A white, inflammatory scaring condition called BXO can also develop in congenital tight foreskin in adults.

The Association Between Phimosis and Balanitis Xerotica Obliterans (BXO) 

Phimosis, a condition characterised by the tightening of the foreskin, leading to difficulty in retracting it over the head of the penis, can appear at birth (congenital) or later in adult life (acquired). This blog also discussed the correlation between acquired tight foreskin and balanitis xerotica obliterans (BXO), also known as lichen sclerosus et atrophicus, a chronic inflammatory condition primarily affecting the genital area. 

Correlation Analysis of Phimosis and BXO: Notably, the association between acquired phimosis and BXO is more pronounced than congenital phimosis. BXO is identified as the primary causative factor for acquired phimosis in both adults and children. The inflammatory nature of BXO triggers scarring and constriction of the foreskin, consequently resulting in diseased and acquired phimosis. While the relationship between congenital phimosis and BXO is less explicit, BXO can also be present in cases of congenital phimosis. 

Significance and Treatment Modalities: The heightened risk of BXO linked to acquired phimosis underscores the critical importance of timely diagnosis and effective management. Early intervention for BXO is paramount in averting complications such as extensive scarring and urethral stricture. 

Treatment approaches vary based on severity and aetiology. In milder instances of acquired phimosis, topical corticosteroids and non-surgical interventions may be required. Surgical intervention, particularly circumcision, may be warranted in severe cases of phimosis or BXO, particularly when they pose significant discomfort, impede hygiene, or disrupt sexual function. 

Recent Study on BXO and Phimosis: A contemporary study sought to enhance our understanding of the correlation between BXO and phimosis. Histological analysis of tissue samples from 120 subjects who underwent circumcision for phimosis was conducted. Findings revealed a substantial presence of BXO, with 45.1% of subjects with congenital phimosis and 62.3% with acquired phimosis manifesting BXO. This data strongly indicates a robust association between BXO and acquired phimosis. 

Key message: The study distinctly underscores a robust correlation between BXO and acquired phimosis. Notably, the type of phimosis (congenital or acquired) emerged as the pivotal factor linked to BXO development in this investigation. Nevertheless, further research is warranted to validate and fortify these observations. 

Consultation with our Urological Specialist: Individuals faced with challenges retracting the foreskin are advised to seek consultation with our consultant urologists for precise diagnosis and tailored treatment options. 

Note: This blog is intended solely to serve an informative function and should not be taken as medical professional advice. For specific concerns, it is imperative to use the expertise of our consultant urologists.

Can Men with Diabetes Undergo Circumcision?

Circumcision in Diabetic Men

Yes, men with diabetes can safely undergo circumcision. Operation for freoskin may be a beneficial treatment option for foreskin conditions in diabetic men. This blog will cover several aspects of circumcision for diabetic men, including reasons for the procedure, necessary health metrics, where to get it done, and who performs the surgery,

1. Reasons for circumcision in diabetic men

2. Normal HbA1c results of diabetes required for the procedure

3. Locations where men can get circumcision 

4. Types of anaesthesia needed for circumcision 

5. Specialist doctors for performing the circumcision 

6. Risks of circumcision in diabetes 

7. Aftercare for circumcision with diabetes 

Reasons for Circumcision in Diabetic Men:

Men with diabetes are more susceptible to developing balanitis, inflammation, BXO, and infection of the foreskin. Fungal infection or other factors often cause these conditions. Despite antifungal and antibiotic treatments, recurring infections can lead to scarring due to BXO and phimosis. Circumcision becomes the most effective option for managing these conditions in diabetic men, especially when phimosis is severe and less responsive to non-surgical treatments.

Importance of Diabetic Control:

Reasonable diabetic control is crucial for optimal healing and reducing the risk of complications. Even if diabetes is not perfectly controlled, circumcision may still be an option, but HbA1c must be less than 7.6%.

Where to Find Adult Circumcision for Diabetic Men:

At the London Circumcision Centre, specialist consultants who are NHS urologists perform circumcisions for diabetic men.

Anesthesia for Circumcision:

Most circumcisions with glue or stitches can be done under local anaesthesia. However, some patients with needle phobia may require general anaesthesia.

Benefits of Local Anesthesia:

Local anaesthesia is a safer alternative for diabetic patients about to undergo circumcision, especially when considering other health conditions that make general anaesthesia risky.

Minimising Infection Risk:

Antibiotics are typically administered after circumcision, and waterproof glue is applied to reduce the risk of infection in diabetic patients. Diabetic patients are also advised to keep diabetes under control afterwards and are given antibiotic cream to use for ten days. Showers or washing are recommended after three days postoperatively.

Specialist doctor:

We are experienced specialist doctor who does circumcision in diabetes patients at London Circumcision Centre

Disclaimer:

This blog post is for informational purposes only and should not be a substitute for professional medical advice. It is essential to consult with a specialist to discuss your situation and determine if circumcision is the right choice for you.

Cuts or tears of foreskin

Cuts and Tears in the Foreskin: Causes, Treatment and When to See a Doctor

The foreskin in men is delicate and prone to minor cuts or tears during sexual activities. While these cuts usually heal within a week, knowing their cause, how to care for them, and when to seek specialist urologist advice are essential. Possible causes of foreskin cuts or tears include rough sex, tight foreskin, diabetic complications, skin lesions like lichen sclerosis (BXO), STDs, and fungal infections. Treatment options include simple care, medications, controlling underlying conditions, and surgery, e.g. circumcision or preputioplasty in some cases.

This blog will explore the potential causes of foreskin cuts or tears, treatment options, and when to see a specialist.

Causes of Foreskin Cuts or Tears

Rough Sex

Friction during sexual activity can cause minor tears. While these minor cuts usually heal within a week, it is essential to know how to care for them in case you have some medical conditions.

Tight Foreskin

A condition called phimosis can make it difficult to retract the foreskin over the head of the penis, leading to tearing during retraction.

Diabetic Complications

Poorly controlled diabetes can decrease blood flow and slow healing, making the foreskin more susceptible to cuts and infections. The repeated infection will require prompt treatment, and tight freoskin will require circumcision in diabetes.

Skin Lesions

Eczema, Balanitis Xerotica Obliterans (BXO) or other skin conditions on the foreskin can cause cuts or tears.

Balanitis

Balanitis is an infection and swelling of the foreskin and the tip of the penis (called the glans penis). Balanoposthitis is called a more severe infection of the head of the penis along with the foreskin.

Sexually Transmitted Diseases (STDs)

Certain STDs can cause sores or ulcers on the penis, including the foreskin.

Fungal Infections

Yeast infections can irritate and inflame the foreskin, making it more prone to tearing.

Treatment Options

Simple Care

For minor cuts, gentle cleansing with warm water and a saline solution, followed by applying petroleum jelly or lubricant, can promote healing.

Medical treatment

Depending on the cause, your doctor might prescribe:

• Antifungal creams for fungal infections.

• Antibiotic creams to prevent bacterial infections.

• Steroid creams to reduce inflammation in early BXO

Controlling Underlying Conditions

If diabetes or an STD is the culprit, managing those conditions can help prevent future cuts and promote healing.

Surgical Options

In some cases, surgery might be necessary. Here are some potential procedures:

• The Dorsal Slit

A small incision was made on the upper side of the foreskin to relieve tightness and prevent future tearing.

• Preputioplasty

Preputioplasty repositions the foreskin to allow for easier retraction and reduce the risk of tears.

• Circumcision

Complete or partial removal of the foreskin.

• Biopsy

Sometimes, a small tissue sample might be taken to rule out more serious conditions or BXO.

Post-Operative Care:

Following surgery, your doctor will provide specific instructions on wound care, pain management, and follow-up appointments after circumcision or other procedures. This might include using steroid creams to reduce inflammation in BXO and monitoring for signs of recurrence of BXO on different parts of the penis.

When to See a Urologist

See our specialist if you experience any of the following:

*  Severe pain or bleeding

*  Signs of infection, such as redness, swelling, pus, or fever

*  Difficulty urinating

*  The cut doesn't heal within a week

*  The foreskin is exceptionally tight

*  You suspect an STD

Conclusion

Most foreskin cuts heal with simple care. However, seeking medical attention is crucial if you experience any concerning symptoms. Early diagnosis and treatment can prevent complications and ensure a speedy recovery.

Disclaimer

This blog is for informational purposes only and should not be a substitute for professional medical advice. Always consult with our consultant urologist for diagnosis and treatment.

Penoscrotal Web Repair

What You Need to Know about Penoscrotal Web

Are you struggling with penoscrotal webbing? This condition, characterised by a fold of skin extending from underneath the penis to the scrotum, can lead to discomfort and dissatisfaction with its appearance. Fortunately, there are solutions available through penoscrotal web repair. This blog post describes what penoscrotal web repair entails, the types of webbing, the surgical procedures, aftercare, and more.

What is Penoscrotal Webbing?

Penoscrotal webbing is a condition where excess skin forms a fold between the penis and the scrotum. This can create the appearance of a shorter penis and may lead to discomfort during physical activities or sexual intercourse. Penoscrotal webbing can occur from birth due to congenital abnormalities or as a result of excessive removal of the foreskin at previous circumcision in childhood or adulthood.

Types of Penoscrotal Webbing

Congenital penoscrotal webbing can vary in severity, ranging from mild to severe. Additionally, it can occur as a result of over-resection after circumcision. Understanding the type and degree of webbing is essential for determining the appropriate treatment approach.

Surgical Procedures for Penoscrotal Web Repair

The surgical treatment of penoscrotal webbing depends on its severity.

• Mild cases may be addressed with transverse incisions and vertical wound closure.

• In contrast, more severe cases may require excision of excess skin and complex reconstructive procedures such as Z-plasty or V-Y-plasty.

• These surgeries aim to improve the appearance of the genital area and alleviate any discomfort associated with penoscrotal webbing.

Aftercare and Recovery

After undergoing penoscrotal web repair surgery, patients may experience discomfort, swelling, and bruising in the wound. However, these symptoms typically subside within a few weeks.

It's essential to follow post-operative instructions provided by your surgeon, which may include taking simple painkillers, avoiding strenuous activities, maintaining proper hygiene, and refraining from sexual activity for 4-6 weeks. Regular follow-up appointments will also be scheduled to monitor healing and address any concerns.

Benefits and Risks

While penoscrotal web repair can offer significant benefits, it's essential to understand the potential risks associated with surgery. These may include bruising, bleeding, infection, scarring, and the need for revision procedures. However, with proper pre-operative evaluation and post-operative care, the risks can be minimised, and patients can achieve satisfactory outcomes.

Conclusion

Penoscrotal web repair offers a solution for individuals struggling with discomfort during sexual activities and dissatisfaction due to excess skin in the genital area. Patients can achieve improved aesthetics and quality of life by understanding the condition, undergoing appropriate surgical procedures, and following post-operative care instructions. If you're considering penoscrotal web repair, consult a qualified surgeon to discuss your options and create a personalized treatment plan.

Don't let penoscrotal webbing hold you back – take the first step towards a more confident and comfortable you today with our specialist.