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Adult phimosis: Need help

June 10 2005 at 11:09 AM
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Hi,

I am 32 yrs old and I have recently found out that I have phimosis and my Urologist has recommended circumcision. I have also been recently diagnosed with Diabetes type 2. I was wondering if stretching would be helpful in my case. I would appreciate all the help that I could.
Regards,
guy_32

 
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Jim
(Premier Login jimsplacetofixthings)
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Yes

June 10 2005, 12:23 PM 

Stretching will provide relief. However, you must eradicate any presence of yeast infection before you can be successful. Are you currently experiencing any itching or inflamation? If so, you need to treat the problem before embarking on a regimen of stretching.

You seem awfully young for having type 2 diabetes. Are you overweight?

 
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Paul B.
(Login Paul_B.)

Adult phimosis: Need more info!

June 10 2005, 2:43 PM 

Well, just a few thoughts at the outset.

Can you explain "I have recently found out that I have phimosis"? I mean, "phimosis" is not something like a tattoo that you wake up in the morning and it's there, but it wasn't yesterday! If you didn't know that your particular body configuration was called "phimosis", then what did you think it was? More particularly, what is the problem - in what way could it possibly restrict you? Until we understand that, we may not be able to properly help you.

As part of that answer, you need to explain why you have seen a "urologist" - which suggests you are American, because in other countries, you actually go to see a General Practitioner to determine whether you have any need to see a surgeon, whose specialty is of course, cutting!

As to the diabetes, well, as Jim says, that is pretty young and being substantially overweight is the most likely causative factor. In which case that takes absolute priority over going and getting operations (even Laparoscopic Gastric Banding!). It is certainly true that any yeast infection needs to be cleared up before you could start repairing a phimosis. Circumcision is a "lazy" way of fixing such a problem, but a really bad omen for health because that is not the only area where it is going to happen (and because it will worsen the impotence problem from the diabetes).

Given that you bring the diabetes and any consequent yeast infection under control, well of course you can repair the phimosis by stretching. The instructions are all on this site, and you only need to read the threads to find them - as well as reassurance that it is effective, and warnings as to why it may not be effective (generally, mental problems).

 
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RE: Adult phimosis: Need more info!

June 10 2005, 11:30 PM 

Hi Jim and Paul,
Thanks for your response. I am a recent immigrant to US( I am from India) and I was not even aware that foreskin needs to come over the head. I had some urinary track problem(I had mucus in my urine), so I consulted a Urologist. When he saw my penus he tried to pull it back to examine it, thats when I told the doc. that I was never able to pull it back. He said the condition is called Phimosis. At the same time I took the urine test and found out that I have Diabetes. I am not at all over weight. I weigh 165 lbs and 5'10 ht. But I have a history of diabets in my family( both my mother and her mom have diabetes). Before the urinary track diesease, I was able to pull my skin and was able to see the head, but now I can't even see the head and the tip of my penus is tighter than before. When I googled for Phimosis I came across this site and found out to be very helpful. I don't know if my condition has worsened because of Diabetes or not.I do not have any itching or burning sensation during urination, but my foreskin near the tip swells while urinating and it is very uncomfortable. Can you please help me, I don't want to go under the knife.

Regards,
guy_32

 
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Jim
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Which is it?

June 11 2005, 2:35 PM 

You said in the first sentence that you were never able to retract the foreskin, but then you said that you could before begin diagnosed with a UTI. What do you mean?

 
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Re:Which is it?

June 11 2005, 4:10 PM 

What I meant to say is, I was never able to get the foreskin over the head completely. I was able to see the head. Now after the UTI, my penus tip is like a pinhole and I can't even see the head. Sorry for the confusion. And Jim, can I PM you to talk about this issue personally.
Regards,
guy_32

 
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Jim
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Thanks for that explanation

June 12 2005, 3:05 PM 

Paul has offered some suggestions that I agree with, so rather than repeat them, I suggest that you read his words.

I'm a bit puzzled over the trip to the urologist also, as normally your gp should have been able to treat a UTI.

No, I don't do private conversations from this website. Many people benefit from what is discussed herein, so if something is discussed outside of these pages, all of them miss the opportunity to learn.

 
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(Login Paul_B.)

Much to be done then.

June 11 2005, 4:14 PM 

Right, we now have a fair amount of detail. Jim is puzzled, but if I may summarise your situation, you used to be able to pull back your foreskin and view the tip of the head, but not the whole of the head, and thereby presumed that was as far as it was supposed to go - which is just like looking at a woman's clitoris. I am of course most curious to know - have you actually had the opportunity to examine a lady's genitalia, which in a fashion asks, have you had sexual experience with a woman? My suspicion would be that you have not, nor have you actually looked at pictures of men's penes (plural of penis) until now, else you would likely have determined earlier that it should be possible to expose the whole head.

"Mucus in the urine" is a rather curious description of a urinary tract problem; could you elaborate on that a bit, including the "Urologist"s observations on it, and what treatment he might have prescribed?

As to the diabetes, that is a major problem indeed. Diabetes of this nature in the absence of obesity is a feature of certain racial groups, and I suspect that not only does it "run" in your family, but is perhaps very well known in their community overall. Or perhaps not. Whilst it has been diagnosed in your case, on a urine test, full assessment and all future management is based on blood testing, mostly home testing using finger-prick samples. The reason is that if you do have sugar in your urine, that represents a very bad level of sugar in the blood - proper management of diabetes should and will be directed at ensuring you never have sugar in your urine.

Frankly, there is as I explained before, a great danger in visiting a "Urologist", especially in America, because he is specifically, a surgeon whose "business" is performing operations. Whilst he of course knows in broad terms what diabetes is, it is most unlikely that he knows much at all about its management, so what you need to do right now, if he has not already instructed you to do so, is to find a doctor competent in the management of diabetes, which could be a specialist (endocrine physician) or a General Practitioner (Family Physician). I think you could very safely forget entirely about the Urologist - and his operations.

You have described a degree of "ballooning" of the foreskin - it blows up like a balloon in front of the glans (penis head) because the foreskin opening is tight. That does represent a significant problem and it is not surprising that the Urologist has recommended a circumcision. The proper treatment of this will be to bring the diabetes under control and there is some urgency to this - it is almost certainly consequential to the unchecked diabetes.

Now the manner in which it occurs, is again, almost certainly the development of a fungal ("thrush") infection of the (inside) foreskin because the fungus thrives on - sugar! I think therefore, we can safely suggest you proceed to treat the infection with an "over-the-counter" medication and whilst there are many to choose from, I generally suggest Daktarin® or better still, Daktacort® cream (note - I have no shares in the company!).

You will actually need to get it inside the foreskin space in front of the glans, because the infection is on the inside. And we know that the foreskin is already narrowed. What will likely be most effective, a couple of times a day after you have urinated and squeezed out the last of the urine from under the foreskin, would be to see how accurately you can insert the nozzle of the tube (with due care about the rough edges; even better if it has an applicator nozzle) a little into the foreskin opening (whilst pulling the foreskin forward, preferably with two fingers from each hand on either side) and squirt just a little of the cream inside the foreskin space. You will not need much at all, and whatever remains on the outside can be left there; the cream inside will leak out anyway.

After using this for a couple of days, you should for one thing, notice less discomfort, less "ballooning", and may then be able to start stretching, both by pulling back the foreskin against an erection, and by picking up the foreskin on both sides and pulling it open.

Over to you!

 
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Re:Much to be done then

June 12 2005, 5:49 PM 

Jim and Paul,
Thank you very much for all the help and advice. I have visited GP the same day Urologist has diagnosed me with Diabetes. Right now my sugar levels are under control, only long term glucose levels are a bit high. Image of the Penis accurately describes my condidtion before it got worse. I will definetly try Daktacort. My Physician wants to do a swab test. I will update you on my condition soon. Thanks again for all your help.

Regards,
guy_32

 
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Jim
(Premier Login jimsplacetofixthings)
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Symptons indicate yeast

June 12 2005, 9:20 PM 

Foreskins don't just suddenly tighten up, so that's an indication that yeast is flourishing in that area. Get that under control, and we can then proceed with stretching.

 
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Re:Symptons indicate yeast

July 5 2005, 4:31 PM 

Hi Jim and Paul,
Upon your advice I discussed this issue with my GP and he has prescribed 1 dose of oral pill Fluconazole. Its been a week since I took the pill but didn't find the symptoms decrease. I tried to buy Daktacort® cream, but could not find it. Is it primarily sold in UK? Are there alternative medication that I could take.

Regards,
guy_32

 
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Jim
(Premier Login jimsplacetofixthings)
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Paul can better answer this

July 5 2005, 9:07 PM 

I believe a prescription is needed for it. Where are you?

There are some over the counter medicine that are often quite effective for yeast problems. Most of them are marketed toward women.

 
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(Login Paul_B.)

Sounds like time to get things going!

July 6 2005, 7:00 AM 

Hello Guy.

On review of your situation, it sounds as if you simply have a rather tight foreskin, which is leading to some "ballooning" of the foreskin when you pee, but no actual irritation or signs of active infection with yeast or otherwise just now. We suspect however, that there has been some (yeast) infection in the past, causing the foreskin to tighten.

The fluconazole (Diflucan®) is good - it will knock back yeast for at least a week per pill, and you should not really need to use any other antifungal at the same time. I wonder however - if the only "symptoms" you are seeing are the ballooning and the tightness of the foreskin, then you may have the wrong idea - you certainly would not expect them to "fix" themselves just because you treated the yeast - though they might improve a little. If you had any itch or soreness, yes, that might respond to the fluconazole.

The point is that if the yeast, consequent to the diabetes, is actually under control and it is certainly reasonable to assume that having taken the fluconazole, it is, then you are in a position to start fixing the phimosis by stretching.

I trust that you have a "feeling" by now, for where the tightness in the foreskin is. That is your target. That is where you need to stretch. You can do this to some extent by the methods described in my June 11th posting above this. The question is, are you doing this already? If not, you have done nothing to improve the situation, and to a minor extent, wasted the opportunity given by a week of fluconazole because without the stretching, nothing is going to visibly change.

I am just repeating this for emphasis so we are totally clear on the matter - the treatment of the tight foreskin is stretching. Yeast infestation is a problem provoked by the diabetes which is the general cause of the tight foreskin and a major hindrance to stretching so you certainly need to get that under control, but doing so is not a "magic cure" on its own.

The primary target of stretching at this point, is to get something - technically called a "dilator" - inside the tight part of the foreskin. When you can do this reliably, you can proceed to get successively larger dilators in there and eventually over a period of time, stretch it to retract over the glans. But as I explain in the discussion threads above this one, I don't think the glans itself is a particularly useful or convenient dilator.

Probably the safest dilators are your fingers (with - and I always say this - properly trimmed and smoothed nails), starting with the smallest. If however, you have a really tight foreskin, then a really smoothly rounded ("torpedo-shaped") end of something like the lid of a pen or perhaps a toothbrush, could be quite useful. To use any of these, you need lubrication, and you need to pull the foreskin forward - away from the glans - while you slip the dilator into the opening. It should be automatically obvious that you have to be careful not to hurt your glans with whatever object it is, so if something is slipped through the tight part, it needs to be pointed somewhat to one side, away from the glans.

Anyway, enough of this, do tell us what you are actually doing by way of stretching, what things seem to be working and so on?

 
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