I've read through many threads on this site and was curious what were Jim and Paul's medical background. I visited a urologist today for my tight foreskin and to get a prescription for steroid cream. He immediately recommended circumcision and I flat out told him that wasn't an option and would attempt stretching exercises. He didn't dismiss the idea but also didn't sound like it would do much good. I was wondering if this is the opinion of most medical professionals or are there doctors who believe stretching is a worthwhile and preferable method. To defend my skepticism, I haven't actually come across any success stories in this forum, though that may be due to people being happy with their results and never looking back and posting an update.
I was just musing on it today, (well) before this posting actually came through.
You will find a trend in postings here, toward two themes. One is the people who are really happy to have found appropriate information and proceed to do the exercises, and other people who incessantly "beat around the bush", are not sure, give it a try for a few days and come back with more and more questions about whether it works or not.
It is true that for some people the stretching does not work. For those, a helpful doctor who could look at the situation, assess what sort of skin disease is preventing progress, and prescribe an appropriate regime of steroid and anti-fungals, would be immensely helpful. Sadly, sexual functioning is not a particularly comfortable topic for many and perhaps most doctors, resulting in situations such as you relate here. Did you actually get the (correct) prescription in the end, and if so, with what instructions?
As to medical background, I put it this way: If it becomes clear there are (many) doctors including supposedly "highly trained" specialists who lack the judgement to comprehend that a procedure that is used in plastic surgery, orthodontics and physiotherapy can be applied just as appropriately to the foreskin, then why would you attempt to judge my advice on my medical qualifications? Are you looking for a titular "pissing contest"?
I'm afraid you are left to read - as you have - my comments and assess them, which I believe to be by far the healthier approach. I do leave a reasonable number of clues, but due to the prevailing social attitude of prudery, it does not suit me to reveal my actual identity and qualifications to associates, acquaintances or clientèle. And as I like to say - the whole of life is a test of your judgement; if you cannot read the clues with sufficient expertise, then there are likely to be somewhat more unpleasant consequences than a penis which does not work quite right and I cannot help you.
Sam (no login)
Re: Ah, I love this question.
February 13 2012, 11:57 PM
Sorry for the late response, but about 10 days ago I decided to stop googling for 'comforting' answers and be the success story I'm looking for. I have been doing a regimen of 10 minutes of stretching the frenal band and 10 minutes of stretching the frenulum each day. Is 10 minutes for each exercise unnecessarily long? Would it be a better idea to break this up into 2 sessions of 5 minutes for each exercise with the sessions being spread throughout the day?
Also, before I visited my urologist, my primary care physician prescribed me hydrocortisone 1% cream because of a fungal infection I had on my foreskin. My urologist then prescribed me Nystatin for the fungal infection and, after requesting the betamethasone, told me that hydrocortisone was the same steroid and to use that for the purpose of stretching. Is the betamethasone better suited for stretching?
Now you're on the right path. As far as time per session, it's just a guideline. If we tell you ten and you do five, at least you're doing it and will find some progress. The key to the correct timing is in how your skin responds. Does it fell more supple at the end of each session? Is there a gradual change occuring in how it stretches? If not, increase either the time per session or the number of sessions. Each time you pee, you could do a mini stretch to encourage the loosening process.
The two substances you cite are different. If you successfully treat the fungus, no medicine will be necessary to help you stretch. Even with the proper medicine, stretching is still necessary. Under its various brand names, betamethasone is what doctor's prescribe for tight foreskins.
Sam (no login)
A little confused.
February 14 2012, 5:59 PM
Actually when I first began, my foreskin was quite sore after stretching, so I backed off on the pressure a bit, and after the first week the soreness disappeared and doing a 10 minute long stretch with a good amount of force feels fine. It definitely feels a bit more supple after the stretch and I can already notice a bit of progress for both the frenal band and frenulum.
I'm confused about the steroid cream. From what I've gathered, the cream basically speeds up the results of stretching as opposed to delivering 'better' results than stretching alone. So after clearing up the fungus with Nystatin, a steroid cream wouldn't give me speedier results while I continue my stretching? And if it were to give me speedier results, I shouldn't bother with the hydrocortisone and should seek out the betamethasone, preferably the ointment? I'd prefer to have faster results if all it takes is a simple application of the steroid cream along with the stretching I'm already doing.
You're already getting results, showing that a boost is not necessary. Progress is limited by the rate at which new skin cells can be generated. The steroid cannot speed up that process. This is also why you cannot produce faster results with more tension. The skin has limits to its elasticity as well as having limits on speed of growth. What more sessions produce is less chance of regression. The skin has a natural tendency to remain as it is unless there is a resistance to the original state. Your fingers provide that resistance. Think of inertia of rest to get an idea of what I'm saying.
To recapitulate what I have explained at various times in the past, the body's response to stretching in general is that short repetitive forces applied to any part do not cause it to yield in structure to the force, but rather to resist it. Your teeth to not sink into your jaw as a result of chewing and your tendons do not stretch as a result of walking.
Where the stretch is persistent or indeed constant however, it generally becomes a signal for growth to remodel the structure, so that tendons lengthen to match as bones grow, and your skin stretches to accommodate what is within, which necessarily includes not just growth to adulthood, but growth beyond the normal; people who become obese stretch to fit rather than exploding.
The implication of this on stretching your foreskin and frænulum, is that the more consistent and persistent you can stretch, the more you are engaging this normal growth process. You do not want to give it a rest every minute or two if at all possible. You always want to do it as long as possible.
So clearly it is the cumulative time spent stretching that is important. Whether it is better to stretch once for ten minutes or at two different times for exactly five minutes each - or once for three and once for seven - is not at all clear. What I will assert with confidence, is that doing it twice for ten minutes each would be better than once for ten minutes.
It is tempting to criticise doctors' advice on second hand evidence. What people think the doctor said is not always what (s)he really did. What you describe about the doctors, if accurate, would be singularly disturbing. Firstly, steroids (hydrocortisone) are absolutely not a treatment for fungus; they suppress the body's (local) immune responses to fungi and yeasts and make it worse unless combined with an actual treatment for the fungus. What they do - by suppressing the inflammation - is make it more comfortable.
Asserting that betamethasone and hydrocortisone are "the same steroid" is absolute nonsense. Either the "urologist" is grossly incompetent, or he is taking you for an idiot and deliberately palming you off with an ineffective treatment. Or perhaps both?
Steroids are graded on a scale of "potency" on which "plain" hydrocortisone is the lowest and betamethasone (most correctly as ointment) is near the highest. You can Google on "steroid potency" to verify this - it's hardly rocket science! But it is important if you are going to use a steroid to assist stretching though as Jim points out, this is not essentially unless the problem is a skin disease in the first place.
I hope this explanation also serves to answer your original question above.
Sam (no login)
A couple questions about thrush.
February 16 2012, 1:19 AM
Thanks guys for all the information you've provided thus far. I'm not sure what I would have done if it weren't for this site.
So first I'd like to go into detail on my exact situation regarding my foreskin since I have yet to do that. Before I began stretching, I could retract my foreskin entirely while flaccid but a tight frenar band was clearly visible. Also, my tight frenulum caused the head of my penis to tilt down. When erect, I couldn't pull my foreskin over the head of my penis without considerable pain and lubrication. Once the foreskin got behind the head, it would get 'stuck' there and basically feel like it was severely squeezing the shaft of my penis right behind the head and I couldn't move my foreskin any further down. Also my frenulum would be stretched very very tight, I could see the urethra stretching as well from the tension. After starting my stretching almost two weeks ago, I can already, with lubrication, pull the foreskin back behind the head with significantly less pain, though I can definitely still feel some squeeze and the frenulum still feels very tight.
Also, for quite a long time, I've had some white bumps along my frenal band and frenulum, though the bumps themselves were never painful or itchy or really bothersome at all. My urologist informed me that this was a fungal infection which I'm now quite sure it is thrush though I didn't ask about the name at the time and I was given Nystatin to treat it.
My questions are:
!. Is this fungal infection what caused my phimosis and tight frenulum in the first place or is a fungal infection of this nature something that happened because of my phimosis/frenulum breve?
2. Does the fungal infection create a roadblock to progress with regards to stretching? I've already seen some great progress with my stretching alone and I'm wondering if, when the infection is gone, I'll be seeing even quicker progress.
3. Finally, how long does it normally take for a fungal infection like this to clear up, assuming I'm consistent with my treatment? Tonight is the first night I've used the Nystatin and the instructions that came with it said to use it twice daily until the prescribed amount is used up since the symptoms can clear up before the actual infection is gone.
Unless you have cited it in another thread, you have not made it immediately clear whether this problem is one that developed recently or has always been there. The only real clue we have is that you have a tight frænulum which confirms that this is primary "phimosis" - it has always been the case. It would then be of some interest to know your approximate age, when and how you discovered that this was an anomaly and whether this has been of any concern to you in sexual function (because there is no necessary reason it should). I always query these things in order to put emphasis on important consequences.
Whether the problem is recent, or has always been the case is of prime importance. A tight foreskin developing where it has previously been functioning quite normally absolutely indicates skin disease, of which Candida - "Thrush" - is by far the most common and therefore the one on which to focus first. Where the foreskin has always been tight (and by implication, the frænulum is tight having never been stretched by regular retraction), skin disease in not so likely to be the cause - except perhaps due to childhood abuse through forcible retraction, really poor hygiene or "bubble baths".
Now you can have episodes of "Thrush" in conjunction with a foreskin that was never retracted, to complicate matters. This is in this situation, not necessarily going to cause tightness since it was not there all the time. It is not uncommonly a consequence of sexual intercourse, as women are quite susceptible to the condition. It is not in itself a consequence of a tight foreskin either; the common myth that having a tight foreskin or even a foreskin at all predisposes to infection is actually reversed - the foreskin protects against ingress of irritants but if soap or detergents do gain entry, it can be that much more difficult to clear them out again and the irritation they set up as a result does predispose to secondary infection.
Does fungal infection preclude effective stretching? Yes!
Treatment time? Generally up to a week, but if you are going to pursue stretching, the treatment should preferably be extended as you perform it.
Now in your case, the question of fungal infection in the first place is unclear. You say your primary care physician diagnosed a fungal infection and then gave you a completely inappropriate and actually counter-productive medication (which is by the way, available over-the-counter, as is the Nystatin and virtually all other anti-fungals). What exactly were your symptoms from which he made this conclusion?
And you mention for "quite a long time" that you have had some white bumps along your "frænal band" and frænulum but these have never painful or itchy, but your urologist informed you that this was a fungal infection. That is palpably absurd! "Thrush" shows as multiple tiny white plaques which develop over a period of hours and scrape off leaving a bright red (inflamed) spot underneath. This does not persist, and the infection (as with other fungal infections with some variation in the time frame) is dynamic - it develops and moves on, previously affected areas "clear" as new spots develop. And most significantly, except where steroids have been used which suppress this, it is virtually always intensely itchy.
I am consequently, at a loss to find in your story so far, any evidence of a fungal or "thrush" infection. The "bumps" in question sound quite non-specific and likely quite normal, possibly the sebaceous glands in this area.
Sam (no login)
February 19 2012, 2:25 AM
Jim - I am not on any antibiotics, though when I originally went to my PCP and received the hydrocortisone, I was also given bactrim to treat a boil I had, which went away after treatment.
Paul - Some background, I am 23, never been sexually active and I've always been good about keeping my foreskin clean. Honestly I cannot remember when I realized my foreskin should be able to retract with no pain, but I would put it at around 2 years where I've been reading up on it the matter. It sounds like I would benefit from a second opinion with a different urologist, thought I'm going to give the Nystatin a chance to work. The bumps have never scraped off and are not itchy, but they are only on the parts of my foreskin that are tight and also add stiffness to the skin.
I'm wondering whether you have really learned from our efforts here? Apparently you simply do not believe us. Why would you imagine a "second opinion" with a different urologist would benefit you?
I am not saying that urologists are universally charlatans, though I do perceive that in the USA, they are more strongly driven by the pursuit of profit than perhaps in other countries. If however your description accurately reflects the advice your doctors have given you thus far, then they in particular would certainly appear to be incompetent.
The point is that they simply reflect the common mentality of their clientèle. As a result of another enquiry here, I have been browsing through the Sexperience UK site. It rapidly becomes clear that for most people (and for the schoolies that site presents), sexual relations are pretty much a "McDonalds" activity where the prescription is you "do" foreplay (which is presumed to be a necessity, but trivial), have intercourse (hopefully with a condom), the fellow ejaculates, and it's done. By this token, if you go to a "urologist" with a foreskin problem, he concludes that the foreskin is the problem and kindly offers to remove it for you.
This is predicated on the observation that he does not see any value for the foreskin and (even if he himself has one and values it,) presumes because the vast majority of fellows who come to see him do not, that you do not see any value for it either - and he acts accordingly. The concept that certain sexual experiences are better than others and should be desired, is "up there" along with unrealistic concepts such as that the girl/ woman should achieve an orgasm through mutual sex. If the fellow can get an erection, put it in a vagina and after the prescribed amount of time, ejaculate, then "normal" function has been achieved.
Hydrocortisone plus (oral) antibiotics does sound like a recipe to encourage "Thrush".
I am a trifle puzzled as to just what you were doing if you have been "keeping your foreskin clean" notwithstanding that you could not retract it? Hopefully not using soap.
Again, "bumps" that are permanent, are almost certainly not "Thrush".
Sam (no login)
Re: Creative head banging?
February 20 2012, 12:51 PM
I'm a little confused why a second opinion would not be valuable. Bumps that weren't always there exist along the parts of my foreskin that are tight and stiff. Is this not worth investigating with someone else who can physically inspect my penis when you've indicated my PCP and last urologist had seemed incompetent in their actions? There's no harm in it considering I've already decided that no one is taking away my foreskin and if people can stretch their earlobes to absurd sizes, I can definitely do the same with my foreskin (and I've already been seeing a bit of progress ).
Unfortunately, I am aware about how profit driven many doctors are in the USA from a prior injury. I'll try to find a specialist who does not run their own private clinic and gets paid the same regardless of what they do. The urologist I did see was recommended to me by my PCP so that's who I saw. Perhaps I just wasn't really aware or ready for how so many physicians would simply tell me to get a circumcision and send me on my way. Whoever I see next will definitely be informed that I think cutting of my foreskin for some bumps and tightness is akin to cutting off my arm for an itchy rash.
As for keeping my foreskin clean, I've always been able to retract it when flaccid (though you can see the tight frenar band and head bowing down from the short frenulum) and rinse it in the shower without soap.
And everything that I've told you about my prescribed treatments has been accurate. If this makes my current physicians sound incompetent or simply in a rush to make a dollar, I'll find one who isn't before I dismiss something on my body as harmless. For now I'll give the Nystatin a chance since it's been less than a week, it's nonsurgical and there's no harm in seeing where it goes. And of course, the stretching will continue.
My goal is to have a foreskin I can easily retract without pain when erect. The issues are a tight frenar band and a short frenulum. I have confidence that the stretching exercises will get me to where I want to be, but from reading the threads, I know that a skin infection can be a roadblock. I think I have such an infection since I have white bumps on my frenar band and frenulum so I want to get that taken care of. Even if it wasn't a roadblock to stretching, it's still worth investigating and something I want to have treated because the bumps weren't there before, it's caused the skin to stiffen and I don't want to ignore a medical issue. Paul's opinion contradicts the opinion of my urologist who has the benefit of actually seeing my foreskin, so I think a second opinion from someone who can closely inspect my foreskin is in order. If anything that indicates I've put value in Paul's opinion.
OK, so these small bumps did not appear to be there before. Quite so, it certainly is difficult to suggest what they represent without being able to see them, and a doctor would in general be the one to see regarding this.
Unfortunately, you appear to have seen two doctors and be none the wiser about the bumps. Since you are in the USA and I am not, I am not in a position to suggest just how you can find a doctor who has a serious interest in such matters. As before, I seriously doubt whether a "specialist" urologist would be any more experienced than a General Practitioner (PCP) because at least in the system with which I am familiar, specialist urologists see only those who have been "sifted" by GPs as having a condition requiring surgical investigation and intervention. So they should have almost no experience on minor bumps compared to a GP, because no such people should be seeing them.
If you want advice on skin bumps, if anything you should seek out a dermatologist. I think my point was - why do you need to see a doctor about them anyway and just what do you expect the doctor to do about them? (Correct answer might be - betamethasone! )
Considering you can already retract when flaccid, you certainly should be seeing results by now if you are using an effective method of stretching. You seem to have understood the primary "message" regarding stretching ("absurd sizes" ), and have an correct understanding of your foreskin.
Glad to confirm you have not been using soap.
Sam (no login)
Re: Given more information,
February 27 2012, 12:29 AM
There's no fluid inside of them. They are pretty flat, giving the area where they are present a rough texture but there is a bump on one side of the frenulum right where the frenulum connects to the head of the penis that is more bulbous and hard like a scab.
The logic on why a urologist would have little experience with bumps definitely makes sense. I may see a dermatologist instead so I can find out what they are and if they are a cause for concern or can be treated. Thanks for the advice you guys have given me, I'm definitely feeling progress with the stretching and am very glad the idea of getting a circumcision is completely eliminated from my mind and replaced with a very achievable goal.
By your descriptions here, these sound to be pretty static (over a period of weeks if not months), cause no irritation and seem to have have no actual connection with the tightness of the foreskin. All of these things individually and together pretty much exclude a fungal problem; I suspect they are simply a structural element (probably distended sebaceous glands) which only came to notice in the process of stretching and has no significance at all (in particular, no reason to interfere with them in any way).
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