Hi

Firstly I would like to thank Paul B and Jim for the great service that you are providing with this forum. There is a huge amount of ignorance on the subject of phimosis and this forum is playing a valuable role in helping people. I only wish I had read it 20 years ago. I also think your comments on getting a dermatologist, rather than a urologist, to help treat phimosis is a very sensible idea. My background:

Im age 39 and located in the UK. I was able to fully retract without any problem until I was about 18 when the foreskin tightened up and I wasnt able to retract at all, when flaccid or erect. At the time I didnt know what had happened. I was a shy teenager and didnt feel able to talk to anyone or go to see a doctor. It is only since I have been able to research phimosis on the internet that I have recently come to the conclusion that I had a thrush infection when I was 18 that caused my foreskin to tighten. I recall the foreskin was red and sore and I had pain urinating. There was also some discharge. Then it would clear up and the foreskin would look normal again, except it had tightened up. Now the opening is only about 10mm in diameter. I can have sex OK wearing a condom. However, I would really like to be able to retract normally again, like I used to be able to, and do not want to have a circumcision. I read about stretching techniques a couple of years ago. I tried it for some time and was starting to see real results but then I would get a little tear in the skin on the inside of the foreskin. I had to stop the stretching and wait for it to heal. I didnt think I was stretching too much the skin seems to tear quite easily. Now every time I try to stretch I get a little split in the skin (also sometimes after sex, even using a condom). Having read your forum and realised the connection between thrush and a tight foreskin, do I need to use some cream for thrush infection first then try betamethasone and stretching? Even after all these years, could thrush still be causing my foreskin to be prone to tearing? I dont now get the symptoms of thrush but could it still be affecting the foreskin and its ability to stretch without tearing? I would welcome your advice.

I think the yeast is still present and needs to be treated. One question is "Why?" Sometimes it just takes hold in one area, and unless treated will continue to flourish happily. However, it could indicate another problem.

By all means, get something to treat for yeast and try it. My guess is that your skin will restore to its normal state once the yeast is gone. Betamethasone would probably give you an edge in stretching.

Let's get one concept sorted for a start. Healthy skin does not tear.

If then you are getting recurrent tearing, then the skin is clearly not healthy, and if you developed an infection which most likely was Candida ("thrush") at the age of 20, then it is most reasonable to assume that your subsequent problems are just the same condition. I think the tearing is actually the cardinal symptom that confirms persistent "thrush".

You did not mention itch in association with the inflammation, pain and discharge associated with an obvious infection at the age of 18, but even if the major infection was with another bacterium, the root cause was most likely to be Candida in any case. The only other contributing factor might be the use of soap (or "antiseptics" or various other "hygiene" products marketed to unsuspecting victims). I do however have to ask whether as "a shy teenager", you nevertheless had any sexual encounters?

It is then most important that you correct the problem of an unhealthy foreskin first, and then consider how to go about stretching - which will be along the lines we frequently explain here. Just look back at what we (I) have explained before regarding Candida treatment and the need to do this before and to continue whilst stretching and perhaps then proceeding with the betamethasone.

As to recourse to doctors, it is not merely a "very sensible idea" to consult a dermatologist rather than a urologist if one needs to for a foreskin problem, it is more like a 99% certainty that you will not be sympathetically and correctly treated by a urologist.

The reason is absolutely simple - a urologist is a surgeon whose specialty is treating diseases of the urinary tract and more specifically those requiring surgery. And he is probably (at least as one would hope,) quite good at it. But people who do not have diseases (and phimosis is not in general, a disease and certainly not an indication for surgery) are generally not referred to a urologist, and certainly should not be. In regards to the foreskin, urologists tend to be "one tune musicians" - you want it cut off, they will do that (though no better than a general surgeon would, if it comes to that), that is what doctors refer people to them to have done, and that is what they do.

Many thanks Jim and Paul B for your responses and advice. I will get some cream to treat the suspected thrush problem and see if that stops me getting the cuts in my foreskin when I try the stretching exercises.

Re your questions Paul, I wasn't using any special antiseptic or hygiene products at the time and I wasn't using soap to any significant extent in that area. You ask about itchiness - yes there was an itch at times as well as the other symptoms I described. Also, you asked if I was having any sexual encounters at the time - no I wasn't active in that way at that time at all. Overall, I do now think it was a thrush infection that caused my phimosis.

Thanks again for your help and for the forum. Hopefully if I can treat the thrush and get the skin healthy again, I will be able to have some success with stretching.

Wash only with clear water, dry, and apply the preparation. Let us know how things progress. You should see a remarkable change in a week or two.