The rate of lichen sclerosus (BXO) was significantly higher among male patients with acquired than congenital phimosis

Balanitis Xerotica Obliterans (BXO) in acquired Phimosis in male patients

BXO is thin white dry patches that appear on the foreskin. It can be troublesome if this is not treated. This causes tight foreskin in children and adults. This is also known as lichen sclerosus

If any male patients who has tight foreskin recently , we must exclude BXO phimosis. Literature showed that it is more likely to due to BXO

Following advice will be given

1. Topical steroids have been used. Topical steroids can offer a reliable option only in the management of mild or early BXO limited to the prepuce in boys with minimal scar formation.

2. Circumcision with frenuloplasty in adults and children with BXO may be required if there is no improvement in the tight foreskin with steroids

3. Further treatment, or treatment of circumcised patients, is more challenging. Topical steroids will require in patients after circumcision who has BXO on glans (head) penis 

4. Steroids injection provides efficacious management for urinary stricture disease in patients with biopsy ­proven BXO before invasive surgery.

London Circumcision Centre

NEWBORN AND ADULT CIRCUMCISION FROM EXPERIENCED SURGEONS AND UROLOGISTS

We provide glue, stitch, staplers, revision adult circumcision, frenuloplasty or preputioplasty at London Circumcision Clinic. We also give balanitis xerotica obliterans (phimosis) treatment

PLEASE CONTACT US FOR FURTHER DETAILS

Please see feedback from the patent after circumcision and frenuloplasty

“My experience with Dr Khan was very relaxing and quick. I felt comfortable throughout the whole procedure. In my first consultation with Dr Khan, everything was explained to me quite simply, so I knew exactly what to expect and all of my options. My procedure was very quick and very professional, I was given all the information required for post-operation care and also emergency contact just in case. Everything went seamlessly and I would definitely recommend Dr Khan to any prospective patient.”

— Written by a private patient at London Circumcision Centre Sept 2021

Tight foreskin - what is the treatment

Phimosis (tight foreskin): What are the alternatives to full circumcision?

When there is a tight foreskin called phimosis, a person wonders whether he needs to be circumcised. There are many alternatives to full circumcision.

FOLLOWING NON-SURGICAL TREATMENTS ARE AN ALTERNATIVE TO CIRCUMCISION.

• Children usually grow out of the natural tight foreskin

•         Stretching exercises: It may help in some cases

•         Steroids - topical or local injections: There is medical evidence that steroid cream cures the phimosis

•         Stretching exercises with steroids: Both treatments may be more effective than one only.

•         Vitamin E cream: More medical evidence may require its effectiveness.

FOLLOWING SURGICAL TREATMENTS ARE AN ALTERNATIVE TO CIRCUMCISION. 

 •         Frenuloplasty: Frenuloplasty provides releasing the frenulum which is a simple and effective treatment of dealing painful or torn frenulum

•         Frenular grafting: Free frenular skin grafting an alternative to circumcision in some men with a combination of tight frenulum and phimosis.

•         Preputioplasty: This operation is mainly to widen the ring noticed after retraction of the foreskin beyond the head of the penis

•         Partial circumcision: There is a very limited role of partial circumcision in the tight foreskin.

However, tight foreskin with balanitis xerotica obliterans (BXO) is treated with steroids, biopsy and full circumcision. 

In conclusion, alternative treatments (surgery or no surgery) consider before male circumcision who have a tight foreskin. We have discussed a method of treatment and every treatment must be considered individually and carefully