Foreskin problems

Understanding Foreskin Problems: Causes, Signs, and Treatment

The foreskin, a protective fold of skin covering the penis in uncircumcised individuals, requires proper care to prevent potential issues later in life. Here's a comprehensive guide to foreskin problems, their causes, signs, treatment, and preventive measures.

What is the Foreskin?

The foreskin is a layered fold of skin that shields the end of the penis in uncircumcised individuals. While it requires no special care in early childhood, attention to hygiene becomes crucial as one grows older to prevent problems like swelling, infection, tightness, irritation, and dryness.

Causes of Foreskin Problems:

In young children, the foreskin is naturally attached to the penis head by the synechia membrane, which dissolves over time. Forcing it back prematurely can lead to issues. Phimosis, where the foreskin is too tight, is another cause, usually resolving between ages two and six. STIs, infections, BXO (lichen sclerosis ) or injuries can trigger problems in teenagers and adults.

Signs of Foreskin Problems:

Look out for pain during urination, itchiness, inability to retract the foreskin, pain during intercourse, redness, soreness, swelling, dryness, or split and bleeding skin. Consult our specialist Urologist if you experience these symptoms.

Treatment for Foreskin Problems:

Treatment varies based on the issue. Dryness may be managed with creams or ointments like steroid cream, while infections like balanitis can be treated with medications. In some cases, procedures may be required, such as moving back the foreskin in children with phimosis or circumcision in adults with persistent issues. Our approach with circumcision with glue is the best option.

Prevention of Foreskin Problems:

Proper care is crucial. Change underwear regularly, opt for loose underwear, avoid heavily scented hygiene products, clean the foreskin daily with warm water, and use protection during sex to reduce STI risks.

Specialists for Foreskin Problems:

A urologist, or a pediatric urologist for children, is the specialist to consult for foreskin problems. We provide these services in the London Circumcision Centre.

When to Consider Circumcision:

Circumcision is only considered when foreskin problems are severe and impact daily life, causing persistent pain or frequent urination issues. Phimosis with a scared or cracked foreskin will require circumcision.

When to Seek Medical Advice:

Call us if you experience difficulty urinating, a burning sensation, increasing pain, or inability to return the foreskin to its original position.

Understanding and addressing foreskin problems early is essential for maintaining male reproductive health. Regular hygiene practices and prompt medical attention can make a significant difference in preventing and managing foreskin-related issues.

Diabetes and Tight Foreskin

A comprehensive study conducted in the United Kingdom focused on a group of 100 men ranging in age from 17 to 82 years, with an average age of 38 years. The study aimed to investigate the prevalence and characteristics of phimosis, a condition characterized by the tight foreskin, in this population.

The researchers found that among the participants, 31% had a lifelong history of phimosis, meaning they had experienced this condition since birth or early childhood, while the remaining 69% had acquired phimosis, meaning it developed later in life. It is worth noting that the prevalence of acquired phimosis was significantly higher than that of lifelong phimosis.

Additionally, the study revealed that among the men with acquired phimosis, 32% had a medical history of diabetes. This finding indicated a notable association between acquired phimosis and diabetes. In fact, the data showed that men with a history of diabetes were 6.7 times more likely to develop phimosis compared to those without diabetes.

Moreover, the researchers observed that phimosis could potentially serve as a warning sign for diabetes. Surprisingly, among the men who had acquired phimosis but had no previous history of glucose metabolism disorders or diabetes, 12% were found to have diabetes (8%) or impaired fasting glycemia (4%). This prevalence of diabetes was higher than the national average in the UK, which stood at 3.6% during the study period. These findings suggest that the presence of phimosis in some individuals may indicate an increased likelihood of diabetes or related metabolic disorders.

It is important to note that balanitis, a condition characterized by inflammation of the glans penis, is commonly associated with diabetes. The recurrent infections and scarring resulting from balanitis are likely contributing factors to the development of phimosis in individuals with diabetes.

In summary, this UK-based study shed light on the prevalence and implications of phimosis in a diverse group of men. The findings indicate that acquired phimosis is more common than lifelong phimosis and that there is a significant association between phimosis and diabetes. Furthermore, the study suggests that phimosis could potentially serve as an indicator of diabetes, as a higher proportion of men with phimosis were found to have diabetes or impaired fasting glycemia compared to the general population. The study also emphasized the relationship between balanitis and phimosis in individuals with diabetes, highlighting the role of recurrent infections and scarring in the development of this condition.

We provide is comprehensive treatment of tight foreskin (Phimosis) and also we treat with tight foreskin with diabetics. In some patients , BXO or lichen sclerosis is also present which required treatment in the form of topical steroids, antibiotics, anti fugal and circumcision in most of the advanced BXO.

Reference:

SJ Bromage, A Crump, I Pearce

Phimosis as a presenting feature of diabetes

BJU Int, 101 (2007), pp. 338-340

Care Quality Commission has given "Good" rating to London Circumcision Centre in all five domains

This service is rated as

Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

CQC carried out an announced comprehensive inspection at the London Circumcision Centre. This inspection was conducted as part of CQC inspection programme of independent health providers.

The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

CQC key findings of our clinic were:

• The service had systems in place which kept patients safe. These included checks on patients attending the service and risk assessments conducted to ensure staff and patients were safe whilst attending the centre.

• Staff at the service had the skills and knowledge to provide effective care.

• Feedback on the provider and service revealed high levels of patient satisfaction.

• Provision of services at the clinic considered patient demand and included timely access appointments which included face-to-face, telephone and video consultations.

• There was a focus on innovative, learning and improvement.

Good Ratings for London Circumcision Centre

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Good Ratings for London Circumcision Centre -

CQC inspected and Rated Good

Skin bridge and Preputial adhesion after circumcision

A penile skin bridge can occur in circumcised males after their childhood period. These bridges cause pain or discomfort and may require correction.

A penile skin bridge requires operative correction as it is a thick skin attachment from the shaft skin of the penis to the head of the penis (glans).  It causes pain and discomfort during Erection due to tethering of skin.  . These will not be resolved on their own and is actually more uncomfortable and bending of the penis with penile growth

What is a penile Skin Bridge?

When the incision heals improperly to the gland in a circumcised male, the shaft skin becomes permanently attached to the glans. The. penile skin bridge develops. 

Penile skin bridge can occur in childhood right after the infant circumcision. But adult may not realise it until he is sexually active and feels a pulling the head of the penis when he has sexual activities and erection. 

Operation for a Penile Skin Bridge 

• A urologist usually carries out the procedure under a local anaesthetic.

• Local anaesthetic nerve blocks also provide post-operative pain relief

• He divides the skin on the top of the head of the penis and both skin edges.

• He uses dissolvable stitches throughout which usually disappear within two to three weeks.

• He applies and seals the wound with glue which sloughs off within 10 days.

• we normally wrap the penis in a loose bandage which you can remove after 1-2 days.

• Some patients may require a circumcision revision if the patient has more scarring with multiples skin bridges.

• The underlying colour of the skin may different colour than the rest of the skin of the shaft and head of the penis.

What can I expect when I get home?

• You will get some swelling and bruising of the penis which may last several days

• All your stitches will disappear, usually within two to three weeks, but may sometimes take a little longer

• Simple painkillers such as paracetamol or Ibuprofen are helpful if you have any discomfort

• Any dressing should fall off within 24 hours; if it does not, or if it becomes soaked with urine, it should be removed

• Keep the area dry for 48 hours; avoid soaking in a bath

• You should not swim or any exercise for two weeks

• Try to keep your wound clean and dry after passing urine

• Apply a little Vaseline to the tip of your penis and around the stitch line to stop it from sticking to your clothing

• Wear tight-fitting clothing for two to three days

• You should retract your foreskin on a daily basis to maintain the benefits of the surgery after 3 days 

• You will be given a copy of the letter which should be given to your GP

• Any antibiotics or other cream, you need to get from any pharmacy

• You should refrain from sexual activity (intercourse and masturbation) for up to four to six weeks 

If you notice any re-attachment happening, please contact us for an assessment

What are the risks, consequences and final outcome?

Most operations are straightforward; however, as with any surgical procedure, there is some chance of side-effects or complications such as:

Bruising and swelling generally happen. Significant swelling of the bridge incision will develop during the first few days. This swelling may last for 2-3 weeks or longer.  bleeding from the wound site (occurs in 2 - 3% of patients) but is usually minimal and settles quickly. Infection can arise and is usually minor but can be possibly serious with an incidence of less common.  Tenderness of the scar at the wound. Dissatisfied with the cosmetic result. Failure to improve your symptoms may result in the need for full revision circumcision. 

Contact us for further consultation