“Operating for phimosis does not increase the size of the penis” – One of the most repeated myths

The foreskin and its myths

The foreskin is the skin that covers the glans and has two parts. The inner face is a very thin mucous membrane that produces secretion and allows the glans to be moist. And a keratinized outer face a little harder than the normal skin and whose function is to protect the glans.

The intervention that eliminates the foreskin is known as circumcision and there are several myths and prejudices around the elimination of this skin that covers the glans.

The removal of the foreskin has led to questions about whether this is better or worse for the quality of sexual life. There is disparity of sensations in the men after eliminating this zone… there are some men that feel better and others that are not so satisfied. Diverse sexual authors also reach different conclusions. This is due to the fact that there are very different cases and different circumstances and points of view when it comes to qualifying the elimination of the foreskin as positive or negative.

When it gives problems the best and most advisable thing is to remove it. For example, if it is very narrow and doesn’t come down (that is to say, it does not let the glans out) it is necessary to operate and in this way there is an improvement in sexual relations for both men and women.

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Technical phimosis 01

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Technical phimosis 03

What does age have to do with it?

When talking about phimosis there is a very determining factor that must be taken into account: age. The newborn child normally is born with the glans covered. A lot of mothers worry about it right after birth. Dr. Cruz advises not to pay attention to this in an obsessive way. He warns that it will be from the age of 3 when this problem can begin to be worrying. It is at this age when practically 90 percent of children must have a foreskin that is practically retractable, that is to say, that allows the release of the glans. Therefore, it is not until after the age of 4 that an intervention should be considered. But… When? When there are infections or when the pathology hinders the urinary function of the child. In adults, it is different, the reasons for undergoing phimosis are related to difficulties and discomfort in sexual relations. The foreskin has to be retractable, it has to let the penis out completely. If this is not the case, there will be discomfort and difficulties in sexual life.

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Relationship to sex life.

There are two factors that affect sex from the point of view of the foreskin:

In our centres in Madrid, Seville or the Canary Islands (Tenerife), we carry out the techniques and treatments with the most modern facilities and the best specialists and equipment to guarantee an effective solution.

From health’s point of view

Leaving the glans exposed does not cause any harm, in fact it is more hygienic, however it should not be removed without reason or massively. There has been a recommendation from the WHO to warn that mass circumcision programmes are not justified in a civilised country and should not be done if there is no real problem.

HIV and Phimosis

From 1980 onwards, a series of 30 studies and 3 large randomised clinical trials were launched in South Africa. These studies were launched because several specialists had observed that patients who had undergone circumcision contracted HIV to a lesser extent. During the trials, some men were circumcised and others were not. The HIV incidence was then seen in both populations and both populations were monitored.

The studies were so successful that they were halted, it had already been proven that 50% of men with phimosis did not contract HIV.

The studies revealed that the inside of the foreskin was more sensitive to infection. There seems to be a greater susceptibility to HIV in the mucous membrane or internal part of the foreskin because there are cells known as dendritic cells, which are more sensitive to HIV. This does not mean that phimosis does not require a condom or that it protects men from sexually transmitted infections or diseases. But at least in these developing countries, men with phimosis are more protected than those without and of course much more so than women.

HPV and Phimosis

The HPV or human papillomavirus creates a few little warts that in most cases are very prevalent. This disease is widespread in today’s society. With so much promiscuity, it is booming due to constant sexual activity with different people. HPV also affects the inner side of the foreskin. In these cases phimosis can be very beneficial.

Criteria for phimosis surgery

If a child doesn’t feel discomfort even if the glans doesn’t come out… do we have to operate? The circumcision intervention has some degree of complication, not too much, in children a 2 or 3% complication. Nevertheless, Dr. Natalio Cruz recommends waiting if it doesn’t bother and choose a treatment such as steroids that can be applied once or twice a day and that can be prescribed by the pediatrician himself. With the application of this treatment during 30 or 40 days, the glans can come entirely out of the foreskin. The problem is that in children general anesthesia is needed, somewhat exaggerated for such a benign pathology, so it is recommended to wait a little so that a local anesthesia is sufficient.

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Caution with sexual information on the Internet

There is a pathology described by WHO that is described as permanent excitement on the part of the woman. They are women who have such continuity of orgasms that make their social life unbearable. Testimonies have been found on the Internet about this topic that have frightened minors due to the way of exposing the topic. One woman claimed to have had five hundred orgasms in a row.

There are few cases of this particular pathology. At the Boston Institute of Sexual Medicine, Dr. Natalio Cruz was able to learn about some cases. Something that seems positive such as being multi-orgasmic, in the case of women, can become traumatic. There are women who cannot have a normal life because the slightest touch causes multiple orgasms.

It has treatment and they are really very isolated cases, but the information about this pathology on the internet stands out. The problem is not the pathology but the way in which the information is poured into the network and the absence of responsibility from everyone related.

Phimosis and penis size

Circumcision does not increase or decrease the size of the penis.

What is removed is that excess of skin that surrounds the glans and it is necessary to do it as it is recommended right now between the specialists, in other words, losing the minimum of skin. Because in some cases, when too much skin is removed, part of the penis is lost because it is buried, skin is lost and the penis is scrotalized. What really happens is that the scrotum rises and the skin free of hair decreases.

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Dr. Natalio Cruz

Natalio Cruz MD, with 25 years of medical experience, has been until 2016 Head of the Andrology Unit in the Urology Service of the Virgen del Rocío Hospital in Seville, National Coordinator of Andrology in the Spanish Association of Urology (AEU) and General Secretary in the ESSM, positions that he has narrowed to focus squarely on this exciting project of offering a high-level private medical consultation in Marbella, Seville, Madrid and Tenerife.

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