This site discusses phimosis in its specific forms of phimotic ring, frenulum breve, adhesions or skinbridges. During erection these conditions inhibit the relationship between foreskin and glans. This functionally restricts the erection, and thus has an effect on the sexuality. With our culture's attitudes on health care, it would be appropriate to encourage early prevention. Jan 2021 : Please read the new summary.

ARC letter: Feb 1999 Dear John, ... This letter is the best reason I've ever seen for pre puberty EDUCATION about sexual matters, inclusive foreskin problems. ... Robin J OHN'S D IARY As promised, here is a much more detailed account of my history. I cannot remember the first time my foreskin was retracted, but I do remember that my parents used to retract it every time I had a bath. They were certainly doing this by the time I was 4, and I think they were probably doing it when I was 3, but my memories of that age and earlier are hazy. I do not remember any pain or discomfort caused by retraction. When I was first entrusted to bathing myself, probably at about age 6, I remember my father reminding me to always pull back the foreskin and wash underneath (incidentally, he was circumcised). I didn't really need reminding, as I found this exercise quite pleasurable and I would always spend part of my bathtime playing with my willy, pulling the skin back, examining the glans, squeezing or stroking it - after all, it was still a relatively unknown and mysterious part of my body. There was no tightness, even with a full erection, no adhesions and the frenulum was loose enough to allow the skin to go fully back with out pulling on the underside of the glans. I think I was probably about 6 when I first saw another boy pull his foreskin back. This was done at my request - a 'you show me yours and I'll show you mine' sort of thing. He was a year younger than me, and said of his glans "my Dad makes it come out in the bath", so he was familiar with retraction but was perhaps not in the habit of doing it himself. I think we perhaps did this on two or three occasions before his mother discovered us and we got into trouble. The next 'mutual inspection' incident I can remember was with my best friend. This time it was he who made the first step, which I took as a signal that it was not unusual, even though it was 'naughty', to be interested in other boys' willies. We subsequently played regularly with each other and became quite familiar with each other's foreskins - this would be from the age of about 7. He too had no problem with his foreskin, though I seem to remember him saying that he had learnt about foreskin retraction from a friend rather than his parents. This regular activity emboldened me to try to see other boys pull their foreskins back, if a suitable opportunity arose, such as being out in the countryside, or at home when my parents were out. Over the next couple of years or so, I perhaps had about a dozen opportunities, and learnt that a significant number of boys had problems with their foreskins, or were ignorant about them (I can remember them in detail and will supply you with more info if you wish). This activity started to die off when I was perhaps about 10, probably due to an increased awareness of the wrongness of it. Perhaps I also started to retract my own foreskin less frequently - I really can't remember. Anyway, when I was about 11 my own foreskin became tight. This happened over a period of a few weeks, I think, or at the most a few months. I remember on one occasion around this time trying to retract and finding it very tight, and once I had got it back it was difficult to get forward again. The next time I tried it was even tighter, but I forced it right back and then tried to pee, but found that I couldn't as the tight ring of my foreskin was digging into my shaft so tightly. I then had real difficulty in getting the skin forward again and got quite worried, but eventually succeeded. I think I probably left it alone for some time after that. The next I can remember was only being able to pull the skin halfway back. The opening would just not stretch any wider without being extremely painful, and of course I was wary of getting it stuck behind the rim again. When pulled back as hard as I dared, the skin dug into the glans, deforming it so that it narrowed into a waist in the middle. It was not long before the skin would not pull back at all. The opening would only just uncover the slit in my glans, and I was afraid that the skin would split if I pulled any harder. Although very tight, the skin was not excessively long, with just a slight overhang when flaccid, and with an erection the skin was stretched slightly and you could just see the slit through the small opening. At first, I thought that the tightness might only be temporary. I was naturally a bit upset, as I had previously enjoyed playing with my foreskin and would not be able to any more, but soon got over it and I don't think it bothered me for the next couple of years. I was aware by then of circumcision, and that it was done as a treatment for tight foreskins, but I didn't see why I should suffer the embarrassment of telling my parents about my problem, because as far as I knew the only reason for pulling the foreskin back was to clean underneath it, and to pull it back for any other reason was 'naughty'. (I was still quite ignorant about sexual matters, although I did by then know the basic 'facts of life'). I knew that some boys were unable to retract their foreskins, and didn't seem to suffer as a result, so I initially regarded it as a trivial problem. By this time I was at a boys-only grammar school, so there were many new penises to observe in the changing rooms, but I now made my observations discreetly, for fear of being thought 'queer'. I could therefore only speculate as to which of my classmates shared my problem. I also used to wonder how many had still not attempted retraction of their own foreskin, suspecting that some of the more reserved, innocent-seeming boys may not have done. It was probably around puberty, 13 or 14, that I realised the significance of the exposed glans in sex - it was the most sensitive part of the penis and so it must be the rubbing of the glans against the walls of the vagina which triggered ejaculation. Hell, I wouldn't be able to have sex! I was also becoming aware of masturbation - it was starting to be mentioned by some of the more 'forward' boys, but usually in a way that suggested (to me at least) that it was a bad thing to do, and that most boys didn't do it - after all, 'wanker' was used as a term of abuse. As far as I could make out, it involved grasping the penis with the fist and moving it backwards and forwards so that the foreskin slid back and forth over the glans, so I wasn't sure that I would be able to do it anyway, and therefore never tried until much later. I did, of course, have regular wet dreams. The realisation at that age that I had a sexual problem was a real blow to my confidence. I didn't want anyone to find out about my 'problem', I was so ashamed, and began to dislike anyone even seeing my penis. I decided that I must start attempting to stretch the skin, and I used to do this whenever I could get the privacy. I started with 'conventional' attempts at retraction, regularly pulling as hard back on the skin as I could without causing too much pain. This did not produce any improvement, and sometimes caused small splits in the skin around the preputial orifice, and I would have to leave off the treatment for a few days until the splits healed, as they made retraction attempts painful. Later I hit on the idea of inserting small objects into the opening and leaving them there. In this way I could keep the skin under constant tension, which I thought would surely cause it to stretch. It did seem to have some effect, as the object would become easier to remove and insert after a few days' treatment. Once it became looser I would look for something slightly larger to use instead. It was difficult to find suitably sized objects and I would sometimes try to force in something too large which would split the skin, then I would have to leave off for a couple of days, after which the opening had shrunk and I was back at square one. A further refinement was to use small cylindrical items which I could wrap tape around to gradually increase the diameter. I think this was a bit more successful, but my foreskin would always become too sore after a couple of weeks of this treatment, so I would always give up again. I did continue with this sort of treatment on and off, and there was a very slight stretching as a result. However, it really was very slight - I think when I started I could only get a 6mm diameter object in, but this gradually increased to about 10mm. This improvement probably took a couple of years, and as I reckoned I would need to get to about ##mm to achieve full retraction, I began to lose hope. A side effect of my phimosis was that I started to have difficulty in peeing without spraying uncontrollably. This problem developed a few years after the phimosis, at the age of 14 or 15. It wasn't as though there was a restriction to the flow, just that the shape and position of the foreskin relative to the slit in my glans disturbed the flow. I had three techniques for dealing with this. At home, or anywhere else with a conventional WC and a lockable door, I would kneel down so that I could get my penis inside the bowl, and then accuracy didn't matter. At stand-up urinals I would pinch the outer foreskin on top of my glans between the thumb and forefinger, and draw it forward so that it formed a nozzle, and this would allow a reasonably well-controlled stream to emerge. The third technique, developed later, was to pull back hard on my foreskin so that it cleared the slit in my glans. This may sound an obvious solution, but in my case it was difficult to maintain the necessary tension throughout the time I was peeing. I had established that the problem was caused by a tight, inflexible collar of skin which had formed around the foreskin opening - a true 'phimotic ring' as described in your essays. I contemplated making a small cut, which I thought might release it, but never had the courage. I also used to scoop out smegma occasionally using a paper clip. I had no adhesions at that stage I am certain that my phimosis has severely constrained my psychological and sexual development. That is probably the subject for another letter, but one consequence was that I didn't begin masturbating until I was 19, despite the regular self-examinations and stretching attempts throughout my adolescence. My examinations would always cause erections and production of pre-seminal fluid, but somehow it never occurred to me to bring myself to orgasm by stimulating my penis more vigorously. One evening, at the age of 19, I decided to have a go, and did this by grasping the shaft skin and sliding it back and forth rapidly. After a couple of minutes I had a very rewarding and productive orgasm, which delighted me. Why on earth hadn't I tried it earlier? From then onwards I was a regular wanker, and I think I gained in confidence, realising that I probably could have sex successfully after all, though I still had not had a proper girlfriend. Although I had no difficulty in wanking with a tight foreskin, I did sometimes feel frustrated in not being able to pull it back, as I thought I would get more intense pleasure by alternately exposing and covering the glans, or by stimulating the glans directly (I now know that the latter is not necessarily the case). When I was about 20 I came across two discarded copies of Forum, and one contained an article on circumcision, which I found fascinating. I remember it quoting the remark by Osmond, that some of his subjects had never before pulled back their foreskin. It helped reassure me that I was far from being alone with my problem, and yet still I didn't have the courage to do anything about it. From then onwards I occasionally bought copies of Forum, just to read articles and letters concerning foreskins and circumcision. In 1984 I wrote to Forum Advisor, asking if there was any way I could restore the elasticity of my foreskin, but their reply indicated that circumcision was the only answer. I was still reluctant to undergo the operation, due to a combination of fear and a persistent faint hope that I might somehow discover a simple cure. Having had a foretaste of the pleasures of retraction as a child, I still considered the circumcised penis to be inferior to the intact version. From Forum I learnt about Acorn, which you are no doubt aware of, and I have subscribed to their newsletter ever since it started. I think it was through reading accounts of men undergoing the operation because of foreskin problems, and being delighted with the results, that gave me the courage to face up to the knife. I was also having increasing difficulty with peeing accurately, as my foreskin was becoming even less flexible. I had the op done privately at the age of 31, under local anaesthetic. It really was as quick and painless as everyone had described, even though the surgeon did have some difficulty separating the inner foreskin and glans, due to the adhesions which had formed over the last 20 years. What a joy it was to have my first pee after the op, and to produce a neat jet straight from the slit, unobstructed by my immobile foreskin. And I cannot find the words to describe my feelings two days later as I soaked off the bandages and set eyes on my glans once again for the first time in 20 years. Released after 20 years of suffocation, without air, light or stimulation. It was as if I myself had been released from imprisonment. Of course it was still bruised and bloody at that time, but it gradually healed over the next couple of weeks. I had my first wank 3 weeks after the op, and it felt quite strange due to the lack of movement of the shaft skin compared with previously, and it took some time to reach orgasm despite the long period of abstinence. I have got used to it now, 7 years later, and there is more movement of the skin, but it is still not as pleasurable as with a foreskin, even an unretractable one, and I put this down to the number of nerve endings I have lost. Overall. I do not regret having had the operation. I think in my condition it was the only option, but I still mourn the loss of my foreskin and ponder over what might have been, had I acted sooner. Other outcomes, which would have been preferable are:- (a) successful stretching of the skin e.g. with the aid of some sort of cream or ointment (b) a dorsal slit (c) much earlier circumcision, i.e. before adhesions had developed Despite the problems I have had, I do not believe in routine infant circumcision, as I know that the foreskin can be a great source of pleasure. However, I have accepted that, like many other situations in life, one sometimes has to settle for second best, and in my case that means a circumcised penis. Of course, for some people that would be the preferred state anyway, and they are entitled to do what they wish to their own bodies. I am fully in agreement with your views on parental neglect. My early encounters with other boys led me to believe that many parents, perhaps a majority, do not teach their sons about genital hygiene, and many boys are left to discover for themselves about foreskin retraction. Hence most foreskin problems go undiagnosed and untreated, a fact backed up by many of the statistics you quote. If you have any further queries, or require more detail about a particular point, just ask. John