Phimosa and circumcision: Have Phimosa for 2 years now... - BASHH

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Phimosa and circumcision

daabren profile image
32 Replies

Have Phimosa for 2 years now and am considering circumcision at 65 y/o but I am not sure........anyone else have this problem ?......and actually gone through with it ?

On a different note [ maybe ] : I have tried taping the skin back to expose the glans but little success. Anyone know of a good method ?

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daabren profile image
daabren
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32 Replies
Galen70 profile image
Galen70

I would be concerned that a 65 year old man has suddenly developed phimosis. Have you had a medical assessment of the area to rule out Lichen Sclerosus ?

daabren profile image
daabren in reply to Galen70

Hi Thanks for the reply. I actually had the first signs when I was 60, and single, but there was no problem and did not concern me. When I was 63 it became a problem and after a thorough exam. the Doctor diagnosed Phimosa. The district marks of Phimosa is very evident in me. Sometimes it can be quite painful about 30% of the time. At the time (when I was 63 and seeing the Doctor he told about Circumcision as an option)......which is where I am now.

It is fine when I am with my girlfriend ( since I was 61), who lives in south of France as she is always wet when we have sex, I am in UK. we get together only about 4 months in 12, so it is when I masterbate is the problem.

Would be good to talk to someone in a similar situation/predicament.

Cheers.

Galen70 profile image
Galen70 in reply to daabren

Ok so the English word is phimosis. When you say "the district marks " do you mean lines or breaks in the skin , or do you mean pale white skin ? Was the doctor a family doctor, sexual health specialist, or a dermatologist ?

daabren profile image
daabren in reply to Galen70

Hi again.

There is roughly 3-4-5 distinct cut like marks spaced around the circumference of the penis maybe 3-4-5mm in length that run parallel with the length of the penis. Sometimes the skin is broken within these lines like an open wound, very red and sore. There is always pale white skin even after the "cut like marks" subside.

I only saw my family Doctor.

It is like.... in the one area around the skin it looks like it has shrunk and is now tight or tightened. So when I pull the foreskin back as far as it will go past the Glans to about 20mm past the glans there is a pale white area that runs all around the circumference of the penis the length of which is about 8-10mm.

Galen70 profile image
Galen70 in reply to daabren

This sounds to me like Lichen Sclerosus . You need to see a sexual health specialist, urologist or dermatologist to make this diagnosis . It may be treatable with a topical steroid but you need a full assessment.

daabren profile image
daabren in reply to Galen70

Ok I will have a little research on this and let you know. Doubt I will get a hospital appointment now though with covid running rampant ....

Galen70 profile image
Galen70 in reply to daabren

Its not an emergency but its important to make this diagnosis. I was hoping to link an internet page with a pic to here, but the google image search pix are absolutely rubbish. The pale white area that runs the circumference to me sounds absolutely classical for LS, but you need a real life assessment. Sexual health clinics are often well placed for identifying this condition ( and often quicker to see )

daabren profile image
daabren in reply to Galen70

Hi.

Also from what I saw on google and from your link LS is a Glans [thing] from what I can see. My Glans is in tip top condition.

Galen70 profile image
Galen70 in reply to daabren

LS can present in many ways. Some people have glans changes only, some people foreskin, some both. It can even affect around the anus, although it is rare .

daabren profile image
daabren in reply to Galen70

Ok understood. I think in any event I will now seek further diagnosis from the sex clinic in Cardiff.

From what you are saying I guess that cicumcision will not cure what I assume what I have....?

Galen70 profile image
Galen70 in reply to daabren

It all depends. Not everyone with LS needs a circumcision. Sometimes strong steroid ointments can help to reduce or even vanish the LS. But if the phimosis is very tight, or doesn't respond to steroids, then circumcision is a good option. As you said LS can sometimes affect the glans, circumcision doesn't fix this. On the other hand, if the LS is restricted to the foreskin, then circumcision can be a curative option for some men.

daabren profile image
daabren in reply to Galen70

Yes, hence my original mailing . Circumcision would seem the best option..... which brings us back to the beginning.....

The reason I mailed my problem was to talk to someone of similar ilk. Just not sure what to do. I am moving to Asia soon and I did not want my problem becoming so serious that I end up in hospital in Asia .....However when I am with my girlfriend there is no problem. Secretly I think I quite fancy the idea of not having a foreskin. But !

Galen70 profile image
Galen70 in reply to daabren

All depends on how soon. Hopefully soon sexual health clinics may return to normal function. If you do get a circumcision, get them to send the foreskin for histology. That will confirm or deny the presence of LS.

daabren profile image
daabren in reply to Galen70

Just spoke to the sex clinic and they say I have to go to my family Doctor and get a referral. That could take a while.

Galen70 profile image
Galen70 in reply to daabren

That seems a bit bizarre. Patients can self refer to sexual health clinics without their GP referring them. It is one of the cornerstones of sexual health clinics.

daabren profile image
daabren in reply to Galen70

Well on the phone she was quite clear that I need to see my own Doctor. Maybe if I ring later or tomorrow I will get a different response...or maybe change my questions ?

Galen70 profile image
Galen70 in reply to daabren

Ok during COVID most clinics are only seeing emergencies. However if you are leaving the country at short notice, you may need to be seen briefly first. You could always walk in and be triaged. But patients can self refer to sexual health services, there is no absolute requirement for a GP referral .

daabren profile image
daabren in reply to Galen70

Yes I am just reading. Clinic is Mon Wed and Fri. Maybe I will go into clinic tomorrow and try.

Galen70 profile image
Galen70 in reply to daabren

If your real question is " what is having a circumcision like , or what is sex like without a foreskin " - this is very subjective. The Wikipedia page I thought was quite balanced on the topic .

en.wikipedia.org/wiki/Circu...

daabren profile image
daabren in reply to Galen70

Thanks for the LINK but I have been googling this for the past 3 years...seen just about every website there is....yes very subjective !

Galen70 profile image
Galen70 in reply to daabren

There is also a small lifetime cancerous risk from LS. This is why its important to make the diagnosis.

daabren profile image
daabren in reply to Galen70

Understood. Thanks for that.

Galen70 profile image
Galen70 in reply to daabren

cardiffandvaleuhb.wales.nhs...

daabren profile image
daabren in reply to Galen70

Yes just looking at your link for sex clinic and think I will try online appointment for tomorrow.

Galen70 profile image
Galen70 in reply to daabren

best of luck

daabren profile image
daabren in reply to Galen70

Cheers Bud. I will post tomorrow how I got on.

Thanks for the chat and advice. I owe you a pint. ATB.

Galen70 profile image
Galen70 in reply to daabren

You are most welcome. I hope you see someone that has experience with LS. Not all sexual health docs do.

Galen70 profile image
Galen70 in reply to daabren

nhs.uk/conditions/lichen-sc...

daabren profile image
daabren in reply to Galen70

Ok so I just Googled Lichen Sclerosus images ( mild and severe ) and I can say that what I have is NOTHING like the images I have just seen. My problem is confined solely to the forskin ...about 20 mm back from the glans...when the foreskin is pulled right back.

Galen70 profile image
Galen70 in reply to daabren

The google images are not representative at all. "It is like.... in the one area around the skin it looks like it has shrunk and is now tight or tightened" - this could be a sclerotic plaque.

If a man in his 60s suddenly develops a phimosis - well there is really no other condition that causes this.

I would still suggest you see a specialist - the average time to diagnosis with LS is 2 years . GPs often misdiagnose it as "thrush " when its not.

If you do eventually see someone , please feedback here

MrMac99 profile image
MrMac99

Hi Man, Galen70 has given you very good advice you should have things check with your GP or clinic in case of LS.

daabren profile image
daabren in reply to MrMac99

Yes Bud, maybe, we will see soon enough.

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