Phimosis and Paraphimosis
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Phimosis
Phimosis is the condition where the foreskin will not retract during erection. After infancy the foreskin of an uncircumcised male should be loose enough to be drawn back so as to completely expose not only the whole glans but also the groove of the sulcus behind it. It should also be possible to pull the foreskin forward again without pain or difficulty. In a mature youth this action should be possible with the penis erect. If the foreskin cannot be retracted, adequate washing is not possible and smegma accumulates.
Phimosis in adults makes sexual intercourse unsatisfactory for both parties; the sensations of copulation are reduced. There are also implications for procreational (as opposed to recreational) sex. Upon ejaculation, semen will not readily be deposited in close proximity to the cervix, potentially resulting in reduced fertility.
In severe cases of phimosis, the opening at the tip of the foreskin becomes so small that even urinating becomes difficult.
[Photos submitted by a CIRCLIST member] |
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Paraphimosis
Paraphimosis is the condition where a retracted foreskin cannot readily be repositioned to cover the glans, instead remaining stuck in the retracted position. In this painful condition, the foreskin strangulates the glans and emergency treatment is necessary.
[Image © 1984, A Color Atlas of Accidents and Emergencies.] |
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Comments applicable to both conditions...
Phimosis and/or Paraphimosis may follow injury or inflammation, or it may be a developmental abnormality. Parents are often surprised to learn that their teenager needs a circumcision, having been assured earlier in life that he was perfectly normal. The explanation is this: Before puberty the opening in the prepuce was large enough to allow the glans to pass through, but during the rapid growth of the penis at puberty only that part of the foreskin which covers the glans enlarges proportionally. In consequence, the tip of the prepuce which lies beyond the glans becomes relatively smaller and the much-enlarged glans will no longer pass through.
A tight foreskin cannot be cured by stretching because small splits or tears form. When these heal they create scar tissue, which (being less elastic than the original) make the condition worse than before.
A favourite recommendation of 'Intactivists' is to suggest that steroidal creams be used to promote enlargement of a phimotic prepuce through stimulated skin growth. This is a course of action strongly opposed by CIRCLIST. Some steroids are carcinogenic and many are estrogen mimics; this has been known for years (Metzler, 1984). Neither of these characteristics appear desireable in a substance applied to male sexual anatomy! It is also somewhat doubtful that they are effective in securing the desired outcome.
The only realistic cure for a tight, phimotic foreskin is circumcision.
References and Acknowledgements
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