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Wrong prescriptions

September 28 2010 at 8:32 PM
Chris  (Login Chris99999)

I've had some bad luck. First, I'm 31, and I am thinking that my skin may not be as susceptible to stretching as if I'd discovered the nature of my problem when I was 15.

Secondly, I recently moved to a very english capable, but not primarily english speaking country in europe. My first doctor here prescribed me Kentokort 0.1% Salve which, after much stretching with no perceptible change, I googled to find out it's useless for my needs.

So I went to a new doctor, and he told me that Betamethasone (which I asked for by name this time) is no longer used, and he prescribed me Elocon 0.1% cream.

At this point, I'd found the polymorph stretching device (brilliant idea, brilliant stuff), and after the doctors 1-cream-application-per-day prescription didn't work, I went to 2 applications a day, with minimal improvement. Always stretching morning and night, usually 30-40 minutes at a time, before the device got too uncomfortable and I would have to remove it.

I then googled Elocon, searched through a bunch of threads here, and found out that once again I was prescribed the wrong stuff.

Can I demand a specific prescription? Can I trust the internet more than 2 doctors? What can I do??

I am hugely frustrated at this point. I finally figured out why I really don't enjoy sex, and despite it leading to an incredibly refined ability to focus on my partners enjoyment, my own has seriously suffered. I'm dying to experience the concept of pleasurable intercourse. I'm contemplating a trip home to the US to find a plastic surgeon capable of a y-v plasty.

Pardon the rant. There aren't many people that I can complain to about this stuff happy.gif

(Premier Login jimsplacetofixthings)

What are you doing?

September 29 2010, 10:09 AM 

You say you are stretching. Exactly how? The device you've used, is it like the illustration?

If you're applying tension to healthy skin or mucosa, it will expand. There could be something present preventing such expansion, and that almost always points to yeast. Treating for yeast with over the counter products will cause no harm, so it might be worth trying.

Paul B.
(Login Paul_B.)

Oh my, tricky question!

September 29 2010, 3:15 PM 

Can you trust the Internet more than two doctors?

That's a very valid point - the Internet as a whole, as a source of information, is anything but trustworthy. wink.gif However, can two separate doctors, chosen as it were at random, both be wrong?

Well, of course, very easily! If you took two doctors in America, and in respect of the matter of foreskins and circumcision, you could almost bet on both being wrong as you can guess with some certainty that both would themselves be circumcised and have a psychological investment in believing that to be the "desirable" state.

In Europe, we presume that (barring the possibility such as I describe below) neither doctor would himself be circumcised, but on the other hand, problems such as "phimosis" are relatively uncommon and therefore considered "bad luck" and circumcision to be an unfortunate but appropriate remedy. Despite the general openness in regard to sexual expression, doctors can still regard it as an inconsequential problem, and not take a sufficient interest in it to develop expertise in treatments focussing on maximising sexual function.

Clearly, neither doctor had any awareness of the use of the "ultra-potent" steroid to facilitate stretching. I suspect neither even suggested or appeared to understand stretching as a solution to the problem in the first place, and so "fobbed you off" with a steroid familiar to them, but entirely inappropriate. I cannot actually locate a product named "Kentokort"at all on the Internet, and of course, Elocon® has effectively replaced betamethasone for routine use in simple eczema so that the latter may not be so readily available (and doctors may nowadays be reluctant to use medications that are reputed to have even infrequent risk of "adverse side effects").

What can you do? Well, if you have picked up the reference to "polymorph" and implemented it, you presumably must have been reading here for some time (or is there some other site on which it is publicised? If so, where?). You should therefore be reasonably aware of all our suggestions.

Jim wonders whether you might have a yeast problem. Probably not, unless there is irritation or cracking. I mention this because your problem has always been present and was probably not due to yeast in the first place (though one might wonder if there is a common factor in foreskins that fail to stretch in childhood). In advising, I would like to know full detail of the problem - degree, exactly how you feel it is limiting your sexual function currently and what your experiences were back at age 15 - as I tend to challenge the supposition that phimosis of itself is necessarily a limitation - I always observe that it generally does not inhibit masturbation and indeed, just the reverse.

And we get back to the observation - the (correct) steroid is useful in assisting stretching, but the stretching is fundamental. If you have implemented the stretcher, you should be in the very best position for success. So if it is not working, I really have to focus on why it is not, and your comment that it becomes uncomfortable after a couple of hours is where I see the problem. I have tried to explain before that the original design illustrated here is not entirely suitable for the purpose and should be modified so that the "fork" between the "shoes" folds back behind the shoes so that it lies beside the penis when worn in clothing, because you need it to be worn for extended periods - preferably all day, perhaps night as well if you get the design right. And wearing it for a much longer duration is a desirable trade-off for more force exerted.

Secondly, the "shoes" should be wider, and curved so as not to impinge on the glans, more like the blades of a typical specula1.gifeye speculum of less traumatic design (note that the hinge on this illustration is necessarily to the side as dictated by the original purpose).

Of course, the very advantage of "polymorph" is that you can make these adaptations easily, so I would anticipate that you should examine just what is causing discomfort, and make a version that you can use continuously.

And I would caution that even an appropriate surgical procedure - being a multiple plasty around the periphery of the foreskin opening, does not relieve you of the need to stretch after the operation to achieve and maintain the desired diameter, but almost certainly would make the stretching more painful. Whilst not a certainty, we have certainly seen people come here having gone through this procedure and been disappointed - we do reasonably suspect that many surgeons offer this with no commitment to success, except their own success in demonstrating that it was "not going to work anyway" and "selling" eventual circumcision.
Now as rants go and the likely motivations of doctors, I may describe a political problem in Australia, where a group of purported "medical experts" representing organisations dealing with HIV/ AIDS, together with known circumcision zealots, are getting publicity by suggesting that infant circumcision be promoted.

I was at a loss to imagine why what I would have presumed to be otherwise worthy and ethical people, would demonstrate such a shocking lack of consideration for contemporary ethics as to support mutilation of unconsenting infants, until my wife pointed out the blindingly obvious. These "leading experts" just happen to be noteworthy members of the Jewish community! In America and Australia, there is a representation of Jewish doctors vastly in excess of their proportion in the population as a whole, and their need to justify their particular religious observances is of course, entirely understandable.

(Login Chris99999)

Re: Oh my, tricky question!

September 29 2010, 11:10 PM 

Wow, thank you both for your replies. I HAVE had the "cracks" in the skin once or twice in my life, but fortunately not in many years. I don't feel or perceive of any scarring (except for a couple of tiny stitch marks from having a questionably necessary procedure on a frenulum breve).

I miss-wrote the other medication, it was Kenacort -t (http://en.wikipedia.org/wiki/Triamcinolone ) salve. Still the wrong stuff though. It's Swedish. It's not sold, under that name anyway, in the US.

As a description to my specific problem, all I can say is that masturbation has never been hindered, but in the act of actual sex, the opening to the foreskin is JUST wide enough to retract completely over the glans if pressure is applied. But it's stretched quite a bit at that point, and quite uncomfortable. I don't believe the frenulum to be the source of the discomfort, the tension is "all over".

During intercourse I have to constantly stop and fix myself manually. It gets stuck fully retracted (but not to the point of paraphimosis), and "chokes" the head. It's really uncomfortable. More often than not, I do not "finish" at all, and have even "faked it" (not as difficult with a condom), because otherwise, I would just keep going, causing more and more discomfort, never getting myself anywhere. I tend to treat it as I imagine it's more common for a woman who doesn't climax does - focusing on the rest of the experience, as well as focusing on her. I try to be as positive about things as I can.

Ultimately, because of all this, sex never motivated me much, and I stuck with what worked. Taking care of myself.

The stretching device (I did find it here, after a loooong night of googling for help, ignoring all the spam sites for phimosis cures)... perhaps I am stretching too much? I didn't think that would be possible, but after about 40 minutes I find myself very uncomfortable, if not in outright pain. Perhaps I should stretch less, but for much longer. Interesting. The device itself is amazing, as compared to manual stretching. It also made the application of the steroid creams many times easier. Based on what you've said, perhaps it's just too much pressure. I'll have to make a 2.0, I've had no problem wearing it under clothes.

(as a complete aside, I am open to the thought that at this point in my life, I may have some mental baggage as a result of this, and I may have to work through it. but I still want to be able to have sex without discomfort.)

Oh and the doctor thing? Before I moved out of the US, I went to a GP, who referred me to a urologist (who performed the operation on the frenulum breve) and 2 other doctors who both wanted to chop me up completely. I had found a plastic surgeon willing to do the y-v plasty, but I am not a fan of surgery, so wanted to exhaust my options. I'm up to 4 or so GP's and a urologist, none of which helped. That's a good point to keep in mind though - I'm not anti-semetic, but I think I'll have to remember to avoid Jewish doctors for this one issue of mine. I hadn't even thought of that. happy.gif

This forum here has pretty much kept me from giving up. You guys are fantastic, and provide an amazing service.

Thanks for being here.

(Premier Login jimsplacetofixthings)

Long shot

September 30 2010, 8:08 AM 

How about trying an anti-yeast medicine to see if that helps?

Paul B.
(Login Paul_B.)

Actually ...

September 30 2010, 2:26 PM 

Kenacort® - triamcinolone - is the right stuff - a close equivalent of betamethasone! You had me just confused with the spelling, though I recognised the similarity.

And you are suggesting that you already had an operation on the frænulum?

I'll look more closely at your answer later, but in general, the stretching device is what you need, and a little less force and a lot longer wearing - as I detailed - would be the way to go.

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