosis doesn’t cause any problems, but in most cases, it leads to complications.
Problems caused by phimosis
Je nachdem, wie stark die Vorhautverengung ausgeprägt ist, variieren auch die Beschwerden und Symptome.
The severity of the symptoms varies depending on how severe the foreskin tightening is.
Typical symptoms include inflammation under the foreskin, itching, swelling, and redness, as well as problems and pain during urination. Severe foreskin tightening can lead to urine retention. In the worst case, the foreskin swells up (“ballooning”), which requires urgent treatment.
Furthermore, foreskin tightness can lead to severe limitations during sexual intercourse: erection and ejaculation problems, as well as pain during sex.
The most dangerous symptom is known as paraphimosis (“Spanish collar”) . This is when the retracted, too-tight foreskin cannot be pulled back over the glans, cutting off blood circulation and causing the glans to swell. In this case, rapid treatment is absolutely necessary, as permanent damage can occur. In addition, thorough cleaning is no longer possible.
This can lead to more severe inflammation, which requires more intensive treatment.
Treatment options for phimosis
The treatment of phimosis depends on several factors: the type and severity of the phimosis and whether it causes discomfort.
Mild cases of phimosis can be treated with a cortisone-based ointment. The ointment softens the foreskin and makes it easier to retract. The ointment is usually applied to the affected area once or twice a day for about six weeks. If the phimosis is caused by an infection, antibiotics or antifungal medication may be prescribed if necessary.
Foreskin stretching exercises can also help in mild cases. Pulling the foreskin back and forth can be used preventively to prevent phimosis from recurring. A doctor can teach the patient how to perform these exercises.
Surgical treatment: circumcision
In more severe cases of foreskin tightness, circumcision is usually performed. This minor surgical procedure, known as circumcision, involves the complete or partial removal of the foreskin.
In complete circumcision, also known as total circumcision, the foreskin is removed entirely so that the glans is completely exposed after the operation. Partial circumcision, also known as subtotal circumcision, aims to remove only part of the foreskin so that the rest of the foreskin can then be easily pulled back behind the glans.
In an extension plasty (“preputioplasty”), the foreskin remains almost completely intact and is only cut or stretched to such an extent that the foreskin can be easily pulled forward and backward again.
If you cannot pull back your foreskin over your glans without pain or if you experience severe pain during an erection, discuss the problem with a urologist.
