The harm of phimosis and redundant prepuce (endangering the physical development and sexual life)

A well-known Chinese sexologist professor Shi CY believes that both men and women should have a further understanding of foreskins problems.

He pointed out that phimosis is a congenital malformation. Almost every newborn infants show this phenomenon, however, the foreskins gradually shorten and evert upward until they are 7 or 8 years old, only a small fraction of them (about 8%) become pathological phimosis.

“The foreskin is very thin, without endermic adipose tissue but with a smooth muscle layer. There are many small metamorphotic sebaceous gland between the foreskin and glans, known as Tyson's gland, which excretes extremely stinky liquid. The bonding of this liquid and deposits from urine is known as urine dirty or smegma”.

He explains that redundant prepuce means the foreskin covers the glans but can be freely everted to expose the part above the coronary sulcus. The cases in which foreskins completely cover the glans and meatus urinarius are called proliferous redundant prepuce; and the cases in which foreskins cover only a part of the penis are known as atrophic redundant prepuce.

Inconvenience for urination

“Phimosis is due to the covering of glans by foreskin and inability to evert foreskin. The inability of eversion is due to either excessive small opening of the foreskin or due to the adhesion between foreskin and glans. Redundant prepuce may turn into phimosis due to inflammation resulting in adhesion, and excessive small opening of the foreskin may affect urination”.

Professor Shi said that redundant prepuce may not necessarily lead to phimosis, however, phimosis may include redundant prepuce, and moreover, phimoseis is generally more serious than redundant prepuce. According to china's data, in a survey on 2447 new students in Lanzhou University in 1956, there are 604 students suffered from phimoseis or redundant prepuce, with the incidence at 24.2%, of which 495 students is diagnosed with redundant prepuce accounting for 20.1%, and 109 students is diagnosed with phimosis accounting for 4.1%.

Recently, a Chinese sexologist Liang CC conducted a external genital organs inspection on 5172 primary and middle school students, which showed that the incidence of phimosis is at 10.09% and than of redundant prepuce is at 67.7%.

Major harm

He points out that the harm of phimosis includes the following aspects, and patients should seek for treatment as soon as possible:

●Inhibiting physical development: Phimosis restricts the development of penis and glans, as a result, they look very small.

●Infection: The deposit from urine and smegma accumulate inside the foreskin, functioning as the nutrition source of germs, or infection and inflammation are induced by stimulation which result in adhesion of foreskins or even infertility in serious condition.

●Obstruction: As the opening of foreskin is too small, the urine fills the foreskin cavity before discharge. When urine discharge is in difficulty, back press may occur. The thin part of the urinary bladder wall protrude as a result of the pressure, which form a vesical diverticulum; as this vesical diverticulum is extremely thin in its wall, it is vulnerable to outside force which may be easily broken, in some serious and chronic cases, it may also causes dilatation of ureter and hydronephrosis. Because of the difficulty in urination and increased abdominal pressure, prolapsus of anus and herniation may occur, sometimes “diverticular double urination” may also occur.

●Calculi: Mucosal epithelial cells fall off after inflammation, acting as the centronucleus surrounded by dirties, which form the calculus of prepuce. Parents usually feel anxious when they find out that there are small firm masses in the foreskin cavity of their children, actually, we may easily take calculi out by slightly enlarging the circular foreskin.

●Sexually transmission disease: Redundant prepuce or phimosis may leave the inner plate and glans in moist condition, which may cause Sexually transmission diseases such as condyloma acuminatum and gonorrhea, moreover, as the local part is unable to be completely washed clean, wives of patients may troubled with the same diseases.

Affecting relationship between husband and wife

●Sexual function

•  In cases of phimosis, the foreskin is not easily movable, which may cause pain or difficulties in sexual intercourse as well as sexual hypoesthesia.

•  In cases of redundant prepuce, spermatorrhea may often occur due to friction in daily activities such as bicycle riding, horse riding, walking or sleeping.

•  Light inflammation may occur due to the simulation on foreskin by smegma, with a sensation of burning and itch, as a result of reflection, the desire for masturbation may be induced.

•  In cases of phimosis, inability of ejaculation may occur due to low sensitivity caused by without having direct contact between glans and vagina.

•  The decreased hedonia may sometimes cause impotence, which affect relationship between husband and wife.

●Tumor: Phimosis or redundant prepuce is closely related to tumor. Most urologists think the formation of tumor is due to pollution by smegma and chronic stimulation, which is the major cause of papilloma of penis. (Dean)

Causing cervical carcinoma: Wives of people who used to have phimosis or redundant prepuce may have larger chance to be suffered from cervical carcinoma, which proved the close relation between cervices and smegma.

Data in literatures usually show: All the patients of carcinoma of penis have the medical history of phimosis or redundant prepuce.

●Paraphimosis: In the cases of phimosis, when foreskin is everted over the coronary sulcus, the constrictive coronary sulcus in the opening forms into a incarceration leading to Paraphimosis, which makes the foreskin congested, swollen, infected or necrotic. This case in children may be caused by toying with penis, in adults may be caused by sexual intercourse or masturbation. If not timely repaired, blood circulation may be blocked leading to congestion of the glans or even necroses of the glans. Once it is discovered, dorsal lateral incision should be conducted to restore the blood circulation.

●Other complications: Many scholars believe that apart from the symptoms mentioned above, there are occasionally many other reflex symptoms, such as dystrophia, chorea and falling sickness, and enuresis is also not rare, however, all the symptom disappear after the removal of the redundant prepuce.