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Phimosis in older boys and adult males can vary in severity, with some able to retract their foreskin partially (relative phimosis), while others are completely unable to retract their foreskin, even when the penis is in a flaccid state (full phimosis).
Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a plastic surgical operation on the prepuce or foreskin of the penis, [1] to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a constriction which has not expanded after adolescence.
English: In the left image male's (age 29) foreskin has only partly retracted off the glans penis even if male's penis is fully erect. In the right image the foreskin has been manually retracted off the glans penis by hand. Usually the foreskin retracts automatically during erection process.
The foreskin responds to the application of tension to cause expansion by creating new skin cells though the process of mitosis. The tissue expansion is permanent. Non-surgical stretching of the foreskin may be used to widen a narrow, non-retractable foreskin. [7] Stretching may be combined with the use of a corticosteroid cream.
Inability to retract the foreskin in childhood should not be considered a problem unless there are other symptoms. [9] Retraction of the foreskin is not recommended until it loosens from the glans before or during puberty. [9] In adults, it is typically retractable over the glans, given normal development. [9]
The diagnosis of severe frenulum breve is almost always confused with that of phimosis and a generally tight foreskin, since the symptom is difficulty retracting the foreskin. Most men with phimosis also have frenulum breve to a certain extent. [5] A milder frenulum breve may go unrecognized, since foreskin may retract over the glans variably.
At birth, the foreskin cannot be retracted due to adhesions between the foreskin and glans, and this is considered normal (physiological phimosis). [59] Over time the foreskin naturally separates from the glans, and a majority of boys are able to retract the foreskin by age three. [59] Less than one percent are still having problems at age 18. [59]
The enlarged and bulbous-shaped end of the corpus spongiosum forms the glans penis with two specific types of sinusoids, which supports the foreskin, a loose fold of skin that in adults can retract to expose the glans. [9] The area on the underside of the glans, where the foreskin is attached, is called the frenulum.