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Foreskin problems
We offer assessment of conditions involving the foreskin such as rashes, abnormalities of the skin, and problems with a tight foreskin.
Most men with foreskin problems complain of a tight foreskin. Younger men may have a tight foreskin due to an abnormality in the formation of the foreskin (a physiological phimosis).
In older men it is usually due to a scarring condition called Lichen sclerosus which can also affect the penis and the opening of the urinary tract in about 2.5% of cases. It may present with complaints of irritation, infection/inflammation or difficulties with urination (e.g. stream spraying or incomplete bladder emptying due to poor flow).
Treatment for mild cases can be tried with steroids, but for those which are at the more severe end of the spectrum or for those that have failed steroid treatment, an operation is recommended.
A circumcision is the ideal choice of procedure for most cases, and would be performed as a day case procedure. Some patients with a tight foreskin which is not from a scarring condition, but due to a natural tightness from birth (physiological phimosis) may be spared a full circumcision and opt for a prepucioplasty. However, the cosmetic results may require a full circumcision later. If the problem is deemed to be due to tightness of the frenulum (band of skin below the head of the penis), then a surgical procedure known as frenuloplasty may be used to lengthen it.
We offer and perform circumcisions and revision procedures as a daycase procedure using dissolving stitches.