Phimosis Surgery: The Process and Possible Alternatives
For years, circumcision has been the go to treatment for the common complaint of phimosis. Where a patient suffers with a narrowing of the foreskin, preventing the glans from being exposed, phimosis surgery has often been the proposed solution.
However, there are various kinds of phimosis surgery available, depending on the case. There are two main types of phimosis, with two further sub-categories:
- Congenital phimosis. This is where the condition is present from birth and as a result, there has been a failure to develop a prepuce in childhood.
- Acquired phimosis. This variation appears as an adult, usually through bacterial infection or other inflammation.
Then there are two levels of severity:
- Tightened phimosis. Here it is impossible to expose the glans, even with a flaccid penis.
- Non-tightened phimosis. In cases of untightened phimosis, the penis can still be partially uncovered, depending on the degree of foreskin narrowing.
In more severe cases of tightened phimosis, problems can arise in everyday life. Difficulty urinating or problems with sexual relations would be two such examples. If neglected and not treated in time, a steady strangling of the glans may occur. This requires urgent intervention, to prevent necrosis.
The development of phimosis is a progressive process. This allows us to intervene promptly, before it reaches the point of no return.
Before deciding on phimosis surgery
As soon as you think you may have phimosis, you should contact your doctor. This is the only way to get the correct diagnosis and evaluate the possible treatments.
Normally, before phimosis surgery becomes an option, we might consider a phimosis cream. This can soften the foreskin and help it to slide over the glans.
Such intervention is a conservative treatment, proven to work well in congenital phimosis cases at a young age. Adults though, who mainly have acquired phimosis, usually need direct surgery. At this stage, with either tightened or untightened phimosis, Phimostop comes into play.
What Is Phimostop?
Based on the natural principle of epidermal tissue dilation, the product uses a special design with patented technology and medical silicone. Phimostop halts the progression of scar tissue, gradually returning the foreskin to its natural state. This unique medical device acts on the phimotic ring. It stimulates the creation of new elastic cells to replace those damaged by scar tissue.
Our product offers 22 progressively-sized tubes, designed to slowly stretch the foreskin, without force or constriction. Depending on the extent of your case, you will quickly see your phimosis regress. The foreskin will once again retract over the glans, even with an erection, with no problems.
The Health Ministry has validated the Phimostop medical device, issuing a Class 1 certification. It has a European patent.
To date, we have sold more than 10,000 products, meaning thousands of men have successfully avoided phimosis surgery. It is sad to think how often surgical circumcision is proposed as the only solution. Even where alternatives like Phimostop exist.
It seems that doctors recommend phimosis surgery just because it is a convenient fix, carried out in a day hospital. However, performing it this way can have deep psychological and physiological impacts which are not always considered until it’s too late.
Steps to take when dealing with phimosis surgery
The first action is to sign up for the hospital’s admissions list during the urological exam at a clinic. Usually, the waiting time between list registration and the actual phimosis surgery ranges from a few months to two years.
Once called for the phimosis surgery, you will have the appropriate consultation with the surgeon and anaesthesiologist. If necessary, voluntary blood tests and an ECG may take place.
Before the procedure, the portion of the prepuce to be removed is marked out using a dermographic pen. You can opt for a total circumcision, where the entire foreskin comes off, or a partial circumcision. The latter aims only to cut away the preputial section which prevents the skin from naturally sliding over the glans.
Partial circumcision allows the foreskin to return to covering the glans of a flaccid penis. With total circumcision, this will no longer be possible and the glans will remain permanently exposed.
Phimosis surgery normally takes place with a local anaesthetic. First, a numbing ointment is applied around the penis. An anaesthetic injection to the base of the penis then increases the numbing effect. However, you may also request a spinal or general anaesthetic.
There are various intervention options for a urologist to evaluate, even in the field of plastic surgery.
Classical circumcision or total postectomy
This type of phimosis surgery sees two parallel incisions made on the prepuce. The skin is cut up to the subcutaneous layer (dartos), before the blood vessels of the foreskin are coagulated by laser or electric scalpel. Once the excess part is removed, the skin is sutured by stitches with resorbable material.
Usually with phimosis surgery, a plastic cast of the frenulum is also made. After the operation, a dressing with a semi-compression elastic bandage is applied. In the days after the procedure, the penis tends to swell. You may also notice small losses of blood and greater sensitivity. As time goes by, these effects will diminish.
After the circumcision, we recommend dressing procedures which can easily be done at home. These should be carried out for seven days. Total recovery occurs in about 4 weeks, after which sexual activity can be resumed.
In this case, there is partial removal of the foreskin, offering the benefits already described, such as maintaining partial coverage of the glans. But this method may result in the phimosis returning in future. The times for healing and return to sexual activity are also around 3 to 4 weeks. Use of anti-inflammatory creams can help to speed up recovery.
These phimosis operations can be carried out with a modern laser technique. This results in a shorter period of post-operative care. Laser circumcision is precise and allows for the simultaneous coagulation of blood vessels. The result avoids suffering the classic postoperative swelling produced by traditional phimosis surgery.
After the operation, there is a post-operative dressing required for 2 -3 days. An antibiotic therapy is needed for 3 to 4 days, along with analgesics. The sutures will reabsorb in around 7 to 10 days. You may resume physical activity after two weeks and sexual activity after 3 to 4 weeks.
Finally there are a series of possible plastic surgery options which remove the phimotic ring, leaving the prepuce intact. They are more expensive and delicate procedures.
In every case, it’s important to remember that phimosis surgery requires very fine and delicate instruments. It requires precision to guarantee a result that is functional (freeing the penis from the phimotic ring) and aesthetic (avoiding visible and annoying scars). Like every operation, the results depend on the responses of the individual, especially in the postoperative phase.
Hospitalisation lasts around 24 hours, after which the patient is discharged. At this point, he receives a letter explaining medication procedures and the measures he must follow. These may include the application of anti-inflammatory creams, use of painkillers or abstention from washing the penis. The postoperative phase lasts for around 3 to 4 weeks.
The alternative to surgery for phimosis
We created Phimostop with a simple aim. To avoid circumcision by relying upon the natural ability of the skin to stretch using appropriate devices for steady expansion. The one exception to this is with cases of paraphimosis.
Phimostop is a legitimate medical device, specially designed, patented and validated by the Ministry of Health. Iti even was the subject of a clinical research conducted by the Polyclinic of the University of Tor Vergata with publication in an international journal
In future, phimosis surgery will become increasingly rare, in line with ongoing research into minimally invasive methods. This will offer great advantages to patients and provide huge savings on public spending. Phimostop has saved €12 million to date, according to estimates.