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QUESTION: sir..my pennis covering skin very tight.. but i tried very hardly to open it.. when i am trying to open out my pennis , pennis covering skin injured sir.. its very painful..little bit blood also coming.. what should i do.. is it a big problem.. please help me sir .. i am very worried about this..

ANSWER: Ramcharan, for the present, there is not much you can do but let the area heal.  It will take only a few days until you are feeling better.  In the meantime, some warm baths a couple of times a day will help and be quite soothing.  Until better, do not try to retract the foreskin.

A tight foreskin (prepuce) is called phimosis.  A male may be born with the condition or it can be acquired, usually from chronic infection (bacterial or fungal) under the foreskin  from improper cleaning.  Repeated trauma to the skin during sexual activity can also be a factor.   As the phimosis is more common in diabetics, a blood test for diabetes should be performed.   If you are able to gently retract the foreskin once healed and stretch it, this may help.  However,  if you develop a fissure (a crack in the foreskin) , retraction  will only create more scarring and worsen the tautness.  If you can pull it back to expose the glans penis completely, wash thoroughly with soap and water then pat dry.  Next apply 3% hydrogen peroxide (available over-the-counter from your local pharmacist) with a cotton tipped applicator to the inner foreskin, glans penis and groove  behind the glans.  After the bubbling stops, pat dry and pull the foreskin forward. You can do the washing in the shower and apply the hydrogen peroxide once you dry yourself off. Do this on a daily basis.  This treatment will not correct the phimosis but will help to prevent infection and further constriction.   If the problem worsens, you are best seen by a urologist.   If infection is present, an appropriate topical cream can be prescribed.  If you do not respond to treatment or the phimosis is so severe that you cannot retract the foreskin, your best option is surgical. 
There are several operations available.  Traditionally this is done via circumcision.   If you are not concerned about cosmetics, a simpler procedure called a dorsal slit can be utilized.  In this operation the foreskin is left intact but an incision is made through part of the prepuce so as to release the constriction.   The incision is continued to the area of the coronal sulcus of the glans penis.  The foreskin is otherwise left intact and "V" shaped incision is then sutured to retain the "V" opening.  In my experience, these procedures have worked 100% of the time.  I must confess that initially they look a bit odd cosmetically as the foreskin falls to the sides.  However, once healed, to the untrained eye they look just like a circumcision (except all of the foreskin is still present).   Another option is a preputioplasties which basically are plastic surgical techniques that involve making a more limited incision into the foreskin and then suturing the incision in a manner to prevent re-stricturing.  Although generally successful, recurrence of phimosis can occur.  All of these operations can all be done on an out-patient basis.  Bed rest is not required.    Even with a circumcision, most men can return to work in 1 week and be back to full activity in 4-6 weeks.  With a dorsal slit or preputioplasty, you could probably return to work in a few days.  Good luck.

---------- FOLLOW-UP ----------

QUESTION: sir..., I am very afraid of it.. because I recovered from the last injury.. today also when tried to open it, it opens wwell but when it becomes longer and bigger I am getting pain.today also I got blood.. sir is there any problem.. sir I thought that I am not recovered completely from that injury.. I am very...very ..very.. much afraid of it. I don't know what to do.. sir pease help me and suggest me....
when I pull the sin to back it opens well.. but when it becomes bigger the skin getting tight and also I am getting pain too. please sir help me...

Answer
Ramcharan,  although the initial injury apparently healed, you must have some residual scarring in the tissues of the foreskin making it tight on erection and prone to bleeding as the tissues stretch.    For the present, you must let this heal.  You will then need to have the foreskin operated on.  Your choices would be the dorsal slit or a circumcision as described in my initial note to you.  Both of these are considered minor procedures and there is only mild post-operative pain for a few days.  Conservative therapy will not solve your problem for the long term.  Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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