How to distinguish between excessive foreskin, phimosis and narrow foreskin orifice

Excessive foreskin, phimosis, and narrow foreskin opening can be distinguished by appearance characteristics and functional performance. The main symptoms are that the foreskin covers the urethral opening but can be turned up, the foreskin completely wraps the glans and cannot be exposed, and the foreskin opening is narrow and hinders urination.

1. Foreskin is too long

Foreskin hyperplasia occurs when the glans of the penis can be fully exposed when the penis is erect, but when the penis is weak, the foreskin covers the urethral opening by more than 1 cm. The foreskin can still be easily turned up to the back of the coronal sulcus without affecting the cleaning and urinary functions. It may be related to genetic factors or delayed puberty. It usually does not require special treatment, but daily cleaning is required to avoid the accumulation of smegma.

2. Phimosis

Phimosis occurs when the foreskin tightly wraps the glans and cannot be turned up manually, regardless of whether it is erect or not. It can be divided into congenital phimosis and pathological phimosis. The former is more common in children, and the latter often causes scar contracture secondary to foreskinitis. When combined with difficulty urinating or recurrent infections, circumcision or foreskin dilation should be considered.

3. Narrow foreskin opening

Preputial orifice stenosis refers to an abnormally narrow opening at the front end of the foreskin, forming a "needle-like" or "fish mouth-like" narrow ring. It is common in patients with cicatricial phimosis. The foreskin bulges like a balloon during urination, and the urine line is thin or even dripping. It needs to be distinguished from phimosis, which is characterized by that the foreskin can be partially turned up but is compressed by a narrow ring. Mild cases can be relieved with hormone ointments, while severe cases require surgical correction.

It is recommended that men observe the elasticity of the foreskin and the exposure of the urethral opening during daily cleaning. If you experience pain during urination, redness and swelling of the foreskin, or recurrent infections, you should seek immediate medical attention from a urology department. If a child still has phimosis or abnormal urination after the age of 3 years old, parents need to take him or her to evaluate whether early intervention is needed. Keep the incision dry after surgery, wear loose cotton underwear, and avoid strenuous exercise until the wound heals.