If you are experiencing a tight foreskin that cannot be fully retracted, it may be causing recurring infections in the foreskin area. Preputioplasty could be a viable option to address this issue, provided it is appropriate for you. However, it is not advisable if your foreskin is scarred due to conditions such as Balanitis Xerotica Obliterans (BXO) or Lichen Sclerosus.
Preputioplasty for a Tight Foreskin
Here are two options for treating a tight foreskin while preserving the foreskin
- Preputioplasty: This is a procedure that widens the foreskin. It involves making incisions on either side of the foreskin to widen it, allowing for full retraction while keeping the foreskin intact. Y-V preputioplasty serves as an alternative to circumcision for boys over the age of 16 and adults.
- Dorsal Slit of the Foreskin: This procedure involves incising the upper part of the foreskin to relieve tightness (phimosis), particularly when the foreskin is stuck over the engorged head of the penis or if circumcision is not preferred.
Benefits of Preputioplasty
One advantage of preputioplasty is that it allows you to retain your foreskin while effectively alleviating the tightness.
Procedure Details
- Our surgeons usually perform preputioplasty under local anaesthetic.
- Local anaesthetic nerve blocks offer post-operative pain relief.
- The procedure involves dividing the foreskin across the top and then restitching it lengthwise, thereby effectively lengthening the foreskin diameter.
- Dissolvable stitches are used and typically disappear within two to three weeks.
- Glue is applied to the wound to seal it, and it usually sloughs off within ten days.
- A loose bandage is wrapped around the penis, and it can be removed after one to two days.
Risks, Consequences, and Alternatives
The success rate of preputioplasty is between 70% and 80%. However, there may be some side effects or complications, such as:
- Bruising and swelling, which typically subside.
- Bleeding (occurs in 2-3% of patients), usually minimal.
- Infection (usually minor but could be potentially severe).
- Tenderness at the scar.
- Cosmetic dissatisfaction.
- The necessity of full circumcision if symptoms do not improve (over 30% may experience scarring following preputioplasty).
Circumcision is the best option for a very tight foreskin.
After the Procedure
- Expect some swelling and bruising, which can last several days.
- Stitches will disappear, usually within two to three weeks.
- Painkillers like paracetamol or Ibuprofen can help with discomfort.
- Dressing should fall off within 24 hours.
- Avoid swimming and exercise for two weeks.
- Keep the area dry for 48 hours, and avoid soaking in a bath.
- Retract your foreskin daily after three days to maintain the benefits.
- Refrain from sexual activity for up to four to six weeks.