Circumcision not always necessary
The foreskin is the front fold of skin that covers the glans (glacier) of the penis. When you get an erection, the glans is exposed. The foreskin then slides back over the glans. If you have a longer foreskin, the glans can also remain covered during an erection. That shouldn’t be a problem, but sometimes the foreskin is too narrow.
In newborn boys it is normal for the foreskin to be narrowed or stick to the glans. Usually the foreskin becomes wider and looser with age. This can last until a boy is 4 or 5 years old. In about 1 percent of adult men, the foreskin cannot be pulled back over the glans: phimosis. It can also happen that the foreskin can be pushed back, but then not back to its normal position. Then there is a Spanish collar, also called paraphimosis.
Symptoms
If the foreskin cannot or only partially be pushed back, various complaints can arise:
- Difficulty urinating (the foreskin bulges during urination).
- Peeing with a weaker beam.
- Not being able to keep the glans properly clean.
- Inflammation of the glans (balanitis).
- Pain during erection and intercourse.
- Waking up to nocturnal erections.
In severe cases, the foreskin can narrow the penis. The blood that flows into the glans cannot escape. This makes the glans very painful and blue-purple in color. With a Spanish collar, moisture accumulates in the pinched foreskin. During an erection, a collar is created around the edge of the glans. Medical help is necessary in both cases.
Causes
You are usually born with a narrowed foreskin. The strap with which the foreskin is attached to the penis – bridle – may also be too short. At a later age, a tight foreskin also sometimes arises as a result of an infection or inflammation. Scar tissue is then the culprit. Very occasionally you can also get a narrowed foreskin due to poor hygiene.
A Spanish collar is not congenital, but arises as a result of inflammation, infection or after the insertion of a bladder catheter. However, paraphimosis can also be the result of a skin lesion of the penis; for example after masturbating too hard.
And then?
If you (or your child) suffer from a narrowed foreskin, always consult your doctor. If you continue to walk with complaints for too long, cracks can occur in the foreskin or part of the skin can die. The latter often results in scarring, making the foreskin even narrower.
When it appears that the foreskin is so narrowed that treatment is necessary, there are several options. Usually a general practitioner or urologist first prescribes a corticosteroid ointment. The ointment must be applied to the narrow part of the foreskin twice a day for four weeks. You have to slide the foreskin slightly backwards.
In most cases, such a four-week treatment has sufficient effect. Sometimes you have to apply for an extra four weeks. If this does not work, a doctor often recommends circumcision.
spanish collar
The treatment of paraphimosis consists of pushing the foreskin back over the edge of the glans. After anesthesia, the urologist can often do this easily. Cooling or applying a nasal spray will slightly reduce the swelling. An infection can be prevented with antibiotics. If you often suffer from a Spanish collar, circumcision is also the best option.
Circumcision
Circumcision involves removing the foreskin from the glans. Sometimes the foreskin is completely or partially removed or the bridle is loosened. In adults this is usually done under local anaesthetic, but in children a doctor usually opts for a general anaesthetic. The procedure takes about half an hour.
After a circumcision, the glans is usually uncovered and therefore very sensitive, especially during the first few days. He often looks red and swollen as a result of the procedure. The body needs about a week to create a new layer of skin on the glans. The stitches will dissolve on their own.
The day after the operation it is important to take it easy; the dressing should also be changed regularly. Until two weeks after the circumcision, you should not exercise, swim, bathe, play with sand and have sexual intercourse.
Getting an erection and urinating can be very painful for a while. Make sure you have enough paracetamol at home for after the operation. Bleeding also occurs regularly. If the pain gets worse, pus or blood comes out of the wound, the penis gets bigger or if you develop a fever, it is important to contact the doctor.
