Circumcision and Phimosis: A clear-cut decision?

My wife is nursing the baby and my kids are planted in front of the TV. I have a few minutes of peace. I sneak into the bathroom, lock the door, and prepare to try to turn my penis inside out.

Days ago, I discovered that my penis wasn’t normal. My foreskin stretches down, rather than retracting. What appeared to be my glans was still all covered up, terminating in a 1mm sized opening at the top. (This man has pics of what I could easily mistake for my own penis)

It explains everything. Sex has always been enjoyable, but always ends the same way: I get tired or she gets bored. Thank goodness I don’t need condoms any more. I have 100% sympathy for men who refuse them. For me, they deaden all feeling except for warmth. (“Am I in you?” “Um, that’s my leg.”). We’ve found other methods of birth control. Not that we need it — I can last forever.

I can either go on with my life or fix this now.

The C word

Many people feel strongly about circumcision. Rightly so — there are vanishingly few reasons to have this procedure done on a child. But as an adult, with a medical reason, I thought the decision would be a no-brainer. If there’s a medical reason, it’s free in Canada, and doctors don’t push unnecessary procedures. (We send all the greedy ones south, and tell them it’s “brain drain”)

I trust facts and data. I trust peer reviewed studies. But what they are telling me doesn’t make the decision easy.

It’s a controversial issue, which means unbiased information is scarce. By some accounts that I have read from people with phimosis, it completely changes their life and they highly recommend it. Other quotes are from people that “lost sensation” or “ruined their life”. The trouble is, all of these quotes are from one-sided internet sites, and not representative of the typical experience.

This testimonial seems encouraging: 

I always felt sexual intercourse was a bit of a let down when I lost my virginity, because it felt no different to when I masturbated. I suppose what I am saying is that the foreskin just seemed to slide back and forth over the glans during intercourse, and that was the same experience that I had when I masturbated.

I always remember thinking when I first had intercourse that it just wasn’t any great revelation. But OOHHH! how different things are without a foreskin to get in the way. I cant believe how good it is now. Last weekend I just couldn’t believe intercourse could be so enjoyable. The feeling of the glans in direct stimulation against the vagina and not a foreskin is wonderful.

You have probably heard it all before, but intercourse certainly is better circumcised. Take it from one who knows. This will make you laugh but I rub vitamin E cream into the wound to help it heal. And then we very gently “… well … let me just say sex is great … fantastic.. nothing to get in the way.

I have no regrets. I have ABSOLUTELY no regrets. There is nothing I miss about my post-operative state. Which is strange because I really went into this being totally realistic and thinking I may have some regrets. But sex is far more enjoyable. And with summer on the way cleanliness is going to be so much easier, even now for that matter. 2 Well it’s late and I am going home. I hope to hear from you soon and thanks for your help and advice.”

On the other hand, @BSR163 from twitter has counselled real people who have been cut after they had reached sexual maturity and had experienced sex prior to circumcision:

All were profoundly affected by the change and loss that they experienced.

Two reported the initial joy of the liberation of the glans, but found it was short-lived. Both subsequently experienced major difficulties reaching orgasm without (in 1 case, using a rough towel) or in the other, using a ‘death grip’. Neither techniques are compatible with normal sexual interiors. The vagina cannot replicate the ‘death grip’. With their increasing difficulties, their confidence was knocked and they experienced ED… even though they were on their 20s.

Once circumcised, you will experience two effects. The ‘liberation’ of your glans will probably be fantastic initially, though at the same time, hypersensitive in an uncomfortable way, not a sexual way. The second effect will be the apparent and immediate loss of the main source of your (up until circumcision) sexual stimulation. It will be absent.

However, once the glans has been exposed for a number of years, the epithelium on the glans will noticeably thicken and keratinize. The net effect of this will be a further dulling of the sensation derived from the glans as the receptors are buried deeper under the thickening skin. In order to reach orgasm, you will likely need to use significant force and friction, resulting in rougher sex or masturbation. Jack-hammer sex is how it is often described.

In a personal message, I confronted the author of A Circumcision Diary with this information. Two years after his experience, he writes:

If that is true then keratinisation is a non-factor for sensation. My glans also doesn’t look or feel any different than it did a month out. The sensation hasn’t changed since the six month mark, either. Knowing what I do about skin physiology, keratinisation shouldn’t affect sensation that much anyway, because it doesn’t change the way the nerves are stimulated. I think that sensation is “lost” because the glans is untrained to touch after being occluded for so long, so there’s a period of increased sensation immediately after surgery, followed by a slow decrease to a new normal. It is simply acclimatisation to new stimuli.

I’m sure we could go on forever. Let us leave the intactivists and the circumcisionists to duke it out on Twitter. In any case, anecdotes are no way to make a life-changing medical decision.

Let’s use science

In 2002 some researchers followed up on men who were circumcised as adults and asked them how they felt. Of the responders, 47% reported that sex was more pleasurable and satisfying after the circumcision. 38% reported a problem or perceived difficulty afterwards. Overall, 62% of men were satisfied with having been circumcised. Read the study

So it’s not a slam-dunk decision. The odds are that I would be happy and raving about it. But there is a four in ten chance I’d have “some difficulties”,  and only a 50/50 shot at better sex.

Dr. John Aquino, medical director of Ontario Men’s Health, echoes this in a Toronto Star interview:

“It’s like rolling the dice. You don’t know what’s going to happen,” he says, adding it can either increase or decrease sensitivity. “Most of the time it’ll probably make (the penis) less sensitive because there’s a lot of nerve endings in the foreskin.”

The other primary method of getting rid of phimosis is to beg your doctor for some steroid cream, and slather it on, and “stretch” daily for 2 months to a year. Reading over the internet forums, it’s clear why American doctors aren’t jumping at the chance to recommend it. Can you imagine your doctor telling you to do something for 20 minutes a day, for months? Patient compliance would be astoundingly low. While you’re at it, why don’t you work out three times a week and and eat ten daily servings of vegetables?

In 2005, some researchers intercepted children who were scheduled for circumcision and gave their parents specific instructions:

  1. Apply steroid cream to the foreskin every day.
  2. Four times a day for a month, retract the foreskin gently as much as possible without causing pain or strictures for one minute.

At the end of one month, 71% of the most severe cases were fully cured. The ones who weren’t  were allowed to go for another month, and a third if necessary. By the end of three months, only 2 / 50 of the most severe cases went on to surgery — a 96% success rate. (Read the study)

That’s rather clear.

At 35 years, I’m much older than the kids in the study, but I have little to loose.

  • I’ll try stretching and cream for a month.
  • If my opening gets any bigger at all, I’ll try it some more.

Odds are good that it’ll resolve my condition. If all else fails, I’ll get snipped and I’m 62% likely to be happy with it.

That’s why I’m locked in the bathroom, stretching my foreskin. I’m frustrated now because I can’t grasp near enough to the opening.

“Can you try get your finger in it?” a forum poster asks. Sure, if I were a gerbil.

I can only pinch the skin around it and raise it higher. The hole remains tight. Not even a soda straw would fit through it.

My wife is calling now. One of the kids has spilled orange juice on the couch. Stretching will have to wait today.

My story continues here.

Follow me on Twitter: @PhimosisJourney

8 thoughts on “Circumcision and Phimosis: A clear-cut decision?

  1. I have the same pinhole phimosis as the OP, but also a lot of scarring, will stretching still work? I have seen numerous urologists and GPs and they all seem to jump the circumcision gun as if it’s my only option.😦 Thanks. I’m scheduled for a circumcision on 7th December but am really hesitant about it and cannot see myself pulling through with it (pardon the pun😛 ).

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    1. I have tried steroid creams in the past, but haven’t really been as rigorous with the stretching regime as the OP has, and I haven’t ordered any flesh tunnels. I did try a Q-tip cut in half once, it was a bit irritating to leave in, especially if it was accidentally wedged into the glans by just being push around in my pants while sitting… I also found that the steroid creams would lead to stinging with urinating and sort of constricted the hole opening even more. Are there even flesh tunnels as small as 2mm? My foreskin hole is really tiny😦 It’s becoming increasingly difficult to even tell where the hole is sometimes, I feel sorry for my glans, they will never see the light of day for a long time to come unless I get a circumcision… I’m more concerned about the long-term bladder/kidney damage and chance of penile cancer or BXO, are these warranted concerns with pinhole phimosis? I’m 23 and have noticed phimosis progressing over the last 2-3 years by itself.😦 I used to be able to fully retract, so i guess that’s a plus since my foreskin balloons when I urinate and I love how far I can urinate😀, but am scared the toll it’s taking on the rest of my urinary system:/😦

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  2. The first guy had better sex after circumcision obviously because his skin didn’t retract. Most men have retractable foreskins, so when we penetrate the foreskin is pushed back and our sensitive areas are exposed. The glans is mainly protopathic (meaning it can only sense pain and temperature). The only part that has any fine touch sensors is the corona.

    Whether or not the glans is keratinized is irrelevant because that’s not where the pleasure comes from anyway. Most of the fine touch sensors are on the inner lining of the foreskin. Some circumcised men have the entire inner foreskin removed. This is called a low and tight cut. A high and tight preserves more of the inner foreskin. This might explain the difference in experience.

    I used to assume my pleasure came from my glans but then I did an experiment where I pulled back the foreskin and only rubbed the glans being careful not to touch the inner foreskin or frenulum. It was pretty much impossible to get any pleasure from it. It wasn’t too painful because I used lube, but it was just numb. It was like rubbing my eyeball. But when I slid my hand past the inner foreskin (and especially the ridged band) I would feel a great pang of pleasure.

    The glans is a red herring. I assumed the pleasure came from the glans because I saw that cut men could still have pleasure without a foreskin. At the time I didn’t realize that some foreskin is usually left behind. But now that I watch videos of cut men masturbating I see that they tend to only touch the corona and the inner foreskin remnant (and frenulum if they have one).

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    1. Hi John,

      Your explanation is reasonable. In the Sorrells penis sensitivity study, on both intact and cut men the sensitivity of the shaft is much higher than the glans.

      Highest of all are the foreskin and frenulum. I deduce that most of the pleasure comes from the foreskin itself being rubbed over the corona or other surfaces.

      I hope to be able to do my own experiment when I can expose enough!

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  3. Oh yes, he’s very happy now, and me too.
    He has been applying a mometasone cream, too, for about 6 weeks. One doctor said the chance of success with the cream is around 40%. But how could it work if you don’t have any possibility to stretch such a small opening…
    The more doctors said a (total) circumcision would be necessary, the more doubtful and suspicious I became, because presently here it seems to be very popular to have the boys (even very young boys) cut because of phimosis, even if there are other, gentle possibilities. I think it’s some easy money for them…
    Well, with those silicone tunnels and some patience you MUST succeed, because when something like this is possible with ears >>> http://de.academic.ru/pictures/dewiki/89/Young_woman_with_stretched_ear_piercing.jpg – why not anywhere else… 😉 Maybe you need some more time than a little boy but at the end the result should be the same. Good luck and patience!

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  4. Thanks so much for your comment. Indeed, I have ordered the flesh tunnels, and they should get here soon. It is very exciting to hear that you got complete resolution in only a few weeks. I hope I can solve it in not too much longer at my age. I have been applying a steroid cream (mometasone furoate 0.1%) and now the skin feels very soft and pliable, but always returns to its shape. I’m missing those tunnels.

    Congratulations on avoiding the circumcision. The more I learn about the worse it gets. I am sure that your son appreciates it, both now and for the rest of his life!

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  5. Hello,
    I (mother of a 10 year old boy) came across your blog while looking for some sites about phimosis. I’d like to spread the news that a circumcision in such a “severe case” must not be necessary. My son had a phimosis that looked exactly like on the photos you shared the link of. We had different dates with different doctors – they all wanted to cut… which I didn’t want to accept. I searched the whole Internet – for many, many weeks. Then, finally some hope: I read in a German forum about the possibility of using “flesh tunnels”. I immediately ordered some sizes from Ebay. You can find some examples here: http://www.ebay.com/sch/i.html?isNewKw=1&mfs=GOCLK&acimp=0&trksid=m2428.l1313.TR0.TRC0.Xflesh+tunnel&sqp=flesh+tunnel&_nkw=flesh+tunnel&_dcat=32050&Material=Silicone&rt=nc . We started with a diameter of 2 mm. It was mid October this year and – believe it or not – the phimosis is gone! After only 3,5 weeks it was totally “healed”. He put in the flesh tunnels overnight only with some normal “Bepanthen” cream and after a very few days he could use the next size and so on. Before we started I wasn’t sure at all that it could work, but it did. You should give it a try. Maybe it’s an option for you, too.
    Best wishes to you from Germany🙂

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    1. I really would like to commend you on protecting your ten-year-old son from an unnecessary circumcision. The doctors were wrong about his foreskin.

      Doctors have been trained with text books that contain data published in 1949 by British paediatrician Douglas Gairdner. He thought that 90 percent of boys should have a retractable foreskin by age 5. This figure has been set in concrete in the textbooks and medical literature, however it is completely wrong.

      It is normal for the foreskin to be non-retractable in childhood. We now know that about 50 percent of boys have a retractable foreskin by age 10.4 years and most of the rest develop a retractable foreskin during adolescence and puberty.

      Your son actually had a normal. developmentally non-retractable foreskin. He probably did not require treatment, if he was not experiencing any problems due to his non-retractable foreskin. His foreskin likely would have spontaneously become retractable later when during puberty.

      Parents should be aware that most doctors have bad information and cannot properly diagnose phimosis in boys. They frequently call a developmentally non-retractable healthy foreskin “phimotic” and want to do a circumcision when it is not necessary.

      Circumcision is a very destructive, damaging, mutilating operation that should be avoided except in the rarest of cases.

      http://www.doctorsopposingcircumcision.org/info/retraction.html

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