What's wrong with the foreskin that can't be turned over?

The inability to turn the foreskin over may be caused by excessive foreskin, phimosis, local infection, Peyronie's disease, congenital developmental abnormalities, etc. It can be improved by manual repositioning, local cleaning, drug treatment, surgical treatment, etc.

1. Foreskin is too long

After puberty, the foreskin still completely covers the glans or only exposes the urethral opening. This may be due to the poor elasticity of the annulus fibrosus at the outer orifice of the foreskin, which prevents it from turning up. It is necessary to keep the area clean and dry every day, and dry it in time after urinating. You can use erythromycin ointment, mupirocin ointment, etc. as directed by your doctor to prevent infection. When the foreskin is inflamed and swollen, you can apply hydrocortisone butyrate cream for a short period of time to relieve it. If foreskin impaction occurs repeatedly or affects urination, circumcision should be considered.

2. Phimosis

The stenosis of the external foreskin opening cannot reveal the glans, which is divided into physiological and pathological conditions. Physiological phimosis is mostly seen in infants and young children, and the natural separation rate is higher after 3 years of age. Pathological phimosis is often caused by repeated infections leading to scarring, which manifests as a pinhole-like foreskin opening, accompanied by difficulty in urinating or thin urine lines. In the acute stage, potassium permanganate solution can be soaked, and if necessary, foreskin orifice expansion can be performed under local anesthesia. In severe cases, circumcision is required.

3. Local infection

Congestion and edema caused by foreskinitis or balanitis can cause temporary difficulty in foreskin retraction. Common pathogens include Candida albicans, Staphylococcus aureus, etc. It manifests as local redness, swelling, increased secretions, and itching and pain. Clotrimazole cream can be used as directed by the doctor to fight fungal infections. Fusidic acid cream can be used externally for bacterial infections. Allergic factors need to be combined with desonide cream for treatment. Avoid forcibly turning up the foreskin during infection.

4. Peyronie’s disease

The formation of fibrous plaques in the tunica albuginea of ​​the penis can lead to foreskin contracture, which is more common in middle-aged and elderly people. Typical manifestations include penile curvature and deformity during erection with a pulling sensation on the foreskin, and induration can be palpated. In the acute stage, local injection of triamcinolone acetonide injection and oral colchicine tablets can be used to relieve inflammation. If the disease lasts for more than 1 year or seriously affects sexual function, plaque removal or prosthetic implant surgery should be considered.

5. Congenital developmental abnormalities

Congenital malformations such as hidden penis or webbed penis may manifest as abnormal foreskin distribution and are often associated with urinary system malformations such as hypospadias. The specific type needs to be evaluated with a physical exam and ultrasound. A mildly webbed penis can be corrected with phalloplasty, while a severely concealed penis requires foreskin inner plate reconstruction. It is usually recommended to complete the treatment before school age.

Daily care should be taken to clean smegma gently and avoid using harsh lotions. Parents of child patients should not forcefully turn up the foreskin. If phimosis persists after puberty, medical evaluation is required. Sudden foreskin retraction disorder in adults requires investigation of systemic diseases such as diabetes. After surgery, patients should keep the wound dry, wear loose underwear to reduce friction, and review the healing regularly. If signs of infection such as pain on urination or fever occur, follow-up visits should be made in time.