Tight foreskin
The foreskin is the hood of skin that covers the head of
the penis. If you have been circumcised, you will not have
a foreskin.
- In small children the foreskin is tight and stuck to
the glans, but normally begins to separate at about the
age of 3 or 4. If the hole in the foreskin looks abnormally
tiny, ask your doctor to check.
- After the age of 7, it is usually
possible to pull the foreskin back over the head
(or glans) of the penis, but in some boys this is
not possible before the age of 14 or 15. So if you
are 13 or 14, do not worry – this
is perfectly normal.
- If you are 15 or over and cannot pull your foreskin back,
it may be too tight.
A tight foreskin is called phimosis . If you have phimosis,
you will not be able to wash under your foreskin properly,
so a white, cheesy material called smegma can accumulate.
Also, if the condition is severe, it may be painful when
the penis is erect.
Some men have phimosis from childhood, but it can also occur
late in life, perhaps as a result of several thrush infections
affecting the head of the penis. Another common reason is
a skin condition called balanitis xerotica obliterans, which
makes the foreskin pale and thickened. The cause of this
condition is not known; it is not an infection.
Treatment
If it
is very tight, there is no point in trying to force the foreskin
back: you will only cause painful cracks on the inside of
the foreskin, which will scar as they heal and make it worse.
NORM-UK suggests that
you try gentle stretching, and advises on how to do this.
If this does not solve the problem, you probably need an
operation.
Circumcision is the most common operation.
The surgeon separates the foreskin from the head of the penis
(if it is stuck down), cuts the foreskin away and closes
the incision with stitches. The glans will seem very sensitive
after the operation, because it is not used to being exposed.
Most men have erections during their sleep, so for a few
weeks after the operation, you may wake in the middle of
the night with a sore penis; taking a pain-relieving medication
at bedtime will help. Wear loose boxer shorts and use a condom
during sex for the first month or two.
If the doctor thinks the cause is balanitis xerotica obliterans,
steroid creams will be used first; this often relieves the
condition for several years, but eventually circumcision
is usually needed.
Preputioplasty is a lesser operation. It
involves making a vertical incision in the foreskin and then
stitching it crosswise to widen the opening; it usually leaves
a very normal appearance.