Dear Dr. G,

I have followed your last two articles on penile enlargement.

I think before the thought of having surgery or exercises to increase the length of our manhood, we should examine issues that might cause one’s penis to grow not as healthily as others.

I think one of these issues is phimosis where the outlet of the foreskin is too tight for the foreskin to be retracted to the shaft of the penis.

Due to this condition, the growth of the penis could be compromised. And this happened to me.

I had problems retracting the foreskin and I could see that my penis was at least half or one inch shorter than the average 5 inches.

I did not realise the severity of this problem until I was in my early 30s.

And then I decided to have my penis circumcised to see if it makes any difference in terms of size or length.

After the procedure, I felt like it had given me a new lease of life and my penis is now above average.

I would like to put Dr. G on the spot and find out whether circumcision can really help resolve such problems?

I think most boys need their parents’ help to ascertain whether they are having a phimosis condition or not.

What can we do to understand this problem as soon as possible?

Expectant Eric

The foreskin is the natural sheath that covers and protects the head of the penis. The skin is completely adherent to the glans penis from birth, and therefore unable to pull back before the age of five in most boys. The foreskin should be easily retractable, allowing gliding during sex and the ease of cleaning in adolescent boys. Although over 90% of the foreskin is fully retractable by the age of seven, some foreskin may still be non-retractable due to preputial adhesions or phimosis.

Phimosis often results in balloon-like swelling under the foreskin during urination. The residual urine can result in regular urinary tract infection in childhood. The inability to pull back the foreskin for cleaning can also result in regular itchiness and discomfort, due to the accumulation of smegma and poor hygiene. This is caused by inflammation of the penile glans, known as balanitis.

Men with phimosis can be adversely affected in theirsexual health. In the early days of sexual maturation, regular “morning glory” becomes less glorious when the erection becomes uncomfortable and often times painful. An effort to pull back the foreskin can also result in tear, inflammation and scarring. This may result in men avoiding penetrative sex, as only “gentle” masturbation without injury to the foreskin is permissible. Although some men can live through adulthood having penetrative sex with caution, they may encounter problems of reduced sexual pleasure and issues of infertility, as the semen may be trapped within the tight foreskin.

The definitive treatment for phimosis is circumcision, however some men are still keen to preserve the foreskin without surgical intervention. Regular efforts to pull back the foreskin, with or without the help of steroid cream, can occasionally loosen the tight foreskin. However, overzealous efforts to pull back the foreskin should be discouraged, as men with phimosis may encounter the potential complication – paraphimosis – when the tight foreskin becomes trapped behind the glans. Paraphimosis is excruciatingly painful and delayed surgical intervention can potentially result in the penis going gangrenous!

Men living with phimosis may be oblivious of their problems until examined and diagnosed by clinicians. Only after the “liberation” of the trapped foreskin by circumcision, the realisation of the compromises they make having the inability to urinate and cleaning penis with ease. With the surgical correction, men with phimosis are also liberated to enjoy more “strenuous” penetrative intercourse and masturbation, without the fear of tear and pain from the tight skin. This begs the questions, whether the lost golden years also compromised the “natural” elongation of the penis to its full potential during the growth spurts of teenage sexual maturation.

In truth, there is no study conducted to identify whether men with phimosis indeed are “short-changed” due to the restriction of penile growth. There is also no study demonstrating men having circumcision in early days are blessed with a longer penis, as they will never live through the constraints of phimosis during sexual maturation. The penis indeed needs plenty of room for growth during those vital adolescent years; therefore technically the restraints of tight foreskin will have theoretical compromises resulting in overall “shortcomings”. In some cases, men with phimosis are also recognized to have “buried penises” as only “backward” growth is permissible during sexual maturation.

Men with phimosis living under the shadow of the foreskin, having been liberated by the simple circumcision often have regrets. It is natural having thoughts of how easy life would have been if the surgical intervention done in earlier years, and wondering how sex life would have been with a “liberated” penis. The American retired track and field athlete, Jackie Joyner-Kersee once said: “It’s better to look ahead and prepare, than to look back and regret.” Liberated men from phimosis often put Dr. G on the spot for his opinion on the issue. His view is “Now you can see the head, be prepared to charge ahead and make up the lost time, as more buried treasure may emerge in later years!”

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