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Stretching To Fix A Tight Foreskin (Phimosis) by Geoff B
Anatomy
The penis has a number of structures that you should know before you start. The head of the penis is called the glans. The foreskin is also called the prepuce. It is attached under the pee hole or meatus by a y-shaped piece of skin called the fraenulum or frenulum (US spelling). The frenulum is similar in structure to the one under the tongue and has an important sexual function. The fraenular band is the tight bit at the foreskin opening that is being stretched in this case. It becomes the tip of the foreskin when the skin is forward (not retracted) and surrounds the foreskin opening.
Warning
Should you experience any painful problems consult a foreskin-friendly doctor (in the US contact NOCIRC for referral to foreskin-friendly doctors). Should your foreskin get stuck behind the glans when you are erect, firstly follow the instructions in the Paraphimosis section below. If you are still unable to get the skin forward again, after trying for some time, seek immediate medical aid.
Phimosis
Phimosis may be mild or severe. Some men can retract their foreskin easily when their penis is flaccid (soft) but experience difficulty when erect. In others the opening is so tight that they can only see a tiny bit of their glans when they pull back on their foreskin.
Why Bother to Stretch?
Although some men manage to live with phimosis there are some disadvantages to having a non-retractable foreskin.
Firstly, it is hard to clean and may smell. Smegma, produced and collected under the foreskin, usually does no harm but it is susceptible to infections that can cause pain and/or odours.
Secondly, having sex with the foreskin forward reduces sexual sensations.
Thirdly, many men with tight foreskins complain that sex without a condom is painful as the foreskin may be forced back during sex.
Betamethasone
You can ask your doctor to prescribe Betamethasone 0.1% or 0.05% ointment. A tiny amount can be applied sparingly to the tight part of the foreskin ONLY. It will speed up the stretching process but won’t do anything on its own, without stretching. Stretching will still work without the ointment, just more slowly.
Stretching Technique One
If the foreskin is very tight, the simplest method is to pull back on the skin (easiest with an erection) so that the opening feels tight without real pain. Hold that for a few minutes and repeat a few times. Do this a couple of times a day. Soaking in a warm bath will make the skin easier to stretch. If the opening becomes sore, or develops splits, stop and let things heal up. Going at it too fast will only slow things down in the end.
Once the opening is big enough to just fit over the rim of the glans when erect, the foreskin is at risk of getting stuck behind it. If this happens paraphimosis may develop. Stretching technique two avoids this risk.
Paraphimosis
Paraphimosis occurs when the foreskin gets stuck behind the glans of an erect penis, trapping the blood that causes the erection in the glans and causing swelling of the foreskin itself. If the foreskin becomes stuck, squeeze the head of the penis firmly to force the blood out and try and ease the foreskin forward. Do this by gripping the skin either side just below the tight part and then try to pull it forward. If it’s gone back it should be possible to get it forward again. Like stretching this may be easier in a warm bath. If after many tries you still can’t do this see a doctor or ER fast. This is uncommon but you should be warned.
Stretching Technique Two
You can either grab each side of the foreskin opening (with the foreskin forward) and gently pull on each side of the opening or, even better, insert the ends of two fingers, even the little fingers and pull them gently apart. Stretch the opening in this way until it feels uncomfortably stretched but not actually painful. Hold and repeat as for method one. Once again this is best done after soaking in a warm bath.
Sensitivity
As you stretch and are able to expose more of the glans you may find that it is very sensitive or even painful to touch. You will find it less painful the more you expose and use it and gradually the over-sensitivity will lessen. A gentle way to start touching the head is by using the shower spray. Also you should use lube when touching the head directly.
Smegma Build Up
As you stretch and are able to expose more of the head you may discover a build up of smegma. This may even contain hard lumps that are hard to remove. Soften them with a light vegetable oil or a non-scented, oily cream such as sorbolene or vitamin E cream. The smegma and softening agent can then be removed with a mild non-scented soap followed by a thorough rinse with plain water. A number of applications over a period of time may be necessary before the build up is cleaned away. Once it is then simple rinsing with plain water every day is enough to keep most penises clean and fresh. Some men can use soap daily but others find it upsets the natural balance and can actually cause infections or irritation.
Tight Fraenulum
Sometimes the cause of difficulty in retracting the foreskin is not a tight foreskin opening but a short fraenulum (frenulum), also known as fraenulum breve. This can also be stretched though it is sometimes more difficult to do this. You can grab the underside of the foreskin opening and pull out away from your body until you feel the fraenulum stretching. Or if your foreskin opening is large enough you can pull back on the foreskin until you feel the fraenulum stretching. Hold and repeat as in the foreskin opening stretching methods.
If the fraenulum can’t be stretched then an alternative to circumcision is a frenuloplasty. It is a simple operation that does not remove any tissue but fixes the problem with minimal healing time.
Keep At It
Keep stretching for a while once you get to the diameter of foreskin opening you want. If you stop too soon it is possible for things to tighten up again. So just keep doing the exercises for a month to six weeks after everything is loose enough to work properly.
Tightening and/or Tears Developing in a Previously Normal Foreskin
Most Phimosis is something that the male has lived with since birth and this is the sort that these instructions were designed for. When a foreskin suddenly tightens up or starts to develop tears easily the usual culprit is a yeast or fungal infection. These sorts of infections can be caught from normal living but can also be passed on sexually. Therefore sexual partners should be treated too and condoms should be worn to prevent cross infection, until both partners are clear. These infections can usually be treated with pharmacy over-the-counter creams and sometimes an oral pill as well. The creams are designed for women's genitals and so are safe on male genitals too.
DO NOT attempt to stretch if you have a thrush (yeast) or fungal infection. The tears that develop can cause scar tissue to form and may cause permanent damage that makes stretching extremely difficult. If scar tissue has formed then Betamethasone is fairly necessary if any stretching is to succeed.
Recurrent yeast infections may sometimes be related to diabetes and if the treatment does not alleviate the symptoms the cause could be a bacterial infection though these usually have differing symptoms. Both these situations require a visit to the doctor.
Care of the Infant Penis
When the penis is formed in the womb it is all as one organ. At birth the foreskin is nearly always fused to the glans. There is no cavity under the foreskin at this stage and therefore nowhere for germs or smegma to collect. Misguided attempts to retract the foreskin at this early stage often cause serious damage. Sadly it is quite common for misguided doctors and nurses to attempt to do this. The infant penis should only be washed on the outside. The foreskin should be left alone for the first few years of life.
Adhesions
As the boy grows, the natural adhesions between the glans and the foreskin break down. Sometimes hard lumps of smegma emerge as this process advances. Young boys often pull on their foreskin and this helps break down the adhesions. At this stage ballooning of the foreskin while urinating is a good sign that the breakdown of these natural adhesions is progressing naturally. As soon as the boy can retract easily he should be taught to wash regularly with plain water. That way any problems can be easily avoided.
In some men who have never been taught to retract and wash regularly adhesions persist. This is not a reason to circumcise. It is sometimes possible to separate the adhesion along the "fault line" by pulling it apart little by little over a period of time.
Alternatively working the foreskin in a circular motion after soaking in a warm bath has been reported to help too.
If neither method works a doctor should be able to separate the adhesion under local anaesthetic, in his/her surgery, using a blunt probe or pulling apart the fused areas more firmly than you can manage without the anaesthetic. Scalpel work is almost never called for and make sure he/she is not planning to circumcise you instead of just separating the adhesions.
From http://www.healthboards.com/boards/showthread.php?t=210347 |
